Fat is a filler with ideal properties: it naturally integrates into tissues, is autologous, and is 100% biocompatible, readily available. It is an active and dynamic tissue composed of several different cell types, including adipocytes, fibroblasts, smooth muscle cells, endothelial cells, and adipogenic progenitor cells called “preadipocytes”. Adipose-derived stem cells (ASCs) have a differentiation potential similar to that of other mesenchymal stem cells as well as a higher yield upon isolation and a greater proliferative rate in culture when compared to bone marrow–derived stem cells. The use of fat grafts to correct congenital deformities and complex traumatic wounds with soft-tissue loss after radical oncological surgery was proposed in 1893 by Neuber, by Hollander in 1912, by Neuhof in 1921, and by Josef in 1931. Liposuction technique, introduced by Fisher in 1974, followed by the tumescent technique, introduced by Klein in 1985, accelerated the development of the lipofilling technique. In 1987, Coleman introduced a new technique to decrease traumatic handling of fat during liposuction. His technique consisted of three steps: manual lipoaspiration under low pressure, centrifugation for 3 min at 3400 rpm, and reinjection in 3D. It minimized trauma to the adipocytes with a 3-mm, blunt-edged, 2-hole cannula connected to a 10-mL syringe. This technique became the current Gold standard.