Facial aging is characterized by volume loss and diminished skin elasticity, leading to wrinkles, sagging skin, and facial hollowing. Facial fat transfer techniques have advanced over time and yield impressive results as both a standalone procedure, and in combination with facial aesthetic surgery. Unlike traditional dermal fillers, fat transfer provides a more long-lasting solution for volume restoration and overall facial rejuvenation. When planning for facial fat grafting, each patient’s concerns and goals should be reviewed and a plan developed according to their unique facial features and desired outcome. Common donor sites for fat harvest include the peri-umbilical area, flanks, and thighs. Harvesting techniques involve the infusion of tumescent anesthetic solution, followed by manual or power-assisted aspiration using micro-cannulas (<2.4 mm OD). Various processing methods for fat grafts exist, including centrifugation for density gradient separation or gravity separation, with centrifugation being the authors’ preferred approach. Injection techniques involve marking the treatment areas, creating entry points, and injecting the isolated fat into multiple tissue planes using 18-22g single port, blunt-tipped cannulas. Early fat resorption is common after facial fat grafting, with most adipocyte cell death occurring within 24 hours and subsequent gradual replacement by adipose-derived stem cells (precursor cells) within three months. The adipocyte lipid volume can continue to increase over the course of one year following the treatment. The volume applied during facial fat grafting varies depending on the specific area being treated, ranging from 1 mL to 15 mL. Platelet-rich plasma (PRP) and tissue stromal vascular fraction (tSVF) can be used as adjunctive treatments to improve fat graft retention. PRP contains growth factors that promote tissue repair and new blood vessel formation, while tSVF cells facilitate adipogenesis and angiogenesis. Evidence of use of cell-enrichment protocols is more effective at long-term volumization.