From October 2010, a new standardize protocol of mega-volume fat graft was developed based upon harvesting the fat by washing it out with least destruction of the cells using water-jet-assisted liposuction (WAL; (Taufig, Liposuction. Springer, Berlin/Heidelberg, 2006)). After clinical evaluation by magnetic resonance imaging (MRI) control, it was published in 2010 (Ueberreiter et al, Handchir Mikrochir Plast Chir 42:379–385, 2010) and in the following years applied in many countries.