Since the standardization of the fat grafting technique by Coleman, lipofilling has become a very important and valuable tool in plastic surgery. The applications of adipose tissue-based techniques were explosively developed in cosmetic and reconstructive fields. The initial goal of fat grafting was to treat volume losses created by disease, trauma, or aging. Microfat grafting was used extensively for this purpose. It is harvested with small-hole cannulas to obtain a lipoaspirate with smaller fat particles and injected into deeper layer of subcutaneous tissue to correct tissue depression. But when tissue rejuvenation came into consideration, nanofat was used for this purpose. The harvested fat was mechanically emulsified and filtered until a liquid suspension was obtained, as Tonnard described. The abundant stem cells were found in nanofat graft, and it could be injected into more superficial layer with fine needle to obtain rejuvenation effect. The exosome, a type of extracellular vesicle of 50 to 200 nm, is mainly responsible for the paracrine effects of stem cells. Exosomes
may therefore represent a new approach in cell free regenerative medicine, such as enhancement of wound healing and tissue regeneration. The use of adipose tissue-based techniques in cosmetic and reconstructive fields will be discussed.

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