Autologous fat grafts have been widely used in soft-tissue augmentation and reconstruction surgery. Despite their numerous advantages, including a simple harvest technique, low cost, and easy accessibility, the applicability of autologous fat grafts is limited by their unpredictable long-term outcomes associated with poor graft retention [1,2]. In recent decades, several advances have been made to overcome the low rate of graft survival, including various refinements of existing techniques, the development of nanofat to reduce the size of fat particles used for injection, and the standardization of protocols for fat harvesting and processing [3-5]. Adipose tissue is composed of at least two functionally distinct types of fat: white and brown [6]. The primary roles of white adipose tissue are energy storage and the release of hormones and adipokines that modulate whole-body metabolism [7]. Consequently, the majority of studies related to adipose tissue have focused on the treatment of obesity, which contributes to an increased risk of developing type 2 diabetes, cardiovascular disorders, and cancer [8]. Additionally, white tissue can act as a thermal insulator and protect other organs from mechanical damage [9]. However, for plastic surgeons, the physical properties of white adipose tissue, not its function, make autologous fat grafts a useful component of their surgical strategies. Fate of fat grafts Adipose tissue is composed of adipocytes, adipose-derived stem/stromal cells (ASCs) and various other cells, including endothelial, mural, immune, and neuronal cells [10]. In addition, adipose tissue is highly vascularized, as each adipocyte is surrounded by an extensive capillary network [11]. Thus, angiogenesis is closely related to the maintenance and remodeling of adipose tissue. A recent study investigating the fate of adipocytes and ASCs after non-vascularized fat grafts identified three zones (survival, regenerating, and necrotic) in grafts [12]. In the survival zone, which is less than 300 μm thick, both adipocytes Archives of Craniofacial Surgery