Autologous fat grafting has been performed for more than one hundred years and there had been a major refinement of fat grafting by Coleman in 1997. Since then, clinical practice using this natural filler is becoming more popular and the results are becoming more consistent. Nowadays autologous fat grafting is utilized broadly for both aesthetic and reconstructive purposes. With the beginning of the twenty first century, adipose stem cell (ASC) was discovered and regenerative medicine is facing a new era of evolution. ASC was applied to fat transfer and 'cell-assisted lipotransfer' technique could be developed. Eto et al. recently presented experimental results of fat graft survival. Their efforts disclosed the important role of ASCs in fat graft, and contributed the progress of fat transfer. Owing to the accumulation of knowledge related with fat graft survival, discovery of ASCs and advancements in surgical techniques, such as Coleman technique and cell-assisted lipotransfer, survival rate of the grafted fat increased and side effects such as fat necrosis decreased. Consequently, there is a new surgical trend of applying large volume fat grafting for augmentation mammoplasty and breast reconstruction with or without silicone implant. Recently, fat grafting is expanding it's limit to new field of treatment of burn, scar, and wound. This article reviews several significant advancements of fat grafting techniques in this century, furthermore intends to widen scientific understandings and contribute to be practiced as a feasible method.