Soft-tissue augmentation with autogenous dermis and fat is a well-known and well-accepted technique. Composite dermal fat segments may be transferred as grafts (nonvascularized) (1, 2, 3, 4), as pedicle flaps (vascularized) (5, 6, 7), or as free flaps (microvascular) (8, 9, 10, 11, 12). Nonvascularized grafts undergo 40% to 50% resorption and must therefore be overcorrected at the time of transfer. Even then, resorption is unpredictable and the ultimate outcome uncertain. Because flaps retain their circulation, the volume transferred is the volume that remains, barring excessive generalized weight gain or weight loss. Free flaps, in general, allow greater leeway in flap design and donor-site choice than pedicle flaps, and this is true for deepithelialized free flaps as well.