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Background: Inadequate projection of the midface skeleton results in midface concavity.Patients with this skeletal morphology tend to have prominent eyes and noses.Lack of skeletal support for the midface soft tissue envelope predisposes to premature cheek descent, resulting in palpebral fissure distortion and lower lid "bags," an appearance of early aging.Severe midface concavity often is seen with the craniofacial dysostoses of maxillary hypoplasia.In the past, surgeons have had 2 techniques with which to improve facial bony contour: osteotomy with mobilization of facial bony segments and placement of implants (foreign-body materials or autologous cartilage or bone) over the bone, under the soft tissue.In this article, we discuss a relatively new third alternative, the use of lipostructure.We have found that the use of lipostructure can improve the concave face (maxillary hypoplasia).In fact ,autologous fat grafts have gained popularity among Cranio-Maxillofacial surgeons within the past years.Objective: We describe the technique for midfacial contour augmentation using lipostructure and present the results of 158 cases (of 325cases with lipostructure)treated between 2010 and 2014.Methods: We conducted a preoperative evaluation to determine for which patients the procedure was appropriate and to identify the need for additional procedures.Fat was harvested with the use of 10-mL syringes with 2 mm needles.Only 5 mL of fat was harvested in each syringe.After the donated fat was centrifuged and purified, the purified fat was infiltrated by means of a percutaneous approach with 18-or 20-gauge needles to redluce trauma and avoid scarring.Thin (2-mm-wide) rolls of fat grafts were placed in well-vascularized tissues to prevent absorption.The amount of fat infiltrated depended on the flatness of the area and accord with aesthetic curve.Results: Most (more than 90%) patients had saisfactory outcomes by a single session after follow-up ranging from 3 months to 3 years.Complications were rare.Conclusions: With appropriate placement, midfacial contour augmentation with lipostructue is a safe, simple, inexpensive aesthetic procedure that provides consistent.long-term aesthetic improvement.