Fat transplantation has endured for decades as one of the optimal methods for restoring volume in the face. There are various techniques of performing fat transplantation, the most recent being fat autograft muscle injection, or FAMI. Initially developed and reported in 1996 by Amar, a French plastic surgeon, FAMI was introduced to the United States in 2001. The distinctive aspect of the FAMI technique is placement of fat parcels in close proximity to, or even within, the muscles of facial expression. The rationale for this placement is that transplanted fat will survive optimally when grafted into the bed of vascular muscle tissue, promoting neovascularization and thus longevity of the transplant. Transplanted fat then will become living tissue, as opposed to a temporary filler. Studies in various fields of surgery regarding fat survival near muscle support this concept, and results as long as five years have been reported.

To learn the FAMI technique, the surgeon must familiarize himself or herself with the muscles of facial expression. Not only is knowledge of the origin and insertion of each muscle critical, but also, awareness of the depth and thickness of each muscle is essential. In addition to establishing a working knowledge of muscle anatomy, the surgeon must gauge the degree of volume depletion in a given patient and develop an artistic sense of where in the face volume replacement is most needed in terms of aesthetic results.