Background <p>Fat grafts are frequently used for tissue augmentation, scar regeneration, shaping of body contours and body rejuvenation. However one of the biggest disadvantages of fat grafting is unpredictable graft loss. According to studies, graft resorption occurs at varying rates after autologous fat graft applications. To increase adipocyte viability in autologous fat grafts, many studies have been conducted, but there is no accepted study yet. Epidermal growth factor (EGF) is known to increase autologous fat graft survival by increasing neovascularization. We hypothesized that preconditioning the recipient area with EGF might improve fat graft survival.</p> Materials and Methods <p>A total of 24 Wistar Albino rats were divided into 3 groups of 8 animals each. In each rat, 0.5 g fat excised from the right inguinal region was implanted into the subcutaneous pouch in the interscapular region. In the control group fat grafts were implanted without any other procedure. 0.5 mL of saline was injected into the recipient site 1 week before in the sham group, and 0.5 mL of 7.5 µg EGF was injected in the study group. Two months after fat injections, fat grafts were excised for histopathological examination.</p> Results <p>No significant statistical difference was found between the 3 groups in terms of weight, inflammation, cyst-vacuole formation and normal fat percentages. Fibrosis and necrosis in fat grafts were found more in the experimental group while vascular density was less.</p> Conclusion <p>According to these results, preconditioning with EGF did not improve fat graft survival.</p> No Level Assigned <p>This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a></p>