Over the last 30 years, there is a constant interest for the use of autologous fat transplantation for breast cosmetic purposes. Fat injection in the breast could result in fat necrosis, cyst formation, and indurations. Fat is metabolically active and consists of a diverse secretory cell population that includes cytokines, hormones, and growth factors. The degree of reabsorption of the injected adipose tissue is unpredictable as has been reported by numerous studies when using the non-stromal-enriched lipograft. Autologous fat breast augmentation using the stromal-enriched lipograft technique by a multi-level, multi-tunnel, and multi-point percutaneous injection of autologous fat can achieve the required aesthetic effect without the drawbacks of the non-stromal-enriched lipograft. In the last 15 years, the results of autologous fat transplantation are predictable and satisfying on the condition that small quantities of adipose tissue are injected using the stromal-enriched lipograft protocol. Mammary lipografting is a procedure that can be offered to patients for breast cosmetic purposes as a safe procedure producing long-term satisfactory results.