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BACKGROUND Recently, there has been increasing research interest in identifying the effect of liposuction procedures on fat graft survival. Whether different harvest techniques affect the quality of fat grafts is unclear. In this study, fat grafts harvested using traditional suction-assisted liposuction (TSAL) and vibration amplification of sound energy at resonance (VASER) approaches were examined to assess the quality and survival of the grafts. Furthermore, the proliferation and differentiation potentials of adipose stem cells (ASCs) isolated from both liposuction approaches were investigated. OBJECTIVES Investigation of the effect of different liposuction approaches on the survival and regeneration potential of grafted fat tissue. METHODS Fat grafts were collected from patients who underwent liposuction procedures with two different liposuction approaches. Some lipoaspirates were implanted into the subcutaneous layer of nu mice for 4 and 12 weeks. The other portion of the lipoaspirate was obtained for ASC isolation and subjected to proliferation and differentiation assays. RESULTS Our results indicated that although in vivo fat grafting presented similar adipose tissue survival for the two different liposuction approaches, more angiogenesis and less fibrosis was observed in the group with VASER based on histological evaluation. Furthermore, VASER-derived ASCs presented better quality in terms of cell differentiation capacity. CONCLUSIONS In summary, our in vivo study confirmed better graft angiogenesis with less inflammation, apoptosis, and scar formation in the VASER group. ASCs harvested with VASER exhibited increased differentiation capacity, representing a great source for fat grafting and regenerative medicine.