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In recent years, augmentation for selected areas of the facial skeleton has become a powerful adjunct in our approach to facial rejuvenation. Although many materials can be used, we generally prefer the use of porous hydroxyapatite granules (Interpore International, Irvine, CA, USA) for their versatility and due to proven clinical experience. The granular form provides surgical flexibility, enabling small volume enhancements if need be, yet with minimal subperiosteal dissection. We have found this approach of directly addressing the underlying deficiency to be preferable to techniques that attempt to camouflage these changes such as extensive tissue redraping alone or the use of supraperiosteal soft tissue fillers.