Abstract Background Outcomes following autologous fat grafting have historically been unpredictable due to variability in fat retention rates. The novel Poloxamer wash, absorption, mesh filtration system (PWAS) uses proprietary technology to stabilize and concentrate lipoaspirate. Its use in low-volume fat grafting has not been reported. This study aimed to compare PWAS technology to traditional lipoaspirate processing techniques in low-volume fat grafting procedures. Methods Medical charts were reviewed to determine a consecutive cohort of patients who underwent fat grafting for facial feminization. All patients had obtained preoperative and postoperative three-dimensional facial imaging. Patients were grouped based on the method of lipoaspirate processing. Analysis software was used to measure change in facial volume, and percent retention was calculated. Results Between September 2021 and February 2023, eleven facial fat grafting procedures occurred using the PWAS system, and five occurred using traditional lipoaspirate osmotic filtration with Telfa. Age and BMI were statistically similar between both groups (p>0.1). The average volume of lipoaspirate that was grafted was 23.4 mL (S.D. 10.9mL) and similar between both groups (p>0.1). The mean follow-up duration was 7.1 (S.D. 3.1) months (7.2 S.D. 3.5 months in the PWAS group versus 7.0 S.D. 2.2 months in the osmotic filtration group, p>0.5). The average fat volume retention was 73.1% (S.D. 6.8%) in patients where the PWAS system was used as compared to 46.1% (S.D. 5.2%) in patients where osmotic filtration was used (p<0.01). Conclusions For patients undergoing low-volume fat grafting, the PWAS technology may result in improved fat retention rates as compared to traditional lipoaspirate processing with Telfa.