Abstract Background Autologous fat transfer is a popular option for soft tissue augmentation, but has a low survival rate. So, enriching the transplanted fat with stem cells (cell assisted lipotransfer) or oral administration of alpha-lipoic acid (ALA) before and after graft injection, were thought to increase the survival rate of the transplanted fat. Aim of Study Is to compare between cell-assisted lipotransfer (CAL) and ALA therapy in improvement of fat graft survival. Materials and Methods Thirty adult female albino rats were used and divided into three groups. Group I: the control group. Group II: CAL group received autologous fat mixed with adipose derived stem cells (ASCs). Group III: ALA group in which animals received oral ALA four days before fat transplantation and continued throughout experiment. Fat grafts were collected from the sites of injection after twenty-eight days. Histological and immune histochemical studies were performed. Statistical analysis was also done. Results Histological evaluation of the fat grafts from animals of control group revealed atrophy and death of adipocytes with formation of fat cysts. Severe inflammatory infiltration with giant cells formation and fibrosis were detected. Significant decrease of VEGF reaction was seen. In CAL group significant increase in number of intact adipocytes together with decrease in inflammation and fibrosis occurred. Moreover, significant increase in VEGF reaction was observed. In ALA group, significant decrease in number of intact adipocytes and VEGF reaction was detected compared with CAL group. Also, significant increase in inflammatory infiltration and fibrosis were detected compared to CAL group. Conclusions Both ASCs and ALA showed improvement in all histological parameters compared with control group. However, enrichment of fat with ASCs showed the best results.