Facial plastic surgery frequently involves the replacement or augmentation of facial soft tissue and mucosal surfaces. Material and technique advancements in this area are frequent. Surgeons must remain knowledgeable to provide patients with services that best meet individual needs. We review the concepts that guide this decision process and discuss a variety of materials: old, new, and investigational. A greater understanding of the options available, with their inherent risks and benefits, increases the surgeon's ability to communicate and guide patients in their decision-making process. New materials will continue to be developed and play a role as the search for the optimal replacement of soft tissue and mucosa continues.