Background: Autologous fat is a safe and effective soft tissue filler. Recent evidence also suggests improved wound healing and immune modulation with fat grafting. Objectives: The aim of this study was to describe a novel technique utilizing fat grafting during primary open rhinoplasty. We hypothesize a more rapid resolution of bruising and edema. Methods: Patients who underwent rhinoplasty were reviewed and compared by presence or absence of concurrent fat grafting. Three-dimensional images were analyzed employing Mirror (Vectra, Canfield Scientific, NJ). Ecchymoses were outlined utilizing a magnetic lasso followed by an area measurement. Volumetric edema measurements were also taken and assessed. Edema and ecchymosis were measured at 2 and 6 weeks postoperatively. Statistical significance was defined as P < 0.05. Results: Sixty-two patients were included. Thirty-three patients (53.2%) received autologous fat grafting and 29 (46.8%) did not. Age, gender, surgical approach, and osteotomy distribution were similar between the groups. The fat grafted group showed 7.29 cm2 fewer ecchymoses (P < 0.001) and 0.73 cc less edema (P = 0.68) in the early postoperative interval. Six weeks postoperatively, the fat grafted group showed 1 cc less edema (P = 0.36) with negligible differences in bruising. Conclusions: Autologous fat grafting is a useful adjunct to rhinoplasty and is associated with significantly fewer ecchymoses in the acute postoperative period.