OBJECTIVES: Centrifugation (Cf) is the standard method of fat processing but is cumbersome and time consuming, especially when large volumes are processed. A new autologous fat processing system (Rv) that incorporates fat harvesting and processing in a single unit offers a simple, more efficient system. This study compared the efficiency and economics of using Rv with CF in terms of fat grafting and operating room (OR) costs. METHODS: Data were collected over 2 years from consecutive breast surgery patients undergoing autologous fat grafting:  January to December 2012 with the Cf method and January to December 2013 with Rv method.  The volume of fat harvested, volume of fat injected after processing, and time taken to complete fat grafting (from harvest to injection) were determined. Standard OR costs ($15-$20 per minute for basic surgical procedure, excluding physician costs) were used to estimate potential savings.   RESULTS: There were a total of 239 cases: Cf=118 and Rv=121 patients. There were no significant differences between Cf and Rv patients in mean age, BMI, smoking status, diabetes, and prior radiation. Mean volume of fat harvested (499.5 vs 122.9 ml) and injected (178.9 vs 78.0 mL) were significantly higher (p<0.0001) in the Rv group compared to the Cf group, respectively. Mean time to complete fat grafting was significantly shorter in the Rv group compared to the Cf group (35.3 vs 89.8 minutes, respectively; p<0.0001). Mean OR costs with Rv were estimated to be $529-$706 vs $1347-$1796 with Cf. After taking into consideration the cost of Rv ($470), the potential net savings in mean OR costs were $347-$620 per case. CONCLUSIONS: The Rv fat processing system decreased operative time, which translated into a potential cost savings, and allowed for a larger volume of fat to be processed for injection compared to standard centrifugation.