Clinical trials in aesthetic medicine increasingly have incorporated a variety of patient-reported outcomes (PROs), including satisfaction, as key end points. Once effectiveness and safety are documentedin trials, patient satisfaction with a product, procedure, and ultimately the perceived outcome is key to asuccessful treatment in practice. The extent of patient satisfaction can affect the quality of the clinician patient relationship, subsequent interactions, and retention in practice. The author explores factors in practice that contribute to the satisfaction of patients receiving facial soft tissue fillers both alone andin combination with other modalities. These factors include the unique properties of the filling agents, the technical skills of the clinician, patient expectations, immediate and extended aesthetic outcomes, length of downtime, pain management during the procedure, office environment, and overall perceived value of the treatment. Clinicians must be thoroughly familiar with the strengths and limitations of available fillers, as well as understand individual patient needs and goals, counsel patients so that the most appropriate therapeutic option is selected, must master the requisite technical skills, and be familiar with the potential adverse events associated with each agent and technique to be able to intervene when necessary. The author presents several case reports to illustrate the ways in which many of these factors can be brought together to help patients achieve highly satisfactory outcomes.