Tissue engineering represents a transformative approach in plastic surgery, combining cells, scaffolds, and biologically active substances to create functioning human tissues and organs. This emerging field addresses the human body's inability to regenerate damaged tissues by offering alternatives to traditional reconstruction methods. Recent clinical breakthroughs include successful fingertip regeneration using growth factor injections and porous scaffolds, and soft tissue regeneration over barren skull bones through synthetic scaffolds and activated growth factors. The field operates through three core components: reparative stem cell technology, tissue scaffolds for cell transplantation, and growth factors that stimulate circulation and tissue formation. Compared to traditional reconstruction methods—autologous, implant-based, and allogeneic approaches—tissue engineering offers unique advantages including biocompatibility, reduced donor site morbidity, and potential for indefinite tissue expansion, though current limitations include high costs and limited clinical applications. Safety considerations focus on adult stem cells from adipose tissue as safer alternatives to embryonic stem cells, with plastic surgeons uniquely positioned to advance the field through their expertise in fat grafting and stem cell harvesting. The tissue engineering market is projected to grow from $7 billion in 2016 to $17 billion by 2023, reflecting the field's significant potential to reduce patient morbidity and mortality while requiring coordinated efforts between clinicians, researchers, and industry for successful clinical translation.