When used to cover facial skin defects, skin grafts and local flaps have limitations such as color mismatch, volume depletion, and long scar. We used skin-fat composite grafts harvested with enough fat tissue over the whole plane to cover full-thickness facial skin defects. This study enrolled 15 composite grafts, and the results were rated by 2 investigators on a scale of 1 to 5 based on skin texture, color, and volume. Skin color analysis using a spectrophotometer was performed on 9 grafts using the L*a*b* score. There were no major complications, but 1 partial loss. The clinical assessment score ranged from good to excellent. Color assessment using a spectrophotometer showed that there were no significant statistical differences in the L* and a* scores between the grafts and the adjacent skin. Skin and fat composite tissue grafts can be a good option for covering full-thickness facial skin defects.