Based on previous experimental connective tissue work in cutaneous wound healing, cell culture, and fat transplantation, the use of positively charged dextran beads for subcutaneous and dermal augmentation was evaluated. When combined with a biocompatible liquid medium, the material easily flowed through small-gauge needles. When injected beneath the facial skin in rats, a profound macrophage response was initially seen at 30 days accompanied by fibroblast proliferation and new collagen formation. By 1 year, a quescient, noninflammatory cellular response with extensive intermaterial collagen deposition was evident. No adverse reactions were seen in the contralateral facial sites, which were injected with only the liquid medium. These preliminary findings suggest good tissue compatibility of this composite biomaterial and provide further evidence of the significant regulatory role of the macrophage in the tissue response to implanted biomaterials.