Purpose: Maxillary sinus membrane elevation is a common procedure intended to increase the volume of the maxillary sinus osseous floor prior to insertion of dental implants. The aim of this study was to evaluate bone formation under a perforated sinus membrane grafted with buccal fat pad (BFP). Materials and Methods: Six consecutive patients (10 sinus augmentations, 24 dental implants) underwent sinus floor elevation, using the lateral window approach. The compartment around the implants under the sinus mucosal lining in the sinus floor was filled with adipose tissues, which were retrieved as free graft from BFP. Clinical and radiologic follow-up was conducted through the healing period; in all cases, samples were taken for biopsy during the stage-two surgery. Results: New bone consolidation in the maxillary sinus was radiologically and histologically observed within an average of 7.2 months after the sinus augmentation. According to the histomorphometric data, 62.8% ± 13.1% vital bone formation was observed. Out of the 24 implants placed, only 1 failed, indicating a 95% overall implant survival rate. Conclusion: Despite the limited size of this case series, BFP can be considered an autologous osteogenic graft material and/or biologic membrane capable of achieving high success rates in sinus elevation procedures. Keywords: buccal fat pad (BFP), sinus augmentation, sinus membrane