Exosomes are very small particles released from cells that enable communication between cells and contain proteins, microRNAs and lipids. They have shown promise in reconstructive surgery because they can reduce inflammation, promote the formation of new blood vessels and rebuild tissue. Exosomes from different sources have different effects – for example, exosomes from fat cells have strong effects on promoting vascular growth and reducing scarring, while exosomes from umbilical cord show high potential for cell proliferation and angiogenesis. The method of application (on the surface, in a gel or by direct injection) affects the results of the treatment. Preclinical studies and initial clinical experience show improvement in wound healing, scarring, and aesthetic outcomes, but clinical evidence is so far largely based on small pilot studies with limited patient numbers and short follow-up. Larger and longer-term studies with control groups are needed to confirm efficacy and establish uniform protocols.