Exosome therapy, or the use of extracellular vesicles, is an emerging and promising technology in regenerative medicine, particularly for skin and soft tissue repair. These nano-sized vesicles carry bioactive molecules that play crucial roles in cellular communication, potentially aiding in tissue regeneration. Preclinical studies, primarily involving animal models, have shown exosomes to be effective in promoting skin healing and restoration, and they hold potential for a variety of applications in plastic and reconstructive surgery. Exosome therapy offers the advantage of being cell-free and ready-to-use, which simplifies its adoption compared to traditional regenerative cell-based therapies. However, no exosome products have been approved by the US FDA yet, and more research is needed to establish clear guidelines for their use. The main considerations for practice utilization include variation in exosome purification, isolation, storage, scalability and reproducibility.