Fat Grafting for lips is not done much anymore due to so many problems
Lip augmentations usually look great and natural except when it comes to fat grafting. Lips injected with fat look huge since you have to over fill the lips a lot since most of the fat goes away in a short time and when it does go away, it gets lumpy bumpy.
Restylane or Juvederm ($550/syringe) looks good and is easy to inject so most patients get this first and later switch to the more permanent implants which now are soft and easy to put in ($1500-2000 per lip). Most doctors don't do fat injections anymore.
There are many different techniques for this.
Obtaining the graft can be done via excising the fat or liposuctioning the fat.
Preparing the fat can be done by: filter, centrifuge, washing, additives, dicing into small pieces, etc.
Placement can be via injection, surgical placement, threading,
Just like any other area, the fat is harvested or liposuctioned from different areas like the abdomen, hips or wherever there is extra. Then the fat is treated and placed into small syringes. A special cannula is used to inject it into the area of desire.
The area is over corrected because a good percentage of the fat does go away. At about 4 months time, whatever correction you have will stay.
The fat is usually harvested from a remote site such as the abdomen or hip. It is then concentrated in a small syringe and then injected into the lips for fullness.
Fat grafting for fat lips
Fat grafting is obtained by hand suction. The fat is then prepared in a number of ways. The most recognized technique was pioneered by Dr. Sydney Coleman. He centrifuges the fat. The non-fat fluid is then removed. The fat is injected in many passes with tiny cannulas (tubes). This lays down multiple thin threads of fat.
Unfortunately, fat grafting in lips does not all last. The lips need to be over-filled by almost double. This technique of multiple passes assures the best survival of fat, but is also traumatic, so lips are very swollen after. The swelling may last weeks. So first lips are too fat, then a variable amount of fat lasts. Fat is less predicable in the lips due to the constant movement and stress on the grafted fat.
Given the many hyaluronic acid products now available, I do much less lip augmentation with fat. There is much less swelling after. Fillers don't require a surgical set-up or harvest. Lip fillers are performed and well tolerated in an office chair with regional local anesthetic.