Hi, I have performed many facial shaping procedures using dermal fillers, facial silastic implants, liposuction and facelifts for over 30 years. In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or silastic facial implant (lip implant, cheek implant, chin implant). For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line. Tissue physiology is quite simple. Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive. Once fat is removed from the body all of these things have been disrupted. Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear. The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner). Injecting fat back into the face does not create the required elements to make the fat living tissue once again. So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon. The other issue that I have with fat transfer is the lack of precision. Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler. Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen. This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume. In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping. There's a significant difference between a 3mm and 5mm thick cheek implant. You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%. In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features? I have performed many lip augmentation procedures using dermal fillers or lip implants for over 30 years. From the photos, your upper lip is small compared to your lower. Following my beauty principles, the lips should be full with upper lip should be approximately 75 % the size of the lower lip for the lips to appear balanced. The lips can be augmented using a dermal filler or a Permalip implant. Dermal filers and lip implants offer a much more reliable volume for augmentation of the lips than permanent fillers or fat injections which are associated with increased, unwanted, side effects. Hope this helps