Fatt grafting over permanent filler? is it possible to inject fat into the lips when I already have filler?

Hi eclectic. That will depend on what "permanent filler" you had injected to your lips. Generally, "permanent" fillers are not injected to the lips because of how they interact with the tissue. Certain injections like silicone may absolutely react to subsequent fat that is injected, so it is critical to know what you were injected with and how safe that was before figuring out if adding fat on top would be safe.

Our results with fat grafting of the lips, including both nano and micro fat grafts, have never been impressive in the long run. After using different techniques in the past 20-25 years, I could say that graft take is in the range of 10-15% and very unpredictable. We still use it as a part of multiple sites facial fat grafting when needed, but very rarely for augmentation of lips only. For minimal volume and shape improvement, which appears to be your case, filler may be a better options? Hope this helps.

Facial fat grafting is inherently imprecise, unpredictable and potentially unforgiving if patients don’t like the outcome. Providers will have different options regarding lip fat grafting including the fact that you had previous “permanent filler” (I’m guessing silicone).
I personally don’t do lip fat grafting any longer and would be less likely to recommend it with a history of silicone? Injections.
I suggest using HA fillers.
Best,
Mats Hagstrom, MD