I am sorry that you had a bad experience. I never do fat grafting for folds near the mouth because it simply does not work at all. Fat is too soft and unpredictable to manage small areas like that. However, fat grafting is literally the most amazing thing to make a face look younger and more attractive. See my results on my Web site, lamfacialplastics.com, to see how the entire face can look pretty but it won't manage the small folds.
As far as the downturns are concerned, even fillers won't completely do this. I always tell my patients that fillers if done well can help turn a downturn toward but may not get there a more horizontally positioned line but not entirely eliminate it. I also combine it with Botox into the depressor anguli oris (DAO) for optimal benefit. With repeated Botox and fillers, you can continue to improve it but you will NOT eliminate the fold.
Now, I always try to get my patients out of what bothers them to what bothers me. What my patients see oftentimes simply won't make them look any better because they are too darn close to the mirror looking for minor flaws that have limited relevance. The things that I do to make a face look amazing requires a global perspective on the face, what I call the blink effect. Malcolm Gladwell wrote about how in a blink of an eye we make our judgments. You do too. You see your best girlfriend 20 feet away and you see if she looks good before you can even see these so-called fine lines and folds. Women in short are too obsessed with their mouth close up. When women come in for small areas around their mouth I usually steer them away because they simply won't be happy. Small things are hard to fix on the face, only they can be improved.
If you are ever interested to consult with me, I will have to first completely change your brain of what bothers you, or I will not be able to help you look your best. I know that sounds crazy but my many loyal patients who fly in for me do not think that after they see what I can do even though it is not what you initially wanted. Artistry, experience, and judgment are the key. I will ALWAYS explain the limitations of anything you do in excruciating detail because I always say the difference between an education and excuse is that an education is told to you before you spend money and an excuse is the same words told you to after you do.
best,
Sam Lam
Watch the attached video to see how I discuss how fat fails for small surface areas and folds.