Fat or Hyaluronic Acid for Lips and Hollowness Around Eyes?

The photos I have seen of people with fat injected to the upper/lower eyelids and lips look great. Fat transfer seems to make the lips look naturally plump and fills out the area around the eyes nicely. Is there a benefit of having fat over other fillers, in this area? Which one gives the best results?

Doctor Answers 11

Fat or Hyaluronic acid filler for lips and under eye hollows?

  I vote for synthetic fillers to treat these difficult areas.  I know big proponents of fat transfer who do not use fat in the lips because of unhappy results.  The area is just to mobile to allow an adequate take of the fat cells and it is likely patients will be disappointed.  Treating the under eye hollows is a popular application for far but the very thin skin here makes it a quite challenging location for fat grafting.  Often the fat is palpable, and sometimes even visible, and this makes for an unhappy patient.  Restylane is a good safe choice for both area in my opinion.

Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 134 reviews

Fat injections for the tear trough for the best results

There is no question tht fat injections to the tear trough give the best and longest lasting results. Injectible fillers like hyaluronic acids can give a quick and easy result but the results are short lived and don't give as nice results as fat.

Jason B. Diamond, MD, FACS
Beverly Hills Facial Plastic Surgeon
3.8 out of 5 stars 15 reviews

Fat grafting versus Fillers to the Face: the best option for you.

Fat grafting is a surgical procedure with greater potential risks and although it costs more, it does have the potential to be permanent which can be good and bad. IT has the advantage of offering tremendous volume whereas the fillers can become quite expensive if large volumes are needed and have to be repeated. I often recommend fillers first to assess if patients "like" the result. If they do we and desire a permanent solution, we can discuss fat grafting at a later more convenient date.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Fillers for the lips

Filling the lips is all about your preferences. Fat injection can be performed although long term survival of fat into the lips is not as promising as in other areas. The resorbably fillers are a good product but they need to be redone periodically.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

FIllers for lips and fat for troughs


I think you can see that the jury is still out on fat vs fillers, especially in the areas you are addressing.

In the tear troughs, especially if you have thin skin, we tend to find that fat works better and lasts longer. There are a few instances where we have seen patients who had fillers placed by outside doctors under the eyes and it caused a boggy fullness, almost like fluid filled bags and we have also seen some patients who get the blue Tyndall color under there eyes. SO fat done by the right surgeon, in a conservative fashion that addresses your concerns without making you look like a different person is our person for under the eyes.

The lips, we find almost the exact opposite- fillers do great, patients are happy and you can always do more relatively easily if you want. Fat in the lips tends to go away relatively fast because of all the movement in the area.

Hope that helps. Let us know if we can answer anything more specific.

All the best and have a great weekend :)

Peyman Solieman, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Hyaluronic Acid for the Lips

Hyaluronic Acid (HA) fillers are consistent, safe, hydrophilic (draw water in for a smooth appearance) and frankly hard to beat in the lips. Fat injections can potentially produce good results in the right hands and are not necessarily a wrong choice. However, in my practice, I prefer the consistency in results achieved with Juvederm and Restylane.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 95 reviews

Fat is good for the face but doesn't always last in the lips

There are a number of considerations when it comes to hyaluronic acid filler vs. fat injection. Fat comes from your own body but it is also a surgical procedure with significant healing time. Since the lips are so active, fat often goes away. So, why go through the extra healing time and cost for lip augmentation when you can pull a filler off the shelf, get a predictable augmentation for a number of months for a lot less money and go right back to work after.

For the lower eyelids, fat is also excellent and has a longer lasting effect. But the skin in the lower eyelids is very thin so fat can look lumpy. These lumps are difficult to treat. If you seek fat in your lower lids, see a Doctor with a lot of experience in this procedure.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 127 reviews

Injecting fat vs a filler

If at all possible fat is preferred because whatever fat survives after transfer is permanent. Most injectable fillers go away with time. However there are pros and cons for each as has been listed above. Your surgeon should go over all of these before the procedure is performed so that you can choose what is best for you. The main problems with fat are unreliable/unreproducible survival rate, possible lumpiness and the size of surviving fat can fluctuate with weight changes.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Fat vs other fillers for the lips

I have found that fat injections in the lips don't produce as long a duration of effect as the hyaluronic acid fillers such as Restylane and Juvederm, at times. Fat acts unpredictably and at times is too thick when the patient has thin lips.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Fat Grafting Vs. Fillers: When To Choose Which

This question is perhaps more complex because it requires multiple factors to think about. As surgeons we all have biases, these are mine:

Fat Transfer Pluses:

1. Permanent

2. Very soft look to the face

3. Great and better for filling around the eyes.

Fat Grafting Negatives:

1. Cost and Recovery (needs 10 days plus to start looking good and needs a year for the result to improve over time with blood supply).

2. Fat in my opinion does not work reliably well in the folds and lips where fillers work much better.

3. not good if the person is very young (under 30) because of weight changes over time with aging or pregnancy. the # 1 risk with fat transfer is excessive weight gain afterward.

Filler Pluses:

1. Immediate results

2. Cheaper

3. Better for lips and folds

Filler Negatives:

1. Not as effective to fill the brow/under eyelid (but ok for under eyes)

2. Not permanent

3. Does not provide as global a rejuvenation as fat does.

See below a link and video for more explanations.


dr. sam lam

Sam Lam, MD, FACS
Dallas Facial Plastic Surgeon
4.6 out of 5 stars 57 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.