Why is fat transfer for lips not as popular as fillers?

Fat grafting to the lips can give a very beautiful, natural looking and permanent result. I often add fat to the lips when I am performing facial rejuvenation surgery. However, The downtime with fat to the lips is somewhat significant.  If someone wants fullness only to the lips, it is hard to justify the downtime when other great and long lasting fillers are available that require very limited downtime. For other parts of the face, nothing compares to fat. 

There are many benefits to fat transfer treatments, including long-lasting results and virtually no risk of allergic reactions. However, when plumping the lips, many people enjoy filler treatments because they provide immediate results with no downtime required. The process of injecting a dermal filler into the lips is easier and takes less time than a fat transfer procedure. Fat transfer to the lips often produces irregular asymmetrical lips and/or hard nodules in addition to swelling that can last for many weeks. If you are interested in adding volume to your lips, ask your dermatologist which treatment is right for you.

Fillers give you a more precise augmentation, less swelling and a quicker recovery.  Fat transfer is longer lasting but much less predictable, and more likely to create significant swelling that will keep you indoors and hiding for days.

To do fat you have to harvest the fat which is a separate procedure.  With filler you just open the box and put it in. Fillers give such a nice look that many people prefer to just do that.   

Fat transfer is a fantastic option for many areas of the body. It also looks great in the lips. However, since fat is designed to be a live graft that will last for many years, the blood supply to the fat is essential for a long life. When fat is placed into the lips, the active movement of talking, smiling and laughing makes it difficult for the blood supply to attach to the graft and then it fails or should I say it dissolves slowly over a 5-6 month period. For that type of duration - other fillers are just as viable alternative.

Fat transfer to the lips entails harvesting and injecting the fat. In my personal experience, patients are not as receptive to the associated bruising, swelling and downtime. Currently available long term fillers cause less bruising and are probably cheaper. Besides, with fat grafting, more fat needs to be injected to get the same result. 

I have been a strong advocate of fat grafting for many years but I'll frequently use fillers because it is easier for the patient - it is not necessary to harvest the graft material.