Hello Aeronca, you have a very common question. Perhaps this will help you understand. The word "permanent" would require an implant vs. dermis or a fat placement. I'm not a advocate of an implant. It does look great but maybe felt. A dermis implant is very different than a fat implant. Both can be used to augment one's lip. I do not use one's fat as one's body weight changes, the fat injected into one's lip also can change is size. I usually use an ONLY dermal implant to provide a lasting augmentation of one's lip. The recovery period is different than injecting fat or HA filler. If you provided pictures, my response could be more focused to your situation. Hope this helps. Sincerely, Michael Kulick MD ASAPS and ASPS member