Safe Permanent Lip Filler on the Market Today?

This is a terrific question. First off it is my preference to start with a lip filler that is not permanent. Why? This gives you the ability to "try out" the new lips and make sure that you are happy with them. It helps to gauge the amount of fill that you would best enjoy. On the slight chance you may not be happy, the filler will absorb within a few months. Restylane, Perlane, Juvederm, all HAs have the added benefit that they can be neutralized with Wydase should you desire to take them away faster.
After trialing a filler, you can then make a deision to continue with it or move to something more permanent. All of these options are not FDA approved. One choice is injections of Silikon, which is FDA approved for the eye in retinal surgery. The lip is usually filled with multiple treatments. There are many physicians who utilize this filler successfully; there are others who have stayed away from silicone products after the controversial breast implant problems over a decade ago.
There is a new soft saline lip implant that is very promising, Fulfil. It is currently not FDA approved for the lips but is still being used for this purpose in both the US and abroad. It was originally produced for facial procedures like orbital implants. The beauty of this implant is that it is a soft thin balloon made of biocompatible materials filled with saline; only takes one procedure to implant; permanent; conforms to the natural contour of the lip; :and reversible. Unlike Silikon which cannot be fully removed this implant can be removed should you change your mind. Remember that tattoo on your back that is no longer fashionable? :)
(A quick side note: BOTOX, Silikon, Verafil (US equivalent of Fulfil) were all ocular medical materials prior to finding their cosmetic indications. As an Ocular Plastic Surgeon I find this interesting).

We have had years of great success enhancing lips with Silikon 1000 - a permanent filler. There are no cases of necrosis, biofilm, necrosis, or blindness with Silikon 1000, so in our experience this may be the best option for permanent results. Hope this helps. Dr Joseph

Lip fillers are FDA approved and very effective at plumping and volumizing the lip. Many patients prefer the lip fillers because they come with less risks than lip implants. Fillers can add volume and create a more defined structure to the lip. Depending on the shape and the fullness you want, will determine the best filler for you. The results of lip fillers can be maintained by being injected at regular intervals, which is usually once a year after achieving desired results. 

There isn't a safe permanent filler that is currently recommended for the lips.  Fat injection sometimes can last 2-3 years.  The most popular option in my practice is the Permalip implants.  They are understated lip implants that are very pliable and soft.  Unlike implants from the past, these implants are made to look natural.  We've had great success with these. 

Thank you for your questions. There are number of fillers available for temporary solution to gain enhanced volume and fullness in lips.  Alternatively you can have fat transfer/grafting to the lips however the Permalip lip implant is the best permanent solution.The Permalip are revolutionary lip implants that are designed to look and feel natural, yet enhance your lip volume to your desired size.  It does not deflate, degrade or rupture over time.  Although it's permanent, it is designed for the ease of placement if a patient wishes to achieve a larger or smaller enhancement or even return to the lips original appearance.  It does not limit lip movement and provides a natural look.  

Fat grafting uses your own fat, usually transferred from your abdomen to your lips.  It is usually the next step for patients who are happy with the look of fillers and wish for permanent results.