Safe Permanent Lip Filler on the Market Today?

I am looking to get my lips enhanced via a filler but I'm not really sure how safe this is. Can anyone advise if I'm able to get a permanent lip filler and if the procedure is safe?

Doctor Answers 10

Fat Grafting Provides Safe, Permanent Natural Looking Fullness to the Lips

A number of 'soft tissue fillers' are available for temporarily improving facial areas that have lostvolume or have developed deep lines and creases. Probably the most popular fillers currently are hyaluronic acid products like Restylane or Juvederm , which can be used to plump up thin lips and to fill out nasolabial folds (lines that run from beside the nostrils to the area beside the corners of the mouth) and marionette lines (lines that run from the corners of the mouth towards the jawline). The improvement generally lasts four to six months.

Some synthetic materials are available which can be used in an attempt to produce a permanent soft tissue augmentation. Unfortunately, the body treats such materials as foreign objects, and as a result the placement of synthetic materials may lead to inflammation, infection, migration and granuloma formation. In general, synthetic materials are less likely to produce a result that looks and feels natural.

For patients seeking permanent enhancement of soft tissue volume, the ideal material to use would obviously be something that is naturally-occurring and not rejected by the body or treated by the immune system as a foreign material. Whether the goal is to restore volume to an area such as the lips or the cheeks, or to fill in a crease or depression such as the nasolabial folds or marionette lines, the ideal material is quite clearly the material that one wishes was there in greater abundance in the first place: YOUR OWN FAT.

The grafting of autologous (your own) fat to reliably restore or improve facial volume is now possible. The fat is harvested from the abdomen, thighs, hips or buttocks using specially-designed instruments and a specialized technique, processed (by centrifugation, which eliminates all components of the harvested material which is not viable fat), and meticulously injected into the facial areas to be enhanced.

Fat grafting has been performed by plastic surgeons for decades. There is no question that fat is the ideal material for soft tissue augmentation, and that the results obtained with fat grafting are the most natural-appearing. However, one problem with this procedure in years past has been resorption (breakdown) of the grafted fat, so that the resulting improvement is not permanent. The grafted fat must gain its own blood supply in its new location in order to persist long-term, and this generally is not possible when large amounts are injected at once and when specialized instrumentation and techniques are not employed.

A relatively new technique has been developed called structural fat grafting, in which small amounts (less than 0.1 cc at a time) of fat are carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just another 'soft tissue filler' of limited duration.

Fat Grafting requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. When performed properly, permanent improvements in facial plastic surgery are possible. If enough fat resorption occurs following a fat grafting procedure such that the desired result is not achieved, a second 'touch-up' procedure can easily be pe"Fat grafting has changed the results of facial plastic surgery dramatically. Traditional facelifts simply do not provide the natural result of microfat grafting," says Dr. Law.

Structural fat grafting can be performed on eyelid hollows, to fill sunken cheeks, for filling sunken hollows under eyes eyes and is often used for blepharoplasty correction when too much skin and or fat has been removed in an eyelid surgical procedure. Some people who have experienced fat loss as a result of procedures such as IPL or Thermage can also benefit greatly from permanent fat injections.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Safe, Permanent Lip Filler - Maybe ? But Not FDA Approved

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).

Mark Berkowitz, MD
Sterling Heights Oculoplastic Surgeon
4.7 out of 5 stars 60 reviews

Permanent Lip Filler

Anytime you're looking at a permanent filler you should consider using your own tissue. It tends to be more lasting with fewer complications as time goes on.

In my practice, we use autologous fat transfer as described by Dr. Law. For a more subtle or less dramatic lip augmentation de-epithelialized dermis depending on the desired extent of correction can be an extremely effective, permanent and safe technique as well. The incisions are hidden inside the lip at the corners and the result is a lasting natural appearance.

I hope this helps!

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 49 reviews

Permalip, Safe & Permanent Solution

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.  

Permanent Lip Enhancement

Currently, the available lip fillers create short term enhancement. For longer lasting enhancement, there are two options: fat transfer or an AlloDerm graft. The fat transfer process uses fat taken from another region of the patient's bodyuses the patient's own fat from another area of the body and it is re-injected evenly into the lips for a natural, complication free enhancement. There are no allergic reactions involved. An AlloDerm graft is like a lattice structure that lets vines grow in your garden. It is a piece of skin that has been stripped of its living cells; all that is left is a soft, collagen structure. The collagen structure is inserted into the lip where it allows the patient's own cells to attach and grow, which provides the enhancement. The graft is placed easily through small, inconspicuous incisions in the corners of the mouth. The result is a very natural look and feel for long term enhancement. Because both AlloDerm and fat transfer use human tissue for enhancement, there is no chance of inflammation or an allergic reaction.

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
4.8 out of 5 stars 107 reviews

Permanent lip fillers have not had good success but there are options for you

Fillers that are permanent in the lips have had issues. Temporary fillers are the most common and popular and have a great history of success. For more permanent options you might want to consider goretex implants, silicone implants, fat injections, the YoungVolumizer, Tissue implants (from your own body that are not fat), lip lifts, and other tissue rearranging procedures. We have some videos that you can watch to learn.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

Lip implants, lip fillers, lip augmentation Beverly hills, lip enhancement Los Angeles

I have performed lip augmentation for over 20 years and I don't believe there is a permanent lip filler that wouldn't have issues. Silicone has significant risks which you can see with a simple google search of silicone complications. Other permanent fillers like Artecol also called Artefil can create lumps that would be as permanent as the material itself. These would pretty much impossible to remove. I recently had a patient travel to Beverly Hills for me to remove Gortex threads, Softform and Bioalchamed in both of her lips placed in another country. You may want to consider using Alloderm for your lip augmentation. Alloderm is soft, supple and lasts 7 years.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Fat grafting from abdomen to lips is the next step for patients happy with fillers looking for permanent results.

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.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Fat injections are the only permanent lip augmentation.


1) Off the shelf fillers like Juvederm and Restylane (which we use a lot), only last a few months in the lips, because the lips move so much.

2) If you want permanent lip augmentation, fat injections or fat transfer works best. We have gotten much better at handling the fat. With very good technique, about 80% of the injected fat survives.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Juvederm is an effective lip filler

Juvederm is a hyaluronic acid facial filler that is ideal for lip augmentation. In one clinical study, approximately 75% of patients had clinical improvement with Juvederm at the nine month point. Juvederm has a high safety profile and has a low risk of developing nodularity after injection.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 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.