Is a fat transfer a good permanent alternative to permalip implants? Can a fat transfer be done with scar tissue in the area?

Thank you for your question. I’m sorry that your Permalip implants didn’t yield satisfactory results. Once you’re fully healed from the implant removal, you may benefit most from dermal filler injections or a lip lift to enhance the appearance of your lips. Augmentation with dermal fillers can add shape and fullness to the lips by increasing volume, while a lip lift surgery can produce more long-term results to make your upper lip appear fuller. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or injector. They’ll be able to review your surgical history, discuss your aesthetic goals with you, and help you decide on the best course of action.

In general, fat grafts do not work very well for lip augmentation in our hands. Any area that moves a lot (like lips) is not good site for any tipe of grafts. Although there is a temporary improvement, volume take in lips is probably less than 10% in the long run. We preffer to use fillers for lip augmentation.

I recommend going slowly and taking one step at a time. Get your implants removed and then give yourself at least 3 to 6 months to heal up properly.
The next step should be an attempt at lip augmentation using HA fillers.
If the scar tissue does not interfere and you get good results with fillers then you may want to consider fat grafting as a permanent solution.
Generally speaking fillers are going to be superior by almost every measure with the exception of longevity.
Grafting fat is inherently unpredictable imprecise and unforgiving if the results don’t turn out the way you had hoped.
With fat grafting it’s better to be conservative and recognize that you may need a second round of fat grafting then to overdo it.
It is very difficult to remove previously grafted fat if you don’t like the outcome of the procedure.
I’d like an implant which is easy to remove this is not the case for previously grafted fat.
Provider selection is paramount and gradually building up the volume of your lips by conservative volumes in a few sessions is probably good advice.
Look for providers who have a proven track record with this procedure.
When reviewing before and after pictures always confirm the time frame when after pictures were taken.
Fat transfer results can look stunning early after the procedure but early results do not represent final results.
After pictures should not be taken within the first 3 to 6 months in order to be representative of what final results look like.
Finally if you have any history of significant weight fluctuations then consider being careful with putting fat in your lips.
Individuals who end up becoming morbidly obese after lip fat transfer can end up with disproportionate looking lips that are very different than what they intended.
Provider selection and understanding your candidacy for the procedure are generally to very important variables.
During each consultation ask each provider to open up their portfolio and show you their entire collection and before and after pictures for this procedure. As mentioned earlier confirm the exact timeframe of when after pictures were taken.
Best,
Mats Hagstrom MD