Asymmetrical healing after fat grafting to the lips? I wanted a more permanent symmetrical look. (Photos)

Question

Hey all! So I recently had a fat graft done to my upper lip on June 22. My upper lip has always been much slimmer than my bottom lip because I was born with a cleft lip and palate. I decided to get a fat graft done because I wanted a more permanent symmetrical look. I am reaching the beginning of the 3 month (give or take 1-2 days), and my upper lip has healed incredibly asymmetrical. The left side is significantly smaller than the right side and looks as though nothing was done to it. Thoughts?

Jason Emer, MD · Answer

You may still have swelling and it's too soon to tell what your final results will be. It can take up to 3-6 months to see final results after fat transfer. I recommend prp to help improve final results. Icing the area, prednisone, ibuprofen and venus legacy treatments can help reduce swelling. See an expert. Best, Dr. Emer

Robert M. Tornambe, MD · Answer

Irene.  Sorry you are having this issue, however sometimes fat take after grafting can be irregular and one side takes better than the other. This can especially be true in the case like yours where there is probably residual scar tissue from your previous cleft lip repair. You may need a revision with more grafting on the side that is smaller. Discuss your concerns with your plastic surgeon. Good luck.

Francis R. Palmer, III, MD (retired) · Answer

Hi, if you are concerned you should follow up with your Lip Augmentation  Surgeon.  The challenge with cleft lip/palate patients is the possible lack of muscle volume in the lips themselves.  This then makes it far more challenging to augment the lips using any augmentation method.  I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or silastic facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

Asymmetrical healing after fat grafting to the lips? I wanted a more permanent symmetrical look. (Photos)

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Asymmetrical healing after fat grafting to the lips? I wanted a more permanent symmetrical look. (Photos)

Answers (3)

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Everything you need to know about Lip Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.