CO2 Fractional Resurfacing laser: I should also do fat transfer to my upper lip for smokers lines ?

Fillers such as Restylane Silk, Belotero, or Juvederm can work well to treat lines around the mouth, but the best first option is laser resurfacing or deep peels to induce collagen production. Superficial radiofrequency devices and microneedling can help as well and are less invasive. I suggest going to an experienced cosmetic dermatologist with expertise in lasers and fillers. Best, Dr. Emer

I do not recommend fat transfer to treat perioral lines, particularly if you didn’t like the results you achieved with dermal fillers. Fat is actually less predictable than fillers and more likely to leave a lumpy result. If you are unhappy with the fat once it’s injected, it is also extremely difficult to reverse the effects. I would recommend the laser resurfacing treatment for this area as this tends to produce the best result. If you need a finishing touch after your laser treatment, very small amounts of filler might be a good choice. Make sure the doctor that administers your procedure is both board certified and has extensive experience treating perioral lines to ensure the best possible result. 

Hello and thank you for your question. If you were not happy with the result dermal fillers gave you above the upper lip, I would not recommend fat transfer in that area. In addition to producing similar results, there is no way to reverse fat injections like you can with some dermal fillers. This area is most effectively addressed through a skin resurfacing procedure with the CO2  fully ablative laser. The treatment stimulates the body to produce more collagen, repairing the dermis at a cellular level. I find that even fractional lasers aren’t quite strong enough for these stubborn lines and patients are disappointed if it is undertreated. Fully ablative CO2 is really the best option, but the downside is 10 days of downtime with the CO2. If you can’t swing that, you can also use RF microneedling in this area, which offers a similar process in three to four treatments. 
I recommend scheduling an in-person assessment with a board-certified dermatologist who has the experience and expertise to tailor your treatment to your precise concerns, skin tone and desired results.