How long do I have to wait to have fat grafting on lips after filler?

Question

Overnight my lips shriveled up. I'm in my mid twenties. I got juvaderm and it really helped but it's expensive and doesn't last. I got juvaderm 5 months ago. I'd like to invest in fat grafting my lips so it's perminant. One doctor said I should wait a long time, like a year, because filler leaves a white chalky residue in the lips that blocks vessels so the fat won't take. How long should I wait? Thank you!

Toby Mayer, MD · Answer

How long to wait after lip fillers before starting fat grafting? I have done fat grafting for 35 years. If properly done I feel it is the best way to make lips permanently full. I have not had any complications such as lumps, irregularities etc. Look at the surgeons before and after pictures of one year results and seek a surgeon who does natural lip augmentation.  Six months after your last injection is probably adequate but I would need to feel your lips to determine this.

Jason Emer, MD · Answer

There is no time between fillers and fat that you need to wait.  PRP can also be added to enhance either.  Best, DR. Emer.

Kenneth D. Steinsapir, MD · Answer

First, Juvederm is absolutely the wrong filler to have in your lip as far as I am concerned.  Smooth fillers are good for bad injectors.  Folks who make lumps and bumps when they place fillers.  Restyalne is my favorite filler for the lip. It is fussy to place but holds were it is placed.  In contrast, so-called smooth fillers like Juvederm, Belotero, Restylane silk drift after placement.  These product when they break down do not leave "white chalk residue" in the lips that block vessels so fat won't take.  That is doctor 'splaining for I do not want to graft fat into your lips because I do not think you should have the service you are asking for.  I would caution you about fat grafting.  In reality it is an awful filler.  It causes scar, lumps, bumps and when you gain weight, your lips get fatter.  I have done so much surgery to remove fat and other things from lips.  You live in LA and will have no problem finding someone to wreck you.  I caution you about this and recommend you try to find a little more money in your budget for treatment that is less likely to harm you.  Hyaluronic acid filler can at least be adjusted if you do not like the service.

Monika Soni, MD · Answer

Thank you for your question. You will need to wait till your body reabsorbs the filler in 6-9 months in order to have fat grafting. This is because your injector will need to have your natural baseline to work with. If you do not want to wait for your body reabsorb the filler you can it dissolved with hyaluronidase. I recommend having a consultation with an expert injector to determine the best treatment plan for you. Best of Luck!

Hardik Soni, MD · Answer

Thank you for your question. If you want to have fat grafting done, you should wait until the filler has been reabsorbed by your body.  It typically takes 6-9 months for Juvederm to be reabsorbed. This is so the surgeon will have your natural baseline lip shape to work with. If you are in a hurry you can always have the filler dissolved with an enzyme known as hyaluronidase. Then after the swelling resolves you can go ahead with the fat grafting procedure. I recommend having a consultation with your injector to determine the best treatment plan for you. Best of Luck!

Vish Banthia, MD · Answer

Based upon the photo, it seems as if your filler may still persist and your lips look like they have good volume (although it could be that the photo is too much of a close-up pic)  -- typically, Juvederm lasts anywhere from 4-9 months from my experience.  It's best to wait until the filler has resorbed so that the surgeon will know how much fat to inject.  One thing to note, however: like most things in life, fat may not last forever...fat also resorbs but may last longer (in appearance) than fillers.

Liliana Manrique, MD · Answer

It is better to wait that the filler gets reabsorbed to plan the fat grafting according to the real volume of your lips. Juvederm takes about 6 months. Best. LM

Curtis Perry, MD · Answer

Juvederm typically lasts 6 to 9 months. If your lips are back to their pre injection appearance have the fat transfer at your earliest convenience. The presence of filler is not the problem but having significant filler present at the time of transfer interferes with surgical planning as to the amount of fat to use. If uncertain waiting a few months can't hurt.

Johnson C. Lee, MD · Answer

Thank you for your photo. If you choose to have fat grafting, you should wait until the filler has been reabsorbed by your body (6 months up to a year) depending on the type of Juvederm that you had injected. That way the surgeon has your natural baseline lip shape to work with.  If you do not wish to wait so long, you can have the filler dissolved quickly with a hyaluronidase enzyme injection and then you can proceed with fat grafting several weeks later once the inflammation has subsided. Keep in mind that fat grafting is not just a permanent version of a filler. The amount of fat that remains permanently is variable and therefore it is more difficult to have a precise control. Fat cannot be dissolved with the same enzyme if you are unhappy with the results. Also, fat continues to grow and shrink so your lips may change accordingly with your body weight. It is best to have a thorough examination and discussion with your plastic surgeon to make sure you are making the best informed decision for yourself. Hope this helps!Johnson C. Lee, MD Plastic Surgery

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