Lip augmentation using a fat transfer is
an outpatient surgical procedure that involves removing fat from one are on the
body to the lips and also as a
dermal filler for a patient who has lost
facial volume as they have aged.
The fat is harvested using the procedure ofliposuctionon one
area of the body:
Most surgeons are
very particular about the location of the fat and the formation of the fat
pockets. To have successful fat grafting, the surgeon needs to be able to
remove the fat cells fully intact and minimize any damage
- the location of where the fat is being harvested is very important - and the
texture of the fat. All of these key issues are important in order to have
a successful fat grafting.
Fat grafting has two major indications:
increase the volume
of the target area
to improve the
quality of the skin
Fat grafting as a successful procedure will
impart a natural fullness and plumpness to the skin or lip area.
Injected fat stimulates a process called "neovascularization"
- by increasing the vessels net and blood supply which can help quickly repair
and restore the target area that needs volumization.
Stem cells are full of "growth factors" and
are considered the most valuable constituents of the fat tissue aspirate,
because they contribute to the complex role in tissue reconstruction.
It is important that the fat is carefully
harvested, processed, refined and prepared so as to avoid washing out these
vital "growth factors".
Once the fat is harvested it is
carefully prepared for injection into the lips. The fat is
removed using a small cannula that has limited suction in order not to damage
the fat cells. This same procedure is used for fat grafting to the facial
area as well.
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Most surgeons will then spin the fat in a centrifuge to remove
the excess fluids and the damaged fat cells. Only the whole undamaged fat cells
are injected. Once the fat is prepared it is injected into the lip area using a
blunt needle or a syringe.
Incisions are made less than 0.2 centimeters in
diameter in the corner of the mouth, and normally the fat is delivered in
Another method of fat grafting to the lips involves
tiny incisions that are made inside each corner of the mouth, and a tunnel is
created under the skin of the lips and then the fat is injected this way.
Although some physicians believe that
fat grafting is permanent, it really does depend on the patient and their own
absorption rate. Fat grafting is highly technique dependent, and most physicians
will have an average re-absorption rate of approximately 50%.
To counter what
the patient might lose during recovery and the body absorbing some of the fat,
most physicians will overfill the area to compensate for this occurring. Physicians who are specialized in fat grafting tend to have a lower absorption
rate due to their technique. Fat grafting tends to last longer in the areas of
the face that has less movement and also if the area being treated is around
muscle and a good blood supply.
Fat grafting is performed on an
outpatient basis and normally takes approximately an hour and a half. The
results from lip augmentation with fat transfer can last from six months to
several years and can range in price from $1,500 - $5,000.
The advantages of fat grafting to the
lips or face is that you are using your own tissue, so there is no chance of an
allergic reaction occurring.
Many plastic surgeons agree that there is no
other product which can improve the quality of
the skin as autologous fat.
The fat aspirate
has the ability to enhance the blood supply of the skin, improve the color,
thickness, elasticity and texture naturally.
The downside of fat grafting is that it requires
another procedure to harvest the fat, which is more invasive than injections
alone. The procedure can be time consuming for the patient with the recovery
period. It also can be more costly because of procedure and time
it takes to harvest the fat. The less movement the treated area gets, the more
fat cells survive. There are forewarnings and uncertainties too with this
The biggest problem is that only a percentage of the injected fat
takes hold in the treated area. Additionally, this percentage may vary widely:
from about 10% to 50% depending on a variety of factors. Many surgeons have
their favorite harvesting and injection techniques and claim higher than average
clinical longevity of the grafts.
The Cosmetic Dermatologic Surgery,
Darmstadt, Germany - Reviewed the effectiveness of fat injections in an article
published in Dermatologic Surgery Journal.
They concluded that:
Clinical longevity of correction after
autologous fat transfer is determined by the degree of augmentation resulting
from the amount of fibrosis induced and the number of viable fat cells. Survival
of aspirated fat cell grafts depends mainly on the anatomic site, the mobility
and vascularity of the recipient tissue, or underlying causes and diseases, and
less on harvesting and re-injection methods.
Swelling is expected after the fat graft
and is dependent on the physician’s technique and the patient’s tolerability.
Swelling can last from two to several weeks after the procedure. Bruising may be
apparent and possible scarring of the fat donor site.
As with any surgical procedure, there
are drawbacks to lip augmentation fat transfer surgery. Part of the fat that is
injected into the lips is subject to
necrosis (tissue death) as a result of the
procedure. Also, excess scar tissue can form inside the lips from having this
Autologous Fat Grafting: Long-Term
Evidence of its Efficacy in Mid-Facial Rejuvenation
By: Meier JD, Glasgold RA, Glasgold MJ
To provide quantitative objective data
demonstrating the longevity and amount of volume augmentation in the mid-face
obtained with autologous fat grafting.
A prospective analysis of all patients who
underwent autologous fat transfer to the midface region at our private practice
and were followed up for at least 1 year. Three-dimensional imaging was
performed with a Canfield Scientific Vectra camera and software, with
quantitative volume measurements evaluating the amount of postoperative volume
Thirty-three patients (66 hemiface-mid-face
regions) were included in the study. The mean follow-up time was 16 months. The
mean amount of autologous fat injected into each mid-face region was 10.1 mL.
Overall, the mean absolute volume augmentation measured at their last
postoperative visit was 3.3 mL (31.8% take). There was variability between
patients in the volume amount and percentage that remained. Touch-up procedures
were performed in 8 patients.
To our knowledge, this study is the
first clinical quantification of autologous fat transfer and/or grafting in the
literature that provides definitive evidence on the amount as well as the
resultant longevity in the mid-face. Autologous fat transfer to the mid-face has
definite long-term volume augmentation results. On average, approximately 32% of
the injected volume remains at 16 months. However, some variability exists in
the percentage of volume that remains that may require a touch-up procedure.