Fat Grafting of Lips and Face, lip plumping

Lip Augmentation / Fat Grafting to Lips

Lip Filling with fat grafting has been known for many years and various methods of fat grafting have been performed for a long time. It consists of the transfer of fat tissue / cells from a donor site such as the abdomen or buttocks to the lips, cheeks and other areas. The face is the most common recipient site but fat may be transferred to the lips,  buttocks, hips or any other area where there is fat deficiency or indentation.

This fifty year old woman is shown before and one week following dermis / fat grafts of her lips.

Age Group:

Fat transfer / Fat grafting  can be carried out at any age. Middle aged woman are the likeliest candidates because they tend to lose their facial fat at that age. Outside of middle age, soft tissue or skin indentation following trauma, surgery or congenital malformation are the usual indications.

Sex:

The aesthetic consequences associated with loss of facial fat make woman the prime candidates for fat transfer. However it is equally effective in males and females.

Anaesthetic:

Fat transfer is an ideal procedure to carry out under sedation / local anaesthetic as a day care procedure.

Fat Transfer Procedure:

Under local anaesthetic and sedation fat is harvested from a typical donor site such as the abdomen or buttock. The fat cells are extracted through a very fine cannula. The fat graft is centrifuged prior to injection. This separates fractions such as blood cells, tissue fluid and liquefied fat which are most deemed suitable for grafting. The fat graft is injected through a very fine cannula. Pre-operatively with the patient sitting the areas to be injected are carefully outlined. When the patient is under anaesthetic, lying flat on the surgical table it is not possible to precisely identify the areas that required fat injection. The cannula is inserted through a small puncture hole in the skin which usually does not require suturing.

Occasionally a fine single suture may be inserted to prevent leakage of fat through the opening.

The procedure is pain free. Patients have little or no awareness during the procedure and wake up comfortable and relaxed as soon as the procedure is over. Patients are fit for discharge from the clinic approximately one hour following completion of the procedure. Post-operatively an antibiotic is prescribed for one week and light pain relief is taken – symptoms tend to consist of discomfort and tenderness rather than pain.

Operating Time:

Full facial fat transfer will take one hour. Fat transfer to the buttocks takes up to two hours. Fat is normally harvested from the abdomen, thighs or buttocks.

Aftercare:

There will be swelling of the face and perhaps bruising also. The swelling will take one to two weeks to subside. An antibiotic is taken for one week and mild to moderate pain relief is taken. An elastic facial support is worn. The fat donor site will not require specific aftercare apart from a pressure garment if a large quantity of fat is suctioned.

Recovery Time:

This will be determined mainly by the duration of the swelling and bruising. With regard to the face this will be in the order of two weeks, by which time you should be fit to return to work and go out socially. If you work from home you should be able to resume work within a few days following surgery. You will not experience severe pain – tenderness and soreness represents the level of discomfort experienced by most patients.

Risks:

  1. Infection – this is extremely uncommon. Antibiotics are taken as a precautionary measure.
  2. Bleeding following the surgery is also extremely uncommon.
  3. Numbness of the skin or muscle weakness due to nerve injury – these complications are rare and I have personally never seen them it in any of my patients.
  4. Absorption of the fat graft – this is the most commonly encountered complication following fat transfer. The graft take is unpredictable. For this reason I advise patients that up to three grafting procedures may be required over a period of six to twelve months. Once a satisfactory amount of fat has taken it can persist for up to five years.

Expectations:

The advantages of fat as a filler are:

  1. The patients own tissue is used as opposed to synthetic or foreign material.
  2. A large volume of donor fat is normally available whereas synthetic fillers come in much smaller quantities, insufficient to graft a face or a buttock.
  3. Once a satisfactory graft has been achieved it is likely to persist for much longer than all other fillers.

Contra-Indications:

There are no absolute contraindications. Bleeding disorders, immune deficiency and heavy smoking are relative contraindications. The performance of fat grafting in the elderly is unproven.

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