What is lipofilling of the lip(s)?

As we age, the skin becomes less elastic and full. Lipofilling or fat grafting places fat tissue in the deeper layers of the skin and provides structural support to the skin.

Advantages

  • Permanent effect (or at least lasts for several years).
  • No allergic reactions are possible.

Disadvantages

  • A surgical procedure is necessary (can be done under local anaesthesia though).
  • A downtime of two to three weeks is normal as there will be considerable swelling and bruising after lipofilling of the lips. You will not be able to eat and drink in the usual way during this period as the lips will be very swollen and stiff with very little sensation.

How does lipofilling of the lips work?

First a fat graft has to be taken from anywhere on your body, mostly the stomach or the inside of your upper legs. Then, this fat will be injected into your lips with very fine cannulas or needles specifically designed for this purpose.

What can lipofilling of the lip(s) do for you?

Lipofilling of the lip can help to augment the lips and restore their volume. It may also help define the borders of the lip. This transition area fades away progressively as we age. Fat grafting can treat wrinkles around the mouth and above the lips.

The vermillion border is considered more feminine when it is fleshy and when it has a good projection. This is also a typical trait of youth. That is why lip augmentation remains one of the most frequently sought-after cosmetic procedures performed in aesthetic medicine today.

It has also been shown that fat grafts have a beneficial, rejuvenating effect on ageing or damaged skin. Cells within the fat grafts are capable or “repairing” damaged tissue and they are presumed to stimulate the skin cells to produce substances that improve skin elasticity and deposition of essential structural proteins.

Who is a good candidate for lipofilling of the lips?

  • Any person (mostly women) who has very thin and flat lips. The person should have a minimal amount of fat (6 ml per lip) available for fat grafting.

Who is not a good candidate for lipofilling of the lips?

  • People suffering of anorexia or athletes in whom no fat at all can be found for grafting.
  • People with a very unstable weight. When they significantly gain weight, the lips can become thicker and vice versa.

How to prepare for lipofilling of the lips?

There is no specific preparation for this procedure.

How is lipofilling of the lips performed?

Fat grafting is usually performed under local anaesthesia. If this procedure is combined with other procedures, it will mostly be done under general anaesthesia. The method used by Dr Bart van de Ven is called the Coleman method.

Liposuction

The fat used to re-inject in the lip(s) can be taken by means of a liposuction from any part of the body that has a sufficient amount of fat, in most cases this will be the stomach or the upper legs. After injecting local anaesthesia, which minimizes bleeding in this particular area, a very small incision is made and fat is aspirated using a blunt needle with multiple perforations and a special aspirator. The small incision is closed with one stitch.

Filtration

This fat is filtered to separate blood, oil and local anaesthetics from the fat cells.

Injection of the fat

If the procedure is performed under local anaesthesia, the lip(s) are injected with a minimal amount of local anaesthesia after which the fat cells are injected with very fine cannulas. If the procedure is performed under general anaesthesia, no local anaesthetics will be injected as it has been observed that the local anaesthetics have a negative effect on the survival rate of the injected fat.

The trick of the fat transfer is to inject only a very small amount of fat with each pass of the cannula. This way, the grafted fat will be in direct contact with the surrounding tissues which allows the fat to grow in the vessels really fast. As a result, the fat can survive.

MAFT-gun

For the injection of the fat, we use a MAFT-gun. This is an innovative instrument developed in Taiwan by Dr Lin. It allows the steady, accurate and precise injection of the fat in drops with a diameter of only one mm, which has been proven to be the optimal diameter of the transferred fat. With this instrument, not only the survival rate of the fat is higher, the degree of bruising and swelling is far lower as well.

The amount of fat that survives depends on the part of the body where it is injected and differs from person to person. It is our impression that on average 50% of the fat that has been injected into the lips is still there after six months.

Therefore, we may do some overcorrection during the operation.

After six months we can speak of a final result because after that we do not see much change anymore. How the transplanted fat will behave over the following years/ decades is still unknown. However, it is likely that the normal aging process will continue and that the fat slowly goes away. On the other hand, we also expect that the difference made by the transplantation will last very long.

After six months, if necessary, another fat graft may be performed until the desired effect has been obtained. Repetition is needed for about 20% of our patients.

What is the average treatment plan of lipofilling of the lips?

As a stand-alone treatment, lipofilling of the lips can be performed as an outpatient procedure.

What to expect and do during the recovery period after lipofilling of the lips?

Swelling

Immediately after the surgery, the lip(s) will be quite swollen and bruised. You will not be able eat or drink the usual way for about two to three weeks.

In the beginning the correction may look rather exaggerated. We usually over-correct, which means that we inject more fat than is actually needed. We do that because about 50% of the transplanted fat cells do not survive.

About seven to ten days after the surgery you will feel confident about going out and taking up your normal social life again. If any bruises have developed, these might remain visible for a little longer but you can hide them quite well with a good concealer (lipstick).

In about three weeks’ time approximately 80% of the bruising and swelling will have disappeared.

After four months you get a good impression of what the final result after six months will be.

Correction

A second session may be scheduled to top up any shortfall in volume. There are many factors that determine how long fat grafting lasts. Your body naturally absorbs fat, so the surgeon must over-inject initially, and success rates can vary considerably. However, some fat is reabsorbed by the body and sometimes only a certain percentage is permanent although newer techniques are showing an increased longevity.

If you gain weight in the future

If you gain a considerable amount of weight after fat grafting, it may show up in the area that was treated.

What are the risks of lipofilling of the lips?

  • Overfilling has never been an issue in our patients. It is questionable if that would be possible at all in one session. Overfilling may lead to a bigger percentage of the injected fat that does not survive. All those people with unnaturally large lips had artificial fillers injected or had multiple sessions of lipofilling.
  • Infections have never been noted by us.
  • Irregularities and dimples are very rare and can be corrected in another session of lipofilling.
  • Sometimes the ‘take’ of the fat is less than hoped for. In rare cases, lipofilling just does not work, not even after several sessions.

How long can I expect the results of lipofilling of the lips to last?

How the transplanted fat will behave over the following years/ decades is still unknown. However, it is likely that the normal aging process will continue and that the fat slowly goes away. On the other hand, we also expect that the difference made by the transplantation will last very long, if not forever.

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