Article Medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
Lip augmentation using permanent lip fillers is an option for those who find that temporary fillers do not last, or for those who would prefer not to have dermal fillers done periodically.
Although hyaluronic acid dermal fillers are currently the most popular form of lip injections used, their longevity is not adequate for some patients. The two main options are;
- Permanent lip filler – The actual name of the product used cannot be stated here due to TGA regulations. The product is intended to last 10 years, and can be injected in a similar manner to other dermal fillers.
- Autologous fat transfer to lips – This involves harvesting a small amount of fat via liposuction of an area such as the abdomen, hips or inner thighs, and transfer of this fat to the lips.
*UPDATE: We have found that temporary hyaluronic acid fillers have greater longevity than the expected 6 to 18 months. Through using MRI scans, we have found that temporary fillers can last 5 to 10 years or more. We also found a significant amount of migration of filler away from the vermillion or red part of the lips with time. This is a particular problem with the upper lip where it migrates to the skin of the upper lip. This migration explains or accounts for those who have had lip filler and found the effects to be short-lived. In actuality, the fillers still remain, but have shifted to a location where they no longer provide an effect.
We believe that despite the increased longevity of permanent fillers, the issue of migration remains. In combination with the longer than expected longevity of temporary hyaluronic acid fillers, the advantages of permanent fillers are fewer than before this finding.
Permanent filler for lip augmentation
Permanent lip filler is an option for those who do not want frequent lip injections, or where temporary fillers have not been satisfactory.
A filler that lasts for approximately 10 years is used, and this product has been used in 400,000 patients worldwide over the past 20 years.
The risks of using permanent lip fillers are more significant in comparison to temporary lip fillers, and therefore extra precautions are taken. The procedure is only performed by Dr. Gavin Chan at Victorian Cosmetic Institute. He has 10 years experience in lip fillers
Infection is a greater risk when performing lip augmentation with permanent filler. We do insist that the procedure be performed in our operating theatre under sterile conditions. Prophylactic antibiotics are also given to help reduce the risk of infection. Infection in permanent filler can be deep set and last for the duration of the filler, causing complications such as hardness, or lumps, or nodules.
An immune response by the body is also possible, and this can lead to nodules or granulomas forming from the injected permanent filler.
There is a degree of inflammation that occurs post permanent filler injection, and this tends to be slightly more than that with temporary fillers.
Injection technique is much more critical with permanent fillers, as any errors are not easily correctable. Risks include; asymmetry, lumps, over and under-filling. We use blunt tipped cannulas to reduce the likelihood of irregularities. Blunt tipped cannulae are generally longer than sharp needles and longer ‘threads’ of filler can be injected, reducing the risk of lumpiness. Furthermore, with permanent dermal fillers, we tend to completely anaesthetise the lips prior to injection of filler to help minimise discomfort and the patient moving during the injections.
Once a permanent filler is injected into the lips, it is not recommended to inject other fillers, such as temporary fillers over them. Further enhancement can be achieved with further injections of the same type of permanent filler.
Autologous Fat Transfer to Lips
For those preferring a long lasting and natural method of lip augmentation, it is possible to transfer your own fat to your lips.
A small amount of fat is required, usually only a few millilitres. This fat is harvested from the body (usually the abdomen, hips or thighs) by liposuction. Liposuction for this purpose is done using fine cannulas and a small syringe to generate negative pressure. The trauma caused by this is minimal in comparison to liposuction for larger volumes of fat removal.
Fat can also be used in the face in areas other than the lips. More information about fat transfer in general can be found here.
Fat transfer to the lips is performed using a similar blunt tip cannula that is used with dermal fillers, however, it is a slightly larger size. The swelling involved with fat transfer can be quite significant, and often takes approximately 1 week to subside.
To achieve the best results, usually more than one session is required. However, the initial liposuction can be used to harvest enough fat for multiple transfers to the lips. Unused fat can be kept in a specialised extra low temperature freezer, and thawed just prior to injection when required.