Yes the possibility of lumping exists. However proper preparation of the fat and good injection technique lessens the chance of lumping. I personally use juvederm in the area, it does not lump up, it does not need a donor site, it non-reactive, and in my opinion lasts almost as long as your own harvested fat injections.
Even in the hands of very experienced surgeons, fat injections can really be hit-or-miss. Some of the fat resorbs, some gets lumpy with fibrosis (scar replacement), and some stays. Given those problems (and they're more common than you think), why use fat?
For the nasolabial folds and marionette lines I prefer to use Juvederm, Radiesse, or Artefill depending on whether the patient wants a short-term filler (Juvederm), a longer-term filler (Radiesse), or a permanent filler (Artefill). All of these have much greater predictability and control.
With the abundance of FDA approved fillers available in the US, there is little reason to use fat in the nasolabial folds and marionette lines. Fat is still unpredictable, since a large percentage of the material injected gets absorbed by the body. We don't know how long a given fat injection will last. In contrast, fillers like Juvederm, Radiesse and even Artefill are safe, effective and reliable. They are also relatively inexpensive and require little, if any, downtime.
Lumping can occur with both fillers and fat injections. It is best to talk to a doctor that specializes in volume procedures on a regular basis. He/She will have advance training in this field.
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