Alexander Rivkin, MD
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Alexander Rivkin, MD
Plastic surgeon | Views: 244105

Friendname: AlexanderRivkinM.D.
Business Name: Westside Aesthetics
Website: www.westsideaesthetics.com
Location: 1033 Gayley Ave #104
los angeles, CA 90024
United States
Telephone: 310 443 5273
Languages Spoken: English

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Ask An Expert > Alexander Rivkin Message Board > lip augmentation - fat grafting
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lip augmentation - fat grafting
I have heard that fat grafting is a process that allows more fat to survive after it has been put in your lips. Does this process really work so that the fat survives over years? And a larger % than the old fat transfer method?
Do you know anyone who is artistic at doing this?
Are the outcomes predictable?

Plastic surgeon
Ellicott City, MD
United States
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Lip fat grafting  October 1, 2012 1:21 PM

There are many options for plumping the lips: injectables, lip implants, and fat grafting. All have pro's/con's. Fat grafting is a nice alternative if it is done by a plastic surgeon experienced in the technique. The fat must be harvested properly, prepared correctly, injected into the correct place in the lips and then you must be given the best things to do after surgery to help it survive. I usually recommend patients to stay well hydrated, avoid smoking, avoid kissing and here's the tough one, avoid talking and chewing for 2 weeks. The fat cells need to "grow" new blood vessels in order for them to live and everytime you move your mouth more of them will die until those blood vessels have formed. Patients who follow these guidelines have about 60-70% of the fat live. Best of luck to you!

Plastic surgeon
Roseville, MI
United States
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  October 1, 2012 2:56 PM

Fat is a wonderful filler for the lip - its natural, smooth and has the potential to last a lifetime. I have photos on my site to view at imagebydesignmd.com if that helps. Good luck. dr. Kayser

Plastic surgeon
Miami, FL
United States
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  October 2, 2012 3:43 AM

The "father" of modern fat grafting is Dr Sydney Coleman in NYC. Most of us have either trained under him or are using his "micro droplet techniques. But there are NEVER longevity guarantees to fat survival.

Plastic surgeon
los angeles, CA
United States
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Fat is nice, but not predictable  October 3, 2012 10:25 AM

Dr. Dauria's answer is quite accurate - and it is the reason why I recommend hyaluronic acid (HA) fillers for lip augmentation over fat 9 out of 10 times.
Aesthetic improvements are measured in millimeters. Precision is absolutely critical. A technique that is somewhat invasive, where you have to recover for 2 weeks with bruising and swelling and where (most importantly) the surgeon cannot predict the results down to the millimeter because you only get 60 to 70% fat survival is just not good enough.
HA takes 5 minutes to inject, you can sculpt it perfectly, bruising can happen, but is usually not too bad and the filler lasts for about 8 months. Most interestingly, I am seeing the filler stimulate natural collagen growth in some of my patients, where they need less and less over time and it lasts for longer and longer. Also, HA is reversible at any time by injecting hyaluronidase.
Fat is not reversible and if there is a miscalculation and you retain more than anticipated, there is no way of removing it other than surgery, which leads to scarring and a poor aesthetic result.

Cosmetic surgeon
Kennewick, WA
United States
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  October 3, 2012 6:11 PM

When using stem cell augmented fat placed using a fine blunt cannula, the process becomes much more predictable, the shape can be very beautiful, and it is quite long lasting. That being said, it does not work as planned on every person who undergoes this procedure, and individual results do vary. However, I would recommend giving it a shot if you are tired of repeated hyaluronic acid injections, and although there is more cost upfront, over time it becomes much more cost effective.



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