One of the single most disturbing manifestations of facial aging is the loss of volume in the lips, lack of lip support, due to dental issues and bone resorption, and lengthening of the upper lip with concomitant vertical wrinkles causing lipstick "bleed." The primary problem is usually the loss of lip volume for which many solutions have been proposed. The latest most elegant and principled solution is "structural fat grafting" as popularized by Sydney Coleman, MD of New York City.
You can throw away all of the preconceived notions regarding the "take" of fat grafts when adhering to Dr. Coleman's method of fat harvesting, preparation, and fat grafting techniques. My experience is 95% of graft take in the glabella, malar and tear trough areas, and 85% take when injected in the upper and lower lips.
The technique includes a unique method of fat harvesting, centrifugal separation of the fat to be grafted for the non-graft fat products such as oil and disrupted cells, and careful injection of the fat graft into the lips for volume, white roll for enhancement, and philtral columns for contour.
The procedure is done under local anesthesia with appropriate sedation. The lips are very sensitive to swelling and some bruising, all of which is resolved by 2-3 weeks. The final result is then permanent but can be fine-tuned if necessary. Note that lip fullness is not manifested by more red vermillon show but as a lip "pout" as seen in the photos below.
Dr. Howard's patients of lip enhancement fat injections is usually one week. Many patients experience more swelling and may not be "presentable" for more than one week. The lips swell, but the end result is the most natural appearing lip enhancement available. Pain is very minor for this procedure. Most patients do not require prescription pain medication after a day or two. Bruising is rare with this procedure.
Dr. Howard's cost for autologous fat transfer for lip enhancement is $2500 - Very realistic considering other lip enhancement options, such as Juvederm, are temporary and cost around $600-$1200 per treatment that only last at best 6 months. Dr. Howard offers Juvederm for lip injections too, but most paients eventually switch to permanent fat injections since it's your own tissue and not a foreign body.
Dr. Howard also offers Juverderm family of temporary facial filler for lip injections and facial wrinkles. The most common Juvederm for the lip area is Juverderm Volbella. The cost for Volbella is $400 per syringe. Some patients may require two syringes to achieve the desired look. The cost for two Volbella syringes is $750. In addition, Dr. Howard also participates in the Brilliant Distinctions program allowing patients to earn points from every Botox, Juvderm, and Natrelle purchase.