This study compares the efficacy of three autologous modalities of lip augmentation: palmaris longus tendon, fat injection and dermal fat.

A retrospective review of pre and post-operative photos evaluated for aesthetic results and scored (1 poor to 5 excellent) was assigned to the comparative individual appearance. Patient satisfaction, complications and revisions were recorded.

A total of 38 patients (18 palmaris/11 fat injection/9 dermal fat) with an average age of 35.1 (range 15-70) underwent autologous lip augmentation between 1998-2005. Indications for operation included cosmetic (15), and reconstruction (23). The average length of follow-up was 19.5 months (range 1-64).

There was improvement of the overall appearance based on evaluation of pre and post-operative photos (Average score 3.7/ palmaris 4.2> dermal fat 3.6>fat 3.5) with a significant improvement of the palmaris graft as compared to the fat injection (p<0.05). Eighty four percent of patients were subjectively satisfied with their appearance, with palmaris satisfaction (94%) greater than fat injection (82%) and dermal fat (78%). Fat injection had a lower rate of complication (9%) compared to palmaris (39%) and dermal fat (33%). There were no donor site complications.

Palmaris longus tendon provided the most reliable soft tissue implant, whereas, fat injection required multiple revisions and dermal fat negatively effected lip mobility.