Permanent fillers are a recent advance that offer the advantages of soft tissue fillers, with the added feature of permanence.
What are the disadvantages of permanent fillers?
The advantage of permanence is also the disadvantage: if you don't like the results, they can only be removed with surgery. They are often a good option for someone who has been very happy with the results of temporary solutions and now wants something more permanent.
Where are these procedures done?
They are usually done in the office, often without any anesthesia at all, since the injections are only mildly uncomfortable.
Fat grafting is available as an alternative to the permanent fillers, since it is in a way the "ultimate" permanent filler. Fat from the patient's own body is used to fill the defect or deep wrinkle, and it takes as a graft, in which case it is permanent - and grows in the new place as it had where it came from.
Is there a disadvantage to fat grafting as a permanent filler?
Fat grafting is usually done in the operating room, a much more extensive procedure than the inert fillers, and requires local anesthesia with sedation. Also, there is the possibility that the graft will not entirely "take" the first time, and a return to the operating room will be necessary.