This attractive 51 year-old woman wanted less deflated-looking lips. She did not want lumpy, irregular, or overly large lips (and named several examples of actresses whose lips she felt were visibly overdone). She also wanted her lip enlargement to be permanent so that she did not have to come in two or three times a year for filler injections. Dermal fat grafts (de-epithelialized dermis with a small amount of attached fat, usually obtained from an existing scar, like a C-section or appendectomy) were placed under local anesthesia via tiny incisions in the corners of her mouth. Swelling was noted for about a week, after which she returned to normal social activities. Soft, fuller, natural lips with normal sensation were achieved permanently without the possible irregularity or multiple surgeries required with fat injections.