Vocal fold fat/lipo augmentation is recommended when the vocal folds do not close in the midline completely (glottal incompetence). This occurs when the vocal folds lack bulk or tone from normal aging (vocal fold atrophy/aging voice) or when the vocal folds do not move properly from vocal fold paresis and paralysis

Vocal Fold Fat Injection Augmentation Procedure

Vocal fold fat/lipo augmentation is performed in the operating room with the patient asleep under general anesthesia. A small incision is made on the abdomen and approximately 10-15 cc’s of fat is collected. Once the fat has been collected, the patient’s larynx (voice box) is brought into view with a metal laryngoscope using a microscope for visualization. The fat is then injected into one or both vocal folds to achieve better voicing. 

Advantages and Disadvantages of Vocal Fold Fat Injection Augmentation 

An advantage of vocal fold fat/lipo augmentaiton is that it is relatively easy to perform and voice quality is significantly improved in many patients. This surgery is performed with the patient asleep under general anesthesia, so the patient is comfortable and not awake. 

The main disadvantage of a vocal fold fat/lipo augmentation is that it is difficult to predict how much of the fat will survive and not be reabsorbed by the patient’s body. Thus, the surgeon must over-inject the fat by at least 25-35%, leading to a slightly strained voice immediately post-operatively. This may last for several weeks until the excess fat is reabsorbed. There is a possibility that in some cases, initial improvements in voice may diminish over time if the body reabsorbs too much of the injected fat. Another disadvantage of this procedure includes the need for general anesthesia as well as a small incision on the abdomen.