Lipoinjection is known to be a safe therapeutic option for disorders of the vocal cords. Unilateral vocal fold paralysis can be treated by lipofilling with an efficacy lasting six months to one year. Lipotransfer seems to improve long-term vocal fold closure, demonstrating utility also in patients with presbyphonia. Recent studies provide excellent results after fat injection in patients with defects after small glottic cancers. Even if improvements in voice and swallowing after lipoinjection may decrease over time, most patients experience long-term benefit. The observed effects might be associated with adipose tissue-derived stem cells. Complications after lipoinjection to the vocal cords are rare in established microscopical and minimal invasive procedures.