I'm a 38 year old female, what procedure would best address my sagging jowl and cheeks? (photos)

Jowling develops when the cheek skin and fat loosen and sag downward with age.  This collects just behind the fold between the nose, the corner of the mouth, and the side of the chin at the jawline.  As your photo shows a squarish shape to your lower face due to accumulation of fat in the lower jowl at the jawline, along with deepening of the so-called marionette fold, I think that you would need at least a lower facelift or short scar facelift to lift up the sagging fat in your lower face.  This would recreate a more youthful heart-shaped look, smooth out the jowl and the marionette fold, and leave you with a  smoother jawline.  Also, some strategically placed stitches under the skin near the front of the cheek can nicely lift up the corner of mouth, therebye creating a more pleasing look.  This surgery could be performed either in an office or other outpatient surgery suite under local anesthesia and IV sedation.  The cost would vary in different parts of the country but would be less than a complete facelift.  

A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.Price of a #facelift is always a concern when deciding whether or not to have a cosmetic procedure. Patients’ needs and goals vary, so there is no fixed price for a facelift. These are the contributing factors to the cost of a facelift:-Surgeon’s fee-Facility fee-Medication cost-Anesthesia feeEstimated fees may also be found here on Real Self, and the American Society of Aesthetic Plastic Surgery website.

I think that a lower facelift with liposuction of your neck would be worthwhile considering in your particular case.  Although you are only 38 years of age, I have performed the occasional lift in patients your age who were quite pleased with their results.

Buccal fat removal is not the right option for you. From the one photo you provide, I would offer you a facelift, submental liposuction and liposculpture. Costs vary between surgeons and facilities. It should also be low down on your list of questions. More important to find a surgeon with a lot of experience in contemporary facelifting who will happily show you results and introduce you to former and current patients. 

A full facelift with liposuction is what you need to remove the excess fat and skin. The cost can be determined after a face to face consultation.  Face forward and profile photos are preferred.