Buccal Fat Removal Q&A
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Liposuction or Facelift After Buccal Fat Removal?

asked 2 years ago by xoxoxo1234 in nj
Latest answer by Sam Naficy, MD
Question viewed 1,736 times
Tags: cheeks, face, jaw line, puffy eyes, scar

I've had buccal fat removal to make cheeks less puffy. I had fat transfer to jaw line and it looked terrible. I had it removed, but unable to get all out due to scarring, etc. I went to 2 doctors for opinions. First doctor said liposuction to the jaw line, and neck. The second doctor said liposuction was virtually useless and that I need facelift and said I do not have enough fat to make difference. Recommendations?

18 answers to Liposuction or Facelift After Buccal Fat Removal?

+3

Revisional facial surgery

You would be best served by a facelift by a very experienced plastic surgeon. Fat injection grafts respond poorly to liposuction because they are fibrous. Unfortunately it is the good tissues that will be removed with liposuction, not the fibrous fat grafts that are deforming your jawline. A volume adjusting facelift will restore volume to your cheeks and enable direct removal of the offending fat grafts. Do not skimp on this next surgery. Your next step will be very critical. more
Brent Moelleken, MD

Beverly Hills Plastic Surgeon
+3

Facial surgery gone astray

I am sorry for what you have been through. You unfortunately demonstrate why buccal fat pad removal is rarely done anymore - you can see very visible indentations in your cheeks and these will look worse as you age. Your fat injections have been overdone and your central neck looks deficient of fat. I would personally recommend a widely undermined facelift and direct sculpting of the fat because in my experience, deformities and contour problems from previous facial surgery can be... more
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+2

A facelift will give you the best result to correct your previous fat grafting.

 I agree with Dr. Moelleken. Liposuction will not really help your problem. See an experienced facelift surgeon who can tell you how he would correct your problem.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+2

Facelift is your best option

You can directly see under the skin to fix the problems going on by doing a facelift and should get a superior result over liposuction alone.  Go get the facelift done if you want things fixed right.  Sincerely, David Hansen, MD
David Hansen, MD

Beverly Hills Dermatologic Surgeon
+1

After buccal fat removal

Your best bet would be to have a face lift with fat injection under the chin and to depressed areas in the upper and lower cheeks
Sam Naficy, MD

Seattle Facial Plastic Surgeon
+1

Liposuction or facelift

A facelift is done to address excess facial skin and laxity in the jowl area. It is also tightens skin of the neck and removes fat deposit in the neck. Liposuction is simply a blind removal of fat in the neck and is not recommended in the face. The aging process of the face removes facial fat volume and it is ill advisable to intentionally remove any fat from the face.
William Portuese, MD

Seattle Facial Plastic Surgeon
+1

Facelift vs Liposuction

As others have said in response to your question, you should have liposuction as part of an open facelift procedure to get the best result. Either procedure alone will limit improvement.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon
+1

Fat grafts and facelift

From the photo you have provided, I would not perform liposuction on the jawline to treat the scar tissue. I would consult with a board certified plastic surgeon experienced in a facelift. Direct exposure with a facelift alllows the surgeon more dimensions to adjust fat, reposition the deeper tissues and tighten skin. Any attempt at further fat transfer or liposuction alone in this area may make it worse.
Andrew Turk, MD

Naples Plastic Surgeon
+1

Facelift and careful liposuction will give the best chance for proper correction

Liposuction alone would carry a high risk of creating lumpiness or irregularities. A facelift together with careful liposuction or direct fat removal would give you the best opportunity to correct the contour of your jawline.  
Michael D. Yates, MD

Huntsville Plastic Surgeon
+1

Liposuction vs. Fscelift for Jawline Issues

The fat grafting and subsequent removal has definitely resulted in scarring. The only way to appreciate the anatomy and correct it is by looking at it directly. A face lift incision should be used. Once the tissues are visualized the decision to placate or elevate the SMAS or use lipstick or a combination can be made. Lipstick alone runs a huge risk of nerve damage. A good surgeon should explain ALL of the options with their risks and benefits.
Christopher L. Hess, MD

Fairfax Plastic Surgeon
+1

Liposuction or facelift for thick jaws from fat injections

Your history is unique enough that a physical exam is necessary to determine what treatment might be best for you. Liposuction might cause a temporary or even permanent damage to a nerve along the jaw which could make it difficult for you to lower that side of the lip when opening the mouth. The asymmetry would be very disturbing. This risk might increase if there is a lot of scarring from the fat injections. A face lift might help support the tissue and create a better jaw line but it... more
Ronald Shelton, MD

Manhattan Dermatologist
+1

A facelift is more invasive than liposuciton

From the picture it appears that a Facelift would allow your surgeon direct access to your troubling areas and give them the most options to enhance your contour. Liposuction would not be able to address some of the contour irregularities with as much precision. I would echo the other experienced plastic surgeon's thoughts and suggest that your plastic surgeon will best be able to give you a plan of action that works in their hands.
Charles Perry, MD

Sacramento Plastic Surgeon
+1

Forget the needle or suction cannula, you need a surgical answer

You need to have the remaining fat in your face repositioned and shaped so it will have a more smooth transition to the neck. In addition you need to have the pre-malar (the area in front of your cheek bones) area built up - probably best done by shift of fat from you anterior face and even a dermal-fat graft (not fat injections) from a donor area. This sort of surgical approach is likely to change the shape of your face and neck and how they relate to each other in a positive direction... more
Nathan Mayl, MD

Fort Lauderdale Plastic Surgeon
+1

You will need to have laser lipo in combination with face lift

Sorry about the bad experience. I have treated few patient with a similar story and I have used laser lipo to remove the excess fat. The reason for the success of the laser lipo in this condition is the that laser lipo uses a small fiber optic and can penetrate through the scar and also melt the small deposit of fat. You will need to have face lift to lift the sagging tissue in combination with the laser lipo.
Kamran Khoobehi, MD

New Orleans Plastic Surgeon
+1

Buccal fat removal

I think what you have at this point very much depends on what you want to accomplish. I must say that the photograph you have provided does not help me form an opinion regarding what you need other than a careful assessment by a competent surgeon. Now you have had two things done. I think it is time to slow down and be very careful. Do your homework. Travel if you must to find a surgeon who makes sense to you. Assess their credentials, study their before and after photos, and see what... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+1

Buccal Fat and Facelift

This presents quite a problem. Liposuction in jaw area is not recommended due to the possibility of injuring a branch of your facial nerve that controls the motion of your lip. Fat transfer to the area where you had buccal fat extraction may be an option. Its difficult to say without examining your face. Best, Dr. S.
Oleh Slupchynskyj, MD

New York Facial Plastic Surgeon
+1

Liposuction or facelift decision needs in-person consult

Your story is quite intriguing, but after having so many operative interventions upon your face, an over the Internet evaluation is a disservice to you and us. You must see in person the plastic surgeons, whether 1 or 5, to let us get an idea of the resultant appearance of you face/neck. I for one can not and will not recommend either a facelift or liposuction or both. Too hard to give a very definitive answer Sorry from Miami
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Facelift or facial and neck liposuction

There is no definitive answer, but I would recommend trying liposuction first if it is the fullness of the area that you find upsetting. If it is the loose skin of the jawline, then a facelift is a better option
Otto Joseph Placik, MD

Chicago Plastic Surgeon

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