I had *bolsas de bichat* removed (I think that's Spanish for buccal fat pads) a decade ago. Now I look completely different. My face is flat and not as attractive. What can I do to look like before? What's the best option: implants, fillers, or any other ideas? If using Radiesse, how much would be necessary to look like before?
How Can I Restore my Cheeks 10 Years After Buccal Fat Removal? (photo)
Doctor Answers (5)
To replace lost volume in your cheeks, I would recommend the use of a dermal filler. For generalized volume, Sculptra is a great product. If you have specific areas that need pin point treatment, then a product such as Juvederm will work well.
Restoring cheeks after fat removal.
Restoring cheeks after fat removal is a common question unfortunately. Your story is why I tell patients not to do this since they need the fat as they grow older to fill out the face. I would need to examine your face to tell if fillers would help and how much it would take to correct the problem. Fat grafting can be used but has its own problems in the face such as irregularities and lumps.
Fillers of Volume Enhancers can Augment Cheeks
Removal of the buccal fat pads can cause some hollowing in the cheeks, which can be an issue for some patients. I like to treat this area with fillers or volume enhancers.
Fillers (Restylane, Juvederm, Perlane, Radiesse) show immediate results and last from 6 to 12 months depending on the filler. Radiesse lasts the longest for most people with results fading at about a year. The down side is that Radiesse is not easily reversible. Most patients need one or two syringes to fill the cheeks. Since the improvement is immediate we will often inject one syringe, give our patients a mirror, and make a determination if a second syringe is needed.
Volume enhancement is performed with fat transfer or Sculptra. We routinely use Sculptra. Although it does not provide the instant gratification of immediate results, it does have better longevity, lasting a couple of years for most patients.
Hope that helps.
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Restoring volume to cheeks
The options for filling the cheeks out include placing cheek implants into the malar or submalar space to give more volumetric augmentation to the cheeks. This is a permanent solution. Fillers are usually a temporary solution and will require repetitive injections.
Restoring Facial Fat Loss
Without an exam it is impossible to advise exactly. However, fat or filler injection can usually help significantly. Both would usually require several injections to get the contour just right. This is especially true of fat if you want it to be permanent. If not fat, I generally use Radiesse since it has a good longevity.
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