John Mesa, MD

When patients in their early 30s experience facial sagging, particularly in the jowl area and a slight downturn of the mouth, it could be due to multiple factors. The fullness in the lower anterior cheeks contributing to jowls could be related to enlarged buccal fat pads, while the downturn of the mouth corners might result from excess skin or skin laxity.

Because these issues may stem from different causes, no single plastic surgery procedure is likely to address all concerns simultaneously. A combination of treatments might be necessary. For example, buccal fat removal could reduce fullness in the lower anterior cheeks and improve the appearance of jowls, especially in patients with minimal skin sagging or good skin elasticity.

The downturn at the corners of the mouth could be caused by muscle imbalances, which might be temporarily improved with Botox injections to weaken the muscles that make the corners of the mouth pull down, allowing the muscles that elevate the corners of the mouth to lift the corners. For excess skin contributing to marionette lines, options could include skin-tightening procedures like CO2 laser or radiofrequency-based treatments like FaceTite. Additionally, fillers might be used to camouflage these lines and enhance their appearance.

It is advised to seek consultation and evaluation with a board-certified plastic surgeon specializing in these procedures to determine what cosmetic procedures would best fit your needs.

I hope this helps!

John Mesa, MD
Buccal Fat Removal Specialist Plastic Surgeon
New York - New Jersey - Miami.

In patients with facial asymmetry, where one cheek appears sculpted and hollow like a model while the other is fuller, asymmetric buccal fat removal could potentially be performed to create a more balanced appearance. However, this approach is suitable only when the rest of the facial structures are symmetrical. In cases where asymmetry is linked to differences in the cheekbone or jawbone structure, it is crucial to address those bone asymmetries first. Why? Correcting the bone structure allows for a clearer assessment of the impact asymmetric buccal fat removal will have. For such patients, treatments like jaw fillers and cheekbone fillers can help achieve a more symmetric bone structure. Once this foundation is established, the buccal fat removal can be tailored to remove the appropriate amount of fullness from the fuller side, ensuring the best possible outcome. I hope this helps! John Mesa, MD Buccal Fat Removal Specialist Plastic Surgeon New York - New Jersey - Miami.

People born with chubby cheeks and significant facial sagging may require multiple plastic surgery procedures to achieve a slimmer, tighter, and more youthful appearance. Fullness in the lower cheeks or chubby cheeks is typically addressed with buccal fat removal, a procedure that eliminates the deep pockets of fat responsible for this condition. Ideally, the patient should have high cheekbones to achieve the best results. For younger individuals with sagging skin, this often suggests underdeveloped high cheekbones. A lack of prominent cheekbones is associated with skin sagging, which can make the face appear older. In such cases, cheekbone augmentation, usually with fillers, is a solution to improve the skin’s appearance and reduce sagging. However, a small percentage of young individuals may experience severe lower face sagging despite having high cheekbones. For these patients, skin-tightening procedures like FaceTite can be effective in addressing this concern. For those dealing with chubby cheeks, lack of high cheekbones, and lower face sagging, a combination of buccal fat removal, cheekbone augmentation with fillers, and FaceTite can significantly enhance the facial appearance, resulting in a more youthful, chiseled, and defined look. I hope this helps! Sincerely, John Mesa, MD Buccal Fat Removal Specialist Plastic Surgeon New York - New Jersey - Miami.

Without a photograph of the face in question that has undergone peri-oral liposuction and buccal fat removal, it’s challenging to recommend additional cheek slimming procedures. To provide the best advice, please consider updating your question by uploading a picture of your face. Thank you for your time.

Facial asymmetry is not an uncommon physical finding where one side of the face appears smaller or larger than the other. This asymmetry is often due to differences in the soft tissues and bony structures of the face. To correct asymmetry, it's crucial to identify the underlying cause and address it appropriately. One common cause of facial asymmetry is a difference in the projection of the cheekbones. When one cheekbone is smaller than the other, unilateral cheekbone augmentation with fillers can help create a more symmetrical facial appearance. If the asymmetry is due to one side of the jaw being smaller than the other, either jaw augmentation on the smaller side with fillers or jaw volume reduction on the larger side with Botox injections to the masseter can also improve symmetry. Regarding soft tissues, asymmetric buccal fat pads are a frequent cause of facial asymmetry. Buccal fat pads are pockets of fat in the lower cheeks that contribute to facial fullness. If one buccal fat pad is larger than the other, it can make that side of the face appear fuller. In such cases, unilateral or asymmetric buccal fat pad reduction or removal can help address the asymmetry. In summary, achieving a more symmetrical face requires identifying the specific causes of asymmetry and addressing them accordingly with one or multiple plastic surgery procedures. I hope this helps! Sincerely, John Mesa, MD Buccal Fat Removal Specialist Plastic Surgeon New York - New Jersey - Miami.