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, MDBuccal Fat Removal Specialist Plastic SurgeonNew 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.

Young patients who are not overweight but have always had a full or round face and wish to achieve a slimmer appearance may benefit from plastic surgery procedures, depending on their ultimate goal. Improvement of a full or round face, especially when smiling, is typically achieved with buccal fat removal. This procedure removes the pockets of fat in the lower anterior cheek that cause the face to look chubby, particularly when smiling. If a patient has a very wide jaw and desires a more V-shaped appearance, combining Botox injections to the masseter muscles with buccal fat removal can help create a narrower, more V-shaped face. However, if Botox to the masseter is performed alone, it may make the face appear even chubbier when smiling if the patient has enlarged buccal fat pads. Chin liposuction is a plastic surgery procedure designed to remove fat beneath the chin, but it does not address facial roundness or chubbiness. I hope this information is helpful! Sincerely, John Mesa, MD Buccal Fat Removal Specialist Plastic Surgeon New York - New Jersey - Miami.

Individuals with a healthy body and average shape who were born with chubby cheeks and a double chin could benefit from cosmetic plastic surgery procedures. Chubby cheeks are often due to enlarged buccal fat pads, making buccal fat removal the preferred procedure to address this issue. Removing the excess buccal fat pads can transform a chubby face into a more chiseled, V-shaped appearance, offering permanent results and a significant boost in self-esteem. Double chin is the result of accumulation of fat under the chin. There is a minimally invasive procedure called Kybella, a medication that dissolves fat where it is injected, that could be used to treat that area. It also is typically used for very small double chins. However, Kybella cannot provide a more defined jawline and neck. Additionally, Kybella is associated with significant downtime, including swelling and bruising that can last several weeks. For patients with small double chins who seek to achieve a sharper jawline and correction in this area, extended chin liposuction is the procedure of choice. In my hands, this procedure is performed under local anesthesia, with minimal downtime, and delivers excellent results that surpass those of Kybella. When combined with buccal fat removal, it creates a very chiseled facial appearance. I hope this helps! Sincerely, John Mesa, MD Buccal Fat Removal Specialist Plastic Surgeon New York - New Jersey - Miami.

When someone feels that their facial features make them look very childish, it’s often due to a combination of two factors: enlarged buccal fat pads and a lack of high cheekbone definition. Younger faces tend to look cherubic, meaning they have chubby cheeks and round faces. They also lack the definition of the cheekbones. In contrast, more mature and attractive faces typically have a chiseled, V-shaped appearance with no chubby cheeks, high cheekbones, and well-defined features. One of the most common procedures that allows patients to correct the roundish appearance of the face and achieve more contour is buccal fat removal. This plastic surgery procedure removes the buccal fat pads, which are deep pockets of fat in the lower anterior cheeks that contribute to a round, chubby appearance and can obscure the cheekbones. Additionally, for those with not high cheekbones, cheekbone augmentation with fillers can further enhance the facial appearance, making it look more mature and attractive. The combination of buccal fat removal and cheekbone augmentation ultimately results in a very chiseled, attractive, grown-up appearance without making the face look aged. This is a very common procedure among celebrities, models, and TV stars. The video below can help someone determine if they are a candidate for buccal fat removal. It's important to note that rhinoplasty won't affect the overall changes in facial fullness or roundness. While chin correction might be indicated for those with very small chins, it won’t significantly impact the overall facial fullness appearance neither. If someone is interested in addressing these physical characteristics, my recommendation is to consult with a board-certified plastic surgeon specializing in facial contouring. This consultation will help determine the best procedures to achieve the desired outcome. I hope this helps! Sincerely, John Mesa, MD Buccal Fat Removal Specialist Plastic Surgeon New York - New Jersey - Miami.

A good solution for correcting asymmetrical results after buccal fat removal depends on the patient's concerns and physical findings. If asymmetry occurs after buccal fat removal, it means that one cheek may appear fuller while the other is more defined or chiseled. In this case, the patient must decide which appearance they prefer. If the patient favors the more defined side, the most common strategy to correct the asymmetry is to return and remove more buccal fat from the contralateral side if any buccal fat remains. However, if 100% or all the buccal fat was removed from both sides, there’s no reason to attempt further removal, as there would be nothing left. In these cases, a solution could be to reduce the definition of the more chiseled side. Another important factor to consider is whether the patient has asymmetrical cheekboness. Often, when a patient detects asymmetry in their buccal fat removal results, it's because they had asymmetrical cheekbones to begin with, where the side that appears more chiseled may have higher cheekbones. Therefore, if asymmetrical cheekbones are present, their asymmetry might be addressed accordingly. In conclusion, the patient should discuss with their plastic surgeon the potential causes of the asymmetry and make adjustments based on their preferences. I hope this helps! Sincerely, John Mesa, MD Buccal Fat Removal Specialist Plastic Surgeon New York - New Jersey - Miami.

To reduce facial fullness, it's important to understand the primary cause of this physical trait. When someone smiles and their face appears quite round or full without definition, the fullness is often due to large buccal fat pads. While prominent masseter muscles can also contribute, they are not the primary cause. Therefore, if someone wishes to reduce facial fullness, the procedural option is buccal fat pad removal. By removing the excess buccal fat pads, the face will appear more contoured, with better definition, and will no longer have a chubby appearance, especially when smiling. Botox injections to the masseter muscle can decrease the fullness of the masseter, located in the lower posterior section of the face, which may make the face look thinner and more V-shaped in individuals without enlarged buccal fat pads. However, if someone undergoes masseter Botox injections and has chubby cheeks, this can make the face appear even chubbier. Reducing fullness in the lower posterior face can accentuate the appearance of enlarged buccal fat pads, leading to an overall chubbier look. I hope this helps! Sincerely, John Mesa, MD Buccal Fat Removal Specialist Plastic Surgeon New York - New Jersey - Miami.