Am I a Candidate for a Buccal Fat Pad Trimming?

Question

I am a 29 years old female and have 2 marionette folds on my chin. I've had them since I was a child but they're becoming more prominent with age and I really want to do something as I believe they giving me a 'bulldog cheeks' look. I've made several enquiries and mini facelift seems to be the best solution. I was also told about buccal fat pad trimming as an cheaper and less invasive alternative. Would you recommend it in my case and if not,- what in your opinion would be the best procedure?

Stephen Prendiville, MD · Answer

Buccal fat Pad Removal is a "C" grade procedure in most cases because it leads to a hollowed look that ages poorly. You would be better advised to seek other options.

John Mesa, MD · Answer

Young patients with chubby cheeks and sagging of the facial skin (e.g evident because presence of marionette lines) very likely have enlarged buccal fat pads and weak cheek bones. Buccal fat removal alone will only address the chubbiness but will NOT correct the marionette lines.To improve the saggy facial skin and marionette lines, very likely the patient requires upper cheek enhancement ( generally with fillers). The results of buccal fat removal depends on the cheek bones.

Benjamin Caughlin, MD, FACS · Answer

You have many options. It is all about fat (or volume) in the right places. Buccal fat removal and/or manipulation can be a great and transformational procedure in the right patient.  Oftentimes fat transfer or filler injection in conjunction with this procedure is able to give a more “ideal” heart shaped face. This can make a significant difference in patients as a combo. It may seem counterintuitive to add fat when you say your problem is chubby cheeks. What we do is add volume to the highest and most projected point of the cheek bone and taper it to the lower face. This helps to camouflage overly chubby cheeks.  This is especially helpful in thin patients and in combination with buccal fat pad removal is a powerful maneuver. Liposuction of the jawline and sculpting is also helpful in some patients. It really depends on your specific anatomy. All of this can be done in clinic with some calming medications and local anesthesia. 
I recommend getting a consult with a surgeon who does this procedure frequently to get a full facial analysis to make sure your specific goals are addressed. 
Hope this helps.
Best of luck.

Anil R. Shah, MD · Answer

Buccal fat pad removal is where a surgeon, typically from an inside the mouth approach, removes a specific encapsulated area of fat located in the cheek.  The goal is to contour the face and avoid bottom heaviness and emphasize cheekbones.

It is very difficult to ascertain if a patient is a good candiate for buccal fat removal based on a photograph.  Patients must be selected properly for buccal fat pad removal, as chosing an inappropriate candidate can lead to a premature gaunt look in the face.

Critera to see if candidate for buccal fat pad removal:

1.  Family history of "full" faces-  Families with full faces who age with full faces are likely to benefit from buccal fat removal.  Families whose fuller faces eventually turn gaunt should avoid this procedure
	2.  Buccal fat excess-  There are multiple fat pads in the face.  The key is to determine if buccal fat pad removal is beneficial

Ali Sajjadian, MD, FACS · Answer

Dear Annabelle81,

	 

	Buccal fat pad removal when performed accurately will give the patient a slimmer and an ideal midface contour. Conservative approach in your case will help deal with "marionette" folds.

	 

	Nonetheless, I encourage you to have a physical examination with a surgeon of ample experience who will advise you on supplemental procedures to give you the ideal midface contour.

	 

	The main goal is to spare you from developing a hollow face as you age but at the same time to preserve your natural looks and enhance your facial beauty.

	 

	Thank you for your inquiry.

	 

	Dr. Sajjadian

Ritu Chopra, MD · Answer

Based on your pictures and young age, you don't need much but what you need must be very targeted.  There is fullness in the cheeks, and with such a thin neck, it's not from obesity.  Buccal fat will help, but re-allocation of facial fat with fat transfer or dermal fillers will go along way.

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