Facial fat reduction or what is the recommendation? 23 yo male with really saggy face. (photos)

Since I remember I have had prominent nasabial folds and tear throughs. Years before they werent as saggy as today. I changed my lifestyle and I started working out so I lost plenty of bf. I am at 15-16% now and I'll try to get to 10-12%. My main issue is with my lower cheeks. I want my face to look firmer and more masculine. I was adviced to consider buccal fat removal. I would appreciate your answer as this has really concerned me. I am also not sure if it has to be more with my bone structure

Doctor Answers 2

Facial fat reduction

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What I see based on the photos is some facial lipoatrophy and thinning of facial structures with weight loss.  First thing is that there is nothing wrong with your face..this is how your face is.  As far as what to do..i would definitely NOT recommend buccal fat pad removal.  This will leave you more hollow.  If you goal is more firmer look, I would consider facial volume augmentiaon first.  This can be fat grafting, sculptra, voluma or some other fillers to help add volume to the cheeks to make them more fuller.  Hope this helps. Good luck.
Dr Vasisht


Voorhees Plastic Surgeon
5.0 out of 5 stars 94 reviews

What is the recommendation? 23 yo male with really saggy face = very likely cheek augmentation #buccalfatremoval #cheek implants

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Patients with saggy lower face, prominent nasolabial folds and chubby lower cheeks usually have a combination of physical findings. 

Chubbiness of the lower anterior cheeks is usually secondary to fullness of the buccal fat. This could be removed with buccal fat removal (bichectomia)

Sagginess of the mid face and lower face associated with prominent nasolabial folds at early age ( 20s) , with normal BMI and normal %BF is usually secondary to  lack of cheek bone prominence. In my practice when I have a patient with these physical findings, I usually recommend cheek bone augmentation with either soft tissue fillers like voluma or cheek implants. Fillers are a good option when the patient requires low # of syringes. IF the patient needs high volume of fillers, is it more cost effective placing cheek implants. I do recommend highly medpor cheek implants over silicone implants due to their multiple advantages.



John Mesa, MD
New York Plastic Surgeon
4.9 out of 5 stars 141 reviews

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