Buccal Fat Removal or Facelift? (photo)

Hello, I'm in my mid 20's and within the past 6 months have developed a sagging left cheek. It forms a small fold over my top lip and actually feels quite bothersome, like a heavy feeling on my face. Its has also formed a second line around the innermost part of my mouth when I smile and I worried this is going to turn into a deep wrinkle. I have always had very big cheeks and am wondering if either of these procedures would be helpful for my problem. Thank you very much for any info.

Doctor Answers 22

Facelift or buccal fat removal.

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Neither of these will solve the issue.  You have a muscle pull pleat and a lovely face.  You will need the fat in your cheeks as you age! Please do  Nothing.  Do not let anyone talk you into surgery. 

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews


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You are too young for either of the procedures in my opinion. Definitely not a candidate for a face lift. Buccal fat pad removal ia also unlikely to give you any worthwhile change. I advise you against either procedure.

Treatment for pleats at corners of lips? (photos)

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In agreement with my esteemed colleagues who have already offered considerable wisdom, HA filler is the most I would consider, and then, only if bothering you significantly.  

Sagging Cheeks

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You have an unusual problem that is not caused by aging but by facial expression and genetics. Buccal fat pad excision is inappropriate and would likely make things worse. A facelift might give you some improvement, but is not indicated as a prophylactic measure. At the very most, I would suggest seeing a Board Certified Plastic Surgeon to consider injectable fillers.

J. Brian Boyd, MD
Rolling Hills Estates Plastic Surgeon
5.0 out of 5 stars 5 reviews

Natural lines of smiling, not age wrinkles

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Thank you for your question.  You have a very lovely smile, excellent skin quality, and a very healthy and natural look.  I do not recommend that you do anything at all.  If your problems worsens, see your medical doctor to see if there may be something else going on, but otherwise, I don't think surgery is in your best interest at this time.

Looking good at your age

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Thanks for posting your question and photos. Having performed numerous facelift and Buccal fat pad reductions procedures you are not a candidate to benefit from either of these surgical procedures. It appears you have nice skin and bone structure and good kip volume. At this time I would leave things be and focus on good skin care. 

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 95 reviews

Facelift in 20s

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   I would not recommend a surgical procedure for your issues at your age.  Depending upon exam, filler may help alleviate your issues or improve them.  Kenneth Hughes, MD Los Angeles, CA

Sagging Cheek For Buccal Fat

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We always want what we don't have.  If we don't have volume, we want fillers.  If we do have volume, we want buccal fat.  In your case, you would best be evaluated in person by an experienced doctor to determine what is the source of your aesthetic concern, if any.  Buccal fat excision can be helpful in contouring faces, but it must be selected for in the right face.  

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 171 reviews

Buccal Fat Removal of Facelift?

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Buccal fat removal or faceliftis inappropriate for your problem and at your age you may need your buccal fat. I would suggest that you try a filler to see if that improves things for you.

Neither Buccal Fat Removal or Facelift

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You do not appear to be a candidate for either a facelift or buccal fat pad removal. The wisest course may be to do nothing. However, fillers may be helpful. Consult in person with 3 - 4 experienced and expert board certified plastic surgeons to review your options.  

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.