Too much buccal fat or overdeveloped masseters? (Photo)

Question

I have always had "fat" cheeks despite being very lean and athletic. People used to call me the Cabbage Patch Kid because of my cheeks, which has made me self-conscious about having photos taken or going on camera for anything. I'm 34, so apparently these cheeks aren't going anywhere with age. Would buccal fat removal or Botox in my masseters help me achieve a more sculpted look?

Ali Riza Öreroglu, MD · Answer

Based on your photos, you do seem like you have a quite a bit of buccal fat, and can benefit from a buccal fat removal procedure. A masseter botox treatment can also provide slimming in the lower face if you have overdeveloped masseter muscles. It is best to consult a board certified facial plastic surgeon in person and discuss your options after a physical examination.
Hope this helps,Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey

Thomas S. Taylor, FACS · Answer

From your photos it appears you are a great candidate for the buccal fat removal procedure.  You definitely have an excess of fat in the area of the buccal fat pads. You may have excess superficial fat as well which is why an examination is important. In cases like yours I prefer to start with buccal fat removal as the risks are extremely minimal and the recovery is rapid. It is a quick and easy office-based procedure and can be done under local anesthesia alone or with very mild sedation. Make sure you choose a surgeon with a lot of experience in this performing this particular procedure.  I hope this information helps! Thomas Taylor, MD, FACSPasadena, CA

John Mesa, MD · Answer

Prominent cheeks specially in the lower face could be secondary to relative excess of bucal fat pad.Overdeveloped masseters usually don't cause a "fat" cheek.  They usually make the lower face/ jaw to look wider and or square. Buccal fat pad excision can decrease the fullness of the cheeks, but could cause the face to look a little bit aged if there is excess of skin. Buccal fat pad removal would be done simultaneously with cheek augmentation with fillers ( like voluma or radiesse) to accentuate the cheek, give a more chiseled appearance and improve any skin excess that could cause increase in jowls and or marionette lines.Patients interested in cheek reduction with buccal fat pad excision should make a consultation with a Board Certified Plastic Surgeon specialized in procedures on the faceJohn Mesa MDBoard Certified Plastic SurgeonNew York City (#NYC) & New Jersey (#NJ)

Stephen Weber MD, FACS · Answer

It does look like you have excess buccal fat but nothing replaces in an person examination. Ensure that if you have this procedure done that your surgeon has the necessary experience. Buccal fat removal, if overly aggressive, can come back to haunt you in the future as you age. It's a fine balance between giving you the look you desire now and maintaining adequate volume in your cheeks as you age. Best.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

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