Face Shape and Cheeks. Too Round and Flat. Options? (photo)

I would like to look more attractive and younger. I think my face looks too round and flat. I had a buccal fat removal 10 years ago and I'm not sure if its making it worse. My upper cheeks look too flat too and I think I have pre-jowls. What would benefit me, lifts, implants and/or fillers?

Doctor Answers 7

Buccal fat pad reduction?

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Buccal fat pad reduction is a procedure that is not commonly performed but can make sense in the right patient.  It is important to understand the anatomy before undergoing the surgery so that you are well informed.  Normal aging reduces the buccal fat pad volume.  It is true that some people have more volume in their cheeks than others.  However, it is also universally true that that volume will decrease and descend over time.  Removing too much buccal fat can cause premature aging.  It is also important to remember that replacing fat that has been removed is extraordinarily difficult if not impossible.  The main reason is the location of the buccal fat pad.  It usually resides underneath a large muscle that is responsible for majority of the power motions of your chewing.  Once that fat is removed that space collapses.  Once collapsed it is very difficult to find the exact space and to reinsert a substance such as a filler or better yet fat.  One potential solution is to use something like Sculptra.  While I generally do not advocate buccal fat pad removal, I understand why somewhat would want procedures such as this.  I tried to choose my patients very carefully and I also tried to be conservative in the amount of fat that is removed.  Surgeons who trivialized this procedure simply don’t understand how difficult it is to correct deformities that may occur.  The cost of the procedure can run anywhere from $3000-$7000, depending upon your geographic locale.  Please visit with an experienced board certified plastic surgeon.  My best advice is to always be conservative with any buccal fat pad reduction.

Derounding The Face By Skeletal Augmentation

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In attempting to deround a face, there are basic options of either skeletal augmentation, fat extraction or some combination of both. You have already had a buccal lipectomy and do have the benefits of that but it has unmasked some cheek flatness. There is little more you can benefit from by facial fat extraction and no form of facial lifting is going to make your face thinner. This leaves the skeletal augmentation approach. It would be interesting to see how your face shape may change by a combination of cheek and chin augmentation. This should be computer imaged to show their effects separately and in combination. 

Face too round and Flat, what can i do?

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Difficult question to answer without a proper exam. thank you for the pictures posted online though. I would recommend a consult with a BC PS to discuss facial revolumizing or possible chin implant. Good luck!

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Treatment for "flat" face.

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Your situation is why I do not do buccal fat removal.  This creates a disproportion in the face as the person ages.  Your lower third can be improved with a chin implant which fills in the prejowl as well.  I would need to see better photos of your face to give a proper answer to the rest.  Choose an experienced facial surgeon to avoid future problems. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Round flat face

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Your quandary intrigues me. I usually spout out my evaluation and it is very accurate since i am a trained portrait artist. I would have to sit with you and work on the computer to see what you prefer. I wouldnt want to recommend the wrong treatment

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Looking younger and attractive with a round face

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Hi Lyn,


Thank you for sharing your photographs.


I recommend that you seek consultation with experienced surgeons especially that you have had buccal fat pad removal 10 years ago.


It is important to consider the fact that with aging, the buccal fat pad will undergo natural atrophy, so it is risky to over-excise the buccal fat pad.


Based on your photograph, it looks like you could best benefit from specific procedures to add the appropriate volume to your jaw, chin and cheeks while preserving a natural appearance and enhancing your facial beauty.


Best of wishes to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Facial rejuvenation options: volume versus lifting

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Thank you for your question.  You will need to sit down with a few plastic surgeons and discuss what you would like to accomplish.  It will be very important to take some photos and look at them together.  I believe one of the components that would help is addressing your small jaw/chin.  A chin implant could help this as would jaw angle implants.  Another option would be a chin implant and fat grafting to the jaw angle, upper cheeks, and temples.  I suspect the second option would likely be ideal.  I do not think you would gain much from a cheek/jowl lift at this time.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

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.