I have overly thick pads of fat at the "front" of my cheeks; when I diet I lose from the "back", around my cheekbones, but never at the front. I hate the way they look, and also the way they feel; they seem to retain water at times, and then they feel "swollen", although their appearance doesn't change much. I'm well within my ideal weight range, and don't want to lose much more. Both my parents have heavy, jowly faces, so I'm pretty sure I know where this is going eventually. 28, female. Any suggestions?
Answer
You should schedule a consultation with a board-certified plastic surgeon. You might get referred to them via a physician who takes care of you. If your volume were indeed fat, and you have it removed, you might be unhappy when you're older and you can't maintain a young appearance because of the hollowness of the cheeks. Liposuction might create problems in the face which are not common elsewhere, such as nerve injury, parotid duct injury or irregular indentations. If it is done, it should be done by a very experienced and conservative surgeon. The cause of your fullness, might not be fat volume. It might be partially or completely due to an enlarged muscle that we use to chew food. Such a hypertrophic masseter muscle could be made flatter by an expert treating it with botulinum toxin (Botox or Dysport). You would need an examination to determine three-dimensionally the cause of your unhappiness. Don't rush into any treatment and make sure you understand all the possible risks. Good luck.
Dr. Ron Shelton, MD
Board Certified Plastic Surgeon
Answer
Thank you for your question and your photo. Liposuction in the face is most effective in the neck and under the chin, and decidedly less precise for contouring the cheeks. Your neck and jawline are already quite attractive. Direct excision of buccal fat pads, done through incisions inside the mouth, might be a reasonable option for sculpting your cheeks.
Dr. Joshua D. Zuckerman, MD, FACS
Board Certified Plastic Surgeon
Answer
You look well! Although further photographic views are necessary to accurately answer your question, midcheek/malar area liposuction is unusual and highly prone to contour irregularities as complications. Indeed, most patients are seeking increased volume to these areas (fat transfer, cheek implants, etc). With my limited assessment, I would recommend you consult an American Board of Plastic Surgery Surgeon, but proceed with caution......
Dr. Marshall T. Partington, MD, FACS
Board Certified Plastic Surgeon
Answer
In your photo, you're smiling which makes evaluation impossible. I almost never suction cheeks because loss of fat with age occurs and suctioning it makes little sense. Sometimes the buccal fat pad can be decreased in size but these are very unusual cases.
Dr. Vincent N. Zubowicz, MD
Board Certified Plastic Surgeon
Answer
I would advise against facial fat liposuction, as there are unecessary risks with surgery. Dimpling and dynamic contour irregularities can cause secondary deformity. Stick with tried and true techniques.
Dr. Raffy Karamanoukian, MD, FACS
Board Certified Plastic Surgeon
Answer
Correction of full cheek can definitely be achieved with a well planned and executed surgery. Liposuction of the cheek areas needs to be done in a precise fashion, so as not to produce irregularities of the cheeks. This area is very unforgiving and requires expertise and experience to achieve the desired result. In addition, on occasion a very specific area of the cheek, buccal fat pad, needs to be addressed. Make sure that your surgeon carefully assesses your cheek anatomy to choose the best surgical approach.
Dr. Boris M. Ackerman, MD
Board Certified Plastic Surgeon