What can I do about the fat on the bottom front part of my face? (photos)

Hi and thank you for your question!
Facial pain as you describe is usually not improved with surgical intervention.  Some of what you are experiencing could be related to your skin irritation and acne.  It could also be related to the chewing muscles.
While buccal fat pad excision can help mid-face fullness in some cases, it can also result in a hollowed look that is very difficult to correct.  I would recommend in person evaluation by a facial plastic surgeon.  The goal would be to assess the amount of skin edema present due to the acne and irritation, evaluate the buccal fat pad, and also your masseter muscle.  I believe a combination of skin care, possible botox therapy to the masseter muscle with or without conservative buccal fat pad excision are all reasonable treatment options.
I hope this helps and I wish you luck.

Thanks,

John Frederick