Facial lipo and buccal fat removal didn’t work - What can I do to remove the fat for good? (photo)

The deformity looks like a mound, a micro liposuction with surgical net should be a good option to resolve the issue

It does not appear that reduction of buccal fat would make much of a difference in your profile. However, liposuction of the neck and jowls with skin tightening (ultrasound, radiofrequency, J plasma) would create desired improvement. Good luck.

Assuming you are talking the slightly softer mound/bulge that is just above your lip but under your nasolabial fold, I wouldn't be 100% sure that that is NOT filler because that blueish/grayish hue and soft appearance is classic for filler and also one does not naturally have fat in this...

You may be a candidate for buccal fat pad reduction and/or lower facial liposuction to improve contour and definition. This can only affect your non-smiling face and will not change the amount of fullness when you smile. Surgery has minimal effect on dynamic changes of the face when people animate.

To address the fullness in your face and achieve the "V" shaped jawline you desire, there are a few different options. First, it would be helpful to measure the thickness of the subcutaneous fat tissue using ultrasound. If there is excess fat, methods like Vaser liposuction (Vaserlipo) can be...

There are several things here that can be considered. We can look at your masseter muscle, the jaw bone, the cheek bone, and the buccal fat. Each of these can be considered to improve symmetry. These are common procedures in my office.