Buccal Fat Removal or Face Liposuction? (photos)

Question

I've always hated my "chubby cheeks" and as I've gotten older my cheeks have gotten "chubbier" with my body staying thin... I would like to have a thinner face that fits my body better, with or without more defined cheek bones. More specifically an oval rather than round facial appearance. I am a 20-year-old: 5'8" tall and 130 pounds, which procedure would I have a better outcome with?

Joubin Gabbay, MD · Answer

I think you are an excellent candidate for buccal fat removal. Your overall jawline contour is very nice, you just have a little bit of cheek fullness. Removal of the buccal fat will definitely improve your facial contour. As the other docs here point out, liposuction of the cheeks is a very bad idea and can result in significant disfigurement. I generally reserve liposuction in the face to underneath the chin and around the neck.It is very important that you seek a plastic surgeon who is certified by the American Board of plastic surgeryAnd has extensive experience in this procedure.I wish you the best. Dr. Gabbay.

John Mesa, MD · Answer

Achieving a chiseled, less chubby, face requires to address multiple factors in the face and the body composition to achieve that goal. 
Some of the factors that may need to be addressed to achieve a slimmer / chiseled face generally are:
-Lower anterior cheek fullness: this could be addressed surgically with buccal fat pad removal
-Lower posterior cheek fullness: this could be achieving my treating the masseter muscle ( a masticatory muscle) with Botox. The masseter muscle gives bulk to the lower posterior cheek fullness at the level of the angle of the jaw bone
-Overall body fat: weight loss to achieve a normal or low normal weight for the height ( normal BMI) is a must. (most models with chiseled face have  are "skinny" and therefore have a BMI in the low normal range)
-Anterior and lateral cheek bone projection: lack of cheek bone projection won't allow to have a chiseled appearance, event if the above factors are achieved. Therefore, it someone has not good cheek bone projection, he or she may require cheek augmentation/ enhancement with either soft tissue fillers like voluma or cheek implants
-Saggy facial skin: young people usually doesn't have saggy facial skin. Patients in the 30s or 40s may have some aging related sagginess that may be improved with soft tissue fillers
Patients interested in determining if buccal fat pad removal may help to achieve a chiseled face should make a consultation with a Board Certified Plastic Surgeon specialized in plastic surgery procedures of the face

Edward J. Gross, MD · Answer

It is best to meet with a board certified facial plastic surgeon in person for facial assessment and recommendations. Cheek liposuction should not be considered an option. Men and women who are otherwise in great physical shape can have unwanted fat deposits in the face that may not reflect the maturity or healthy vitality they feel within. People who are bothered by chubby or "hamster" cheeks know that facial fat is often unrelated to body fat. In fact, fat that accumulates in the cheeks, called buccal fat, often has a genetic component, making it resistant to moderate weight loss. Surgical buccal fat removal is a minimal-downtime procedure that can yield significant changes in a person's profile.

Ariel N. Rad, MD, PhD, FACS · Answer

Hello!Although I'd like to see your entire face to see what procedures might suit you best, suffice to say that buccal fat removal will give you the safest and most predictable result with minimal down time.  Buccal fat removal is a straight forward procedure to reduce chubby cheeks and chisel or define the lower face. It's quite comfortable to undergo and can be done with local anesthesia in the office (no need for general anesthesia). The incision is small (about an inch) and completely hidden inside the mouth which makes it a virtually scarless procedure. The risks are very low and recovery is just a few days. So you could have the procedure on a Thursday, take Friday off for a long weekend and expect to go back to work or school by Monday. I don't recommend liposuction of the face above the jawline under any circumstances because of the important nerves and muscles that would be damaged. Nerve damage could result in unnatural and weakened facial movements, drooling, difficulty speaking or smiling, etc., and it would take 6 or more months to resolve.  Neck liposuction by a board certified plastic surgeon is fine. But if you've ever received a recommendation for facial liposuction then I would not go back to that person!Full face photos are important to see how chubby cheek reduction might influence your upper face. This is important because making your lower face appear smaller may accentuate your upper facial features (i.e. make them look a bit larger). Therefore, I plan multi-procedure procedures in order to create the best facial balance and proportion. All the best in your search!- Dr. Rad

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