Liposuction or Facelift After Buccal Fat Removal?

I've had buccal fat removal to make cheeks less puffy. I had fat transfer to jaw line and it looked terrible. I had it removed, but unable to get all out due to scarring, etc. I went to 2 doctors for opinions. First doctor said liposuction to the jaw line, and neck. The second doctor said liposuction was virtually useless and that I need facelift and said I do not have enough fat to make difference. Recommendations?

Doctor Answers 19

Revisional facial surgery

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You would be best served by a facelift by a very experienced plastic surgeon. Fat injection grafts respond poorly to liposuction because they are fibrous. Unfortunately it is the good tissues that will be removed with liposuction, not the fibrous fat grafts that are deforming your jawline.

A volume adjusting facelift will restore volume to your cheeks and enable direct removal of the offending fat grafts.

Do not skimp on this next surgery. Your next step will be very critical.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Facial surgery gone astray

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I am sorry for what you have been through. You unfortunately demonstrate why buccal fat pad removal is rarely done anymore - you can see very visible indentations in your cheeks and these will look worse as you age. Your fat injections have been overdone and your central neck looks deficient of fat.

I would personally recommend a widely undermined facelift and direct sculpting of the fat because in my experience, deformities and contour problems from previous facial surgery can be improved best under direct vision.

Solutions for an unsuccessful buccal fat removal

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Hi Xoxoxo1234,


It is such an unfortunate situation you are enduring and I truly sympathize with you.


The good news is that your photograph shows good details to make a facelift and a well planned fat injection in the depressed areas the appropriate combination to best resolve the case.


Preserving the NATURAL traits of your facial features is crucial. Therefore, it is highly recommended that you seek a consultation with a well experienced surgeon; a revision of such a nature requires an extensive mastery of the necessary procedures.


Thank you for sharing your photograph and your concerns.


Best of Luck.

Dr. Sajjadian

A facelift will give you the best result to correct your previous fat grafting.

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 I agree with Dr. Moelleken. Liposuction will not really help your problem. See an experienced facelift surgeon who can tell you how he would correct your problem.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Facelift is your best option

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You can directly see under the skin to fix the problems going on by doing a facelift and should get a superior result over liposuction alone.  Go get the facelift done if you want things fixed right. 


David Hansen, MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

After buccal fat removal

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Your best bet would be to have a face lift with fat injection under the chin and to depressed areas in the upper and lower cheeks

Liposuction or facelift

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A facelift is done to address excess facial skin and laxity in the jowl area. It is also tightens skin of the neck and removes fat deposit in the neck. Liposuction is simply a blind removal of fat in the neck and is not recommended in the face. The aging process of the face removes facial fat volume and it is ill advisable to intentionally remove any fat from the face.

Facelift vs Liposuction

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As others have said in response to your question, you should have liposuction as part of an open facelift procedure to get the best result. Either procedure alone will limit improvement.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Fat grafts and facelift

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From the photo you have provided, I would not perform liposuction on the jawline to treat the scar tissue. I would consult with a board certified plastic surgeon experienced in a facelift.

Direct exposure with a facelift alllows the surgeon more dimensions to adjust fat, reposition the deeper tissues and tighten skin.

Any attempt at further fat transfer or liposuction alone in this area may make it worse.

Facelift and careful liposuction will give the best chance for proper correction

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Liposuction alone would carry a high risk of creating lumpiness or irregularities. A facelift together with careful liposuction or direct fat removal would give you the best opportunity to correct the contour of your jawline.


Michael D. Yates, MD
Huntsville Plastic Surgeon

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.