4 years post buccal fat removal and cheek liposuction - Should I get cheek liposuction again? (Photos)

Just based off your side profile is limited in our assessment for all the things you listed you want to correct - ideally need frontal views, other side profile, bird's eye, oblique views.. But let's try to assess what we can from the limited photos. The cheeks have some fullness (can benefit...

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...