How do I get rid of fat in my lower cheeks? (photo)

Question

I have a slim face but have excess fat in my lower cheeks. I want to get rid of it but don't know how. I've already done master Botox 3 times, which helped with my pronounced jaw and clenching, but hasn't helped with the excess bulging fat. When I lift my skin in this area it looks so much better. Someone told me to do Kybella or buccal fat removal, but I’m not sure that will solve the issue or is worth it given the risks. I am 23.

Ella Fedonenko, MD · Answer

Injecting fillers(Voluma or Restylane Lyft) into the cheeks area will help with minimizing lower face fullness by creating a lifting effect similar to what you see when you lift skin in that area.

Nick Slenkovich, MD · Answer

Hello, I'm Lauren, the aesthetics injector at Colorado Plastic Surgery Center. It sounds like you're experiencing a common concern that many patients face. Kybella can be an excellent non-surgical option to address this. It’s an injectable treatment that works by breaking down fat cells and is typically used under the chin but can also be applied to areas like the lower cheeks. Kybella may require a few sessions to achieve your desired results, and while it’s generally well-tolerated, some swelling and discomfort can occur, with results taking time to show fully. For personalized recommendations, it’s always best to consult with your provider to determine the most suitable approach for you!

Jonghyun Hong, MD · Answer

Hello,
This is Dr. Hong from Seoul, Korea. After reviewing your picture, I notice slight puffiness around the mouth and in the front-lower cheeks, as well as hollowness in the side cheeks, creating what we refer to as a "peanut shape."
Based on this picture alone (and keeping in mind that the reality may differ), there are two possible options to consider:
1. Lower Cheek Liposuction: By reducing the volume in the lower cheeks, the face will achieve a more defined, V-shaped contour.
2.Fat Transfer to the Side Cheeks: Adding volume to the side cheeks through fat transfer will give your face a more rounded and smoother appearance.
I strongly advise against masseter Botox. Over time, as the masseter muscle shrinks, it can lead to sagging in the lower face, potentially causing what is known as “bulldog cheeks,” where the cheeks gather around the mouth.
I hope this information helps you in making a well-informed decision for your future treatments.
Warm regards,Dr. Hong

Michael P. Morrissette, DDS, FACS · Answer

You have a beautiful and the fullness that you have is mostly due due to the bony structure or prominent mandibular angles. To provide a slimmer appearance if that is your goal then you would need to consider reducing the width of the mandibular angles. Some people would try Botox to the masseter muscle or lower facial liposuction, but the underlying bone is what determines the lower facial width.

Anna Chacon, MD, FAAD · Answer

When considering options for reducing excess fat in the lower cheeks, it's important to weigh the benefits and risks of each procedure. Here are some potential options:

Kybella (Deoxycholic Acid Injections): Kybella is FDA-approved for reducing submental fat (under the chin), but it has also been used off-label for other areas with localized fat deposits. It works by breaking down fat cells, which are then naturally eliminated by the body. However, results can vary, and multiple treatments may be necessary. It's important to consult with a skilled practitioner to determine if this is suitable for your specific concerns.

Buccal Fat Removal: This surgical procedure involves the removal of buccal fat pads from the lower cheeks, which can help contour the face and reduce fullness. While it can provide a more sculpted appearance, it is a more invasive option with associated surgical risks. Additionally, it's important to consider the long-term effects, as excessive fat removal may lead to a gaunt appearance as you age.

Facial Contouring with Fillers: Sometimes, adding volume to other areas of the face with dermal fillers can create a more balanced appearance, which might reduce the perception of fullness in the lower cheeks.

Ultrasound or Radiofrequency Treatments: Non-invasive treatments like ultrasound (Ultherapy) or radiofrequency (Thermage) can help tighten skin and improve facial contours by stimulating collagen production. These can be a good option for those looking for non-surgical interventions.

Consultation with a Specialist: Given your age and the specific nature of your concerns, it's crucial to consult with a board-certified dermatologist or plastic surgeon. They can assess your facial structure and recommend a personalized treatment plan that aligns with your aesthetic goals while minimizing risks.

Ultimately, the best approach depends on your individual anatomy and desired outcomes. A thorough consultation with a qualified professional can help you make an informed decision.

Camille Cash, MD · Answer

I encourage you to begin by visiting with a board certified plastic surgeon in your area for a consultation.    An exam is needed to give the proper recommendation.  Be aware of the risks of removing too much fat which can age the face.

Leonard Grossman, MD · Answer

That one photograph that you submitted is not nearly enough to make a judgment call as to what needs to be done. You really need to be evaluated by a plastic surgeon in person or at least have a virtual consultation in order to determine what it is exactly that you’re not happy with and how to address the issue. I hope this helps and good luck from Leonard Grossman, M. D., organic Plastic Surgery

Richard R. Orr, MD · Answer

My advice would be not to rush into trying to get rid of the fat in the lower face.  I have been in practice over 30 years.  One of the signs of youth is fat in the face.  Actually, one of the areas being pursued in the world of plastic surgery is fat grafting into the face to attain the appearance of youth.  
In residency, we did some liposuction of the face.  We quickly quit doing that.  It made the face look skeletonized and aged.  Like an old person's face.  
There are people out there who will gladly treat your fat, either with surgery, or Kybella, or other options.   Please don't rush into that.  What part of your face I see looks very attractive.  I know, all you see is the bulging.  I see youthful cheeks!!  Look at any child.  They have full cheeks.  So many older patients I see wish they had the fullness back into their cheeks.
Good luck to you!!