Procedure to reduce fat pockets around mouth? Buccal fat reduction? (Photos)

Question

While I'm happy with the prominence of my cheekbones and the fullness of my face overall, I've become increasingly dissatisfied with the shadows around my mouth that I believe are caused by protruding pockets of fat. Especially when my face is relaxed, it gives my mouth a kind of gloomy, trout quality that I'm not a fan of. I have no lines on my face and am quite sure that these are not nasolabial folds. What would be an appropriate procedure to correct this? A buccal fat reduction? Thank you!

John Mesa, MD · Answer

Shadows around the mouth (that go from the corner of the mouth to the jaw linen either a vertical or oblique direction) specially when  the face is relaxed are NOT caused by buccal fat removal. These lines are commonly know as 'marionette lines'Enlarged buccal fat pads cause chubby cheeks = bulging of the lower anterior face.Marionette lines are caused by sagging of the facial skin around the mouth This is commonly present in patients in the late 20s and above since it is one of the signs of initial aging.If by pulling the skin of the cheek bones up ( with a finger (vertically), the marionette lines improve or disappear, this confirms the diagnosis of marionette lines. Potential treatments for marionette lines are cheek bone enhancement ( when weak) or skin tightening (with Fractora or C02 laser) but NOT with buccal fat removall

Jonathan Kulbersh, MD · Answer

Buccal fat excision is an appropriate surgical procedure for patients that of overly full and wide cheek areas. In common terms, it is good for patients who have chipmunk cheeks. Fillers may be beneficial in camouflaging the pockets around the mouth. In reviewing your picture, is difficult to tell if you're a good candidate because your cheek area is slightly full but not overly full. You are a patient that would need an in person consultation for a complete evaluation and explanation of the positives and negatives of these procedures in your situation. I hope this helps.

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