How can I get rid of lower cheek fat (chipmunk cheeks!!) and what feels to me like loose skin at the age of 21? (photo)

Question

As I get older my lower cheeks keep getting wider and saggier.. I only weigh 48kg and I am very slim for my height so losing weight isn’t a solution. My father has similar cheeks and he is in his 60’s now and his cheeks sag down almost in line with the bottom of his chin... I have looked into buccal fat removal but I am yet to see any before and after photos that show any real different on somebody with my face shape. I would like a dramatic reduction in my lower cheeks...

Benjamin Caughlin, MD, FACS · Answer

You have many options. It is all about fat (or volume) in the right places. Buccal fat removal and/or manipulation can be a great and transformational procedure in the right patient. Often times fat transfer or filler injection in conjunction with this procedure is able to give a more “ideal” heart shaped face. This can make a significant difference in patients as a combo. We are able to create shadows and sharpness where you want it. It may seem counter-intuitive to add fat when you say your problem is chubby cheeks, but we add volume to the highest and most projected point of the cheek bone and taper it to the lower face. This helps to create a shadow just under the malar area and is especially helpful in thin patients. Another powerful maneuver would be to combine the above procedure with buccal fat pad removal. Liposuction of the jawline and sculpting is also helpful in some patients. It really depends on your specific anatomy. All of this can be done in clinic with calming medications and local anesthesia.
I recommend getting a consult with a surgeon who does this procedure frequently for a full facial analysis to make sure your specific goals are addressed.
Hope this helps.
Best of luck,
DrC

Jason Emer, MD · Answer

Facial sculpting and contouring of the face can be created with well-placed fillers (Voluma, Contour, Radiesse, Bellafill) and Sculptra, which would give improvement in facial balance. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Jed H. Horowitz, MD, FACS · Answer

Hello chelsinaThere are various options available, i would advice you schedule a consultation with  board certified plastic surgeon.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question.  As you are very young I would suggest a temporary solution such as cheek fillers to create some volume and fullness to balance your facial features.  Juvederm Voluma would ensure this last about 9-18 months.  I would suggest starting with this and see how you like it, then explore different options such as jawline liposuction or facial fillers (chin or jawline).  All The Best

Alicia Sigler, MD · Answer

Hello and thank you for your question. In your case it may be best to use fillers to help boost your cheeks up a bit. I would also discuss having implants put in place to help with the lift effect you want. Please consult in person with a surgeon as they will be able to gauge what treatment will suit you best.

Samir Undavia, MD · Answer

Thanks for your question. You do have several options. Part of the problem might be that your cheeks don't project enough. In some people either a small cheek filler or an implant can help raise your cheeks and define them.  Alternatively, placing filler along your Jaw line just lateral to the chin could help camouflage them. Finally, carefully placed Kybella might be an option to make your cheeks slimmer.  Good luck!

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek implants, chin implants, lip implants), liposuction and/or facelifts for over 30 years.  From the photos, your cheeks are very flat in the front, there is excess fat in the mid and lower face, I suspect that the chin is weak (can be confirmed with a side photo) as are the back segments of the jaw line.  Due to the lack of bony volume to support and shape these tissues the face becomes an elongated, thin, rectangular shape.  
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using silastic cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  Liposuction can reduce excess fat to further shape the cheeks and face.
 There are many faces that have excess fat over the cheek area which hides the "true" shape of the cheeks below.  In addition to obstructing the cheek shape, this excess fat will sag prematurely as it is pulled by gravity at an accelerated rate versus a face without excess fat in the mid face.  Removal of the excess fat, with liposuction, is key when properly shaping the cheeks with cheek implants.  I have used this in combination with cheek implant surgery for 30 years.  In my experience these procedures when combined in a face with excess fat in the mid face are extremely safe, effective and reliable in the aesthetic results they produce.  While the bony volume will not improve with age, the degree of excess fat in the face typically decreases significantly by the mid to late twenties.
 I have performed many Chin Augmentations using chin implants for over 30 years.  From the photos, your chin is weak.  A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. 
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.
 The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft).  Be sure to see a surgeon that is a facial shaping expert.
Hope this helps.

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