Safest and Best Way to Remove Cheek Fat -Smart Lipo, Mesotherapy,,meso-therapy, Buccal Fat Removal?

Unless you are a candidate for facelift, where the excess fat can be excised under direct vision in precisely-sculpted amounts, your best bet is small cannula liposuction. I would absolutely avoid any kind of injectable "fat dissolving" techniques, as these can leave calcified nodules, retraction, scars, and make a bad situation truly terrible! This includes LipoDissolve, Mesotherapy, or any kind of injectable fat-dissolving technique, regardless of it's cute marketing name or the surgeon's urging.

I would also avoid any kind of laser or even ultrasonic liposuction procedure, not because they don't work or are inherently unsafe, but because there is increased potential (however small) for damage to the branches of the facial nerve, which could cause temporary or permanent facial paralysis (think stroke- appearance). Truthfully, this risk also exists for small cannula liposuction, but an experienced facelift plastic surgeon or facial plastic surgeon will be able to do this with extreme precision and the lowest possible risk to the nerve branches. This is true for SmartLipo, Vaser lipo, or other laser or ultrasonic trade names, but more energy, however minimal or localized, increases the risk of nerve damage.

See several ABPS-certified plastic surgeons, or American Board of Otolaryngology (with certificate of additional training in facial plastic surgery)-certified facial plastic surgeons for consultation. Good luck!

There is likely no easy solution as the fat has likely been injected in multiple layers and in very small quantities. Although autologous fat injection to the face can be a very long lasting and worthwhile solution for age related deflation, it can be very difficult to reduce when those fat cells enlarge with weight gain or as a side effect to some medications.

Mesotherapy is potentially dangerous and unpredictable. Surgical excision is not possible as your transplanted fat is in multiple layers and in very small clusters. Surgery to remove the buccal fat pad can achieve a contour reduction in the lower face. With this procedure the normal buccal fat is reduced, the transplanted fat is not changed but the net result is a thinner lower face where smile dimples would normally occur.

Using a laser assisted lipo technique may be your best solution but only in experienced hands. The laser fiber can be used to break up fat cells (lipolysis) and  stimulate skin retraction with or without suctioning out the broken up cells. SmartLipo, SlimLipo and Acculaser are the most common technologies.  Incremental improvements with this approach are likely to be more predictable than any other strategy. I would strongly recommend a Plastic Surgeon experienced with these technologies to get a more thorough discussion of your options.  Be prepared for more than one treatment and improvement rather than perfection.

Dr. Mosher

Mesotherapy has not been shown to produce acceptable results and I would caution against it. Liposuction with a fine canula is an option. I do not see that buccal fat removal would address the area which you find problematic and may produce an even more unsatisfactory outcome.

Removal of your own fat from your face can be very tricky.  I would not pursue mesotherapy; at this time, it is not a proven or safe procedure.  Smartlipo, because of its ultra-thin, miniaturized technology and the ability to "melt" small amounts of fat in very localized areas, is your best option.  Small amounts of fat should be removed in stages; multiple procedures may be necessary.  Make sure and go to a board-certified plastic surgeon with considerable experience in this technique because the risk of complications is high. 

The safest approach to injected cheek fat removal would be small cannula liposuction. This would be successful at removing some of the injected fat which presumably is largely in the subcutaneous tissue layer beneath the skin. It also poses no danger to removing too much fat and would risk the least potential damage to the terminal buccal branches of the facial nerve. Injecting mesotherapy/lipodissolve solutions poses more risk because it is a chemical concoction whose actions are not well controlled. Buccal fat removal is the not the fat that was injected but it is worthwhile to look at exactly where on the cheek you want the fullness reduced. If it is in the submalar region, buccal fat removal may make sense as what you care about is reducing the fullness. It is not matter what fat is removed if it ca\n achieve the end result you desire. It is a less traumatic procedure than liposuction.

If you truly want to go slow and remove small quantities of fat at a time, liposuction with a fine cannula is probably the safest and most controlled way to proceed. Stay away from lasers and chemicals. If your problem is the fat that was placed six years ago, buccal fat pad removal is not the right procedure because you would be removing the wrong fat!!

There is only one way to remove fat reliably, and that is by Liposuction. Whether you use standard Liposuction or one of the new Laser Lipo procedures really does not matter as long as the surgeon is very skilled in this area.The face is very unforgiving and must be done carefully. Doing a Buccal Fat Pad excision in you is probably a bad idea since the margins will not be tapered.