Which procedure would be best for removing fat aroound the modiolis? not interested in filler or RF (photos)

Question

Hi drs! I've had many in person consultations and no one has answers. I'm open to surgery but not "treatments". I'm F/40s, and fat has left my upper cheeks and descended to either side of my mouth. I have been told by every PS that I don't have enough laxity to warrant a FL, and it would only mask shadows but not address the fullness. I'm desperate for help, been looking for answers for 2yrs and very distressed. No one will excise the fat for me:( Thank you..

Lucian Ion, FRCS · Answer

Hello,

Thank you for your question regarding the slight fullness along your jawline and the corners of your mouth. Given your preference for surgical treatment rather than non-surgical options, here’s how we can assess whether a facelift procedure is suitable for you.

Assessing Suitability for a Facelift:

1.	Self-Examination Technique: To get a better idea of how a facelift might impact your facial features, I recommend examining your face in the mirror while lying down completely flat without a pillow. This position can help mimic the effects of a deep plane facelift. Look at your face in the mirror rather than taking a selfie, as this can give you a more accurate view.
	2.	Deep Plane Facelift as a maintenance procedure: If you find that the appearance of your face in this position aligns with your goals, a deep plane facelift could be a suitable option. This procedure tends to produce a similar impact, providing a natural and long-lasting lift that can improve facial contours and address fullness along the jawline and corners of the mouth. Minimal access facelift represents a potential alternative but it is more difficult to know how much impact it would have for the corners of the mouth

Considerations for Micro-Liposuction:

•	Micro-Liposuction Around the Corners of the Mouth: While micro-liposuction can be performed to refine the area around the corners of the mouth, it is typically done with caution. The fatty tissue under the skin helps reduce the visibility of lines when smiling. Aggressive micro-liposuction in this region can lead to increased visibility of lines lateral to the corners of the mouth when smiling, which can detract from the overall cosmetic result.

Conclusion:

In summary, if the appearance of your face when lying flat meets your aesthetic goals, a deep plane facelift could be a good solution for you. Micro-liposuction can be considered but should be approached conservatively to avoid unwanted side effects.

Gary M. Horndeski, MD · Answer

The best technique for you would be a lip lift.  A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.

Jacob Tower, MD · Answer

Hello, hope you are well. Based on the photos that you have shared, there appears to be excess buccal fullness in your area of concern. The most straightforward way of removing fat to slim this area is with buccal fat removal. This is a quick surgery that's performed under local anesthesia. The buccal fat is removed from a small incision on the inside of the mouth, so there is no scar.

Best,
Dr. Tower

Zoran Potparic, MD · Answer

It is very likely that “smile surgery” would help; it will correct down-word tilt of mouth corners and eliminate what appears like a fat pads in that area. Scar is placed in the junction of skin and red vermilion border. Good luck.

Jeffrey H. Spiegel, MD · Answer

You could potentially consider a deep plane facelift, where I should be able to lift that area away.  For a less involved procedure we could do microliposuction with buccal fat removal in the office.

Which procedure would be best for removing fat aroound the modiolis? not interested in filler or RF (photos)

Answers (6)

Answer: Smile surgery

Answer: Smile surgery

Answer: Buccal fat and microliposuction

Answer: Buccal fat and microliposuction

Recommended reading

Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.

Which procedure would be best for removing fat aroound the modiolis? not interested in filler or RF (photos)

Answers (6)

Answer: Smile surgery

Answer: Smile surgery

Answer: Buccal fat and microliposuction

Answer: Buccal fat and microliposuction

Browse related questions

Recommended reading

Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.