Is there any way this could be herniated buccal fat? Could a scan distinguish between buccal fat and other types of fat? (Photo)

Thank you for your question and sharing your photographs. It is possible to have pseudo herniation of the buccal fat, but it is also possible to have a lipoma in the buccal fat, which is indeed a rare entity, but has been well identified.

A simple way to evaluate what is happening there is to use an ultrasound scanner. My suggestion for the soft tissue ultrasound would be to have it carried out with you sitting. This means that the displacement of the tissues corresponds to the appearance that bothers you, and it would be easier to map the substructures to get a clear understanding of what is going on.

A sitting MRI scan is a more comprehensive investigation, and unfortunately also an expensive one. However, the soft tissue ultrasound in the hands of an experienced sonographer is also very accurate for problems of this nature.

Based on the pictures, it is impossible to determine where exactly in the face the lump is located. Please resubmit the pictures with arrows pointing to the specific area of the face where the lump is located to provide more accurate feedback.
I hope this helps!
Sincerely,
John Mesa, MD Buccal Fat Removal Specialist Plastic Surgeon New York - New Jersey - Miami