Would buccal fat removal be appropriate for my lower cheek fullness? (Photos)

Question

I’m looking for advice about fullness around my lower cheeks/corners of my mouth. I notice it from the front as well as at 45°, and feel it makes my lower face look softer/heavier than I’d like. I’ve been looking at buccal fat removal before-and-afters and really like the slimmer lower-cheek effect, but I’m unsure whether the fullness in my case is actually buccal fat, superficial fat, soft-tissue descent, or simply my facial anatomy. Do you think I could be a suitable candidate for buccal fat removal? Or would another treatment such as RF microneedling, HIFU/Ultherapy, or something else be more appropriate? I’m in my early 30s and looking for a subtle, natural slimming/definition rather than a hollow or overly sculpted look I’d particularly appreciate opinions from surgeons or people who have had a similar concern, and any advice on what you think is actually causing the fullness.

Vikram Mookerjee, MD · Answer

Based on your photos, you do appear to have some fullness in the buccal fat pad area. That being said, the fullness in your lower face may be a combination of both buccal fat pad herniation and some mild, early jowling. However, you do not appear to have significant facial laxity, so a buccal fat pad reduction may be a smaller, more conservative treatment option that still meaningfully improves your lower face contour.
One way to test whether the jowling has a component of buccal fat pad herniation, is to push the fullness and depress it back into your face. Hold that for a few seconds, then remove your finger. If the fullness promptly springs back into place, it is probably more of just pure jowling. However, if the fullness slowly returns to place, like a sponge unfurling, that is more indicative of buccal fat pad herniation.
The key with buccal fat pad reduction, as with any plastic surgery, is all in the judgement of how much to do/remove. If too much fat is removed, it can create hollowness. However, a conservative trim can be a nice way to slim the lower face and improve the overall contour.
You are welcome to try RF microneedling, but I do not think it will meaningfully improve the soft tissue contour. It is moreso a tool for skin texture and tone, and promoting collagen production. I would also not recommend Ultherapy to try and address this.
An in-person consultation with a plastic surgeon will be very helpful, because they can perform a physical exam and give a better understanding of what are the causes of the lower face fullness. And, based on their findings, provide treatment recommendation options. Hope this helps, good luck!

Would buccal fat removal be appropriate for my lower cheek fullness? (Photos)

Answers (1)

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