Is bichectomy appropriate for older patients? (Photo)

Question

I'm 58 YO, recently had a face/neck lift which minimally improved my lower face but did not completely correct my jowls. I also have a very heavy lower face and was told in the past that I could benefit from buccal fat removal. Although I'd love a slimmer lower face, I'm not sure to would be the right procedure for me at my age. Any thoughts?

John Mesa, MD · Answer

Buccal fat removal is a cosmetic plastic surgery procedure to make the face thinner by decreasing the fullness of the lower ANTERIOR cheeks.  This procedure does not address residual jowls post facelift nor the fullness of the lower POSTERIOR cheeks.When the fullness of the face is caused by chubbiness of the lower POSTERIOR cheeks, usually botox to the masetter is the procedure of choice so shrink that area.

Raffy Karamanoukian, MD, FACS · Answer

Treatment of ‘chubby cheeks’ cannot be achieved alone with buccal fat pad removal; a fact that I encounter time and time again when seeing patients in consultation for lower facial sculpting. My approach is to use a combined protocol that redefines aesthetic contours of the face. This includes the following: 
  
Buccal Fat Pad Removal Non-surgical Muscle-Fascia Tightening Venus Legacy or Venus Viva Ultherapy Submental Liposuction or Coolsculpting   
The combined approach is ideal. Buccal fat pad removal is a exceptional procedure that can remove excess fat from the cheek pads. Using an intraoral approach, a small incision is carried through the mucosa to remove a small fat pad within the cheek. Closure of the incisions is minimal with an absorbable suture and patients will experience some swelling post-operatively. We use SwellX tablets post treatment. Once healed, the contour of the cheek is improved and we begin Non-invasive tissue tightening to further enhance results. 
  
Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Sagar Patel, MD · Answer

First off, I agree with the elder statemen's opinions below that you are not a candidate for buccal fat removal based upon the shape and contour of your face.
 That being said, for others reading this, buccal fat removal can ABOSULTELY be performed in older individuals. It is often done in conjunction with a facelift which is why it is shocking to me to hear so many other surgeon's say that it will make you look aged.

Barry L. Eppley, MD, DMD · Answer

Buccal fat removal is a midface or cheek reduction procedure not a lower facial one. Where you have your facial fullness is not the area that is affected by a buccal lipectomy procedure.

Val Lambros, MD, FACS (retired) · Answer

absolutely not for you. Your face had joker lines before surgery and more now, taking away buccal fat will exaggerate the hollows by your mouth and across the cheek and make you look alien.  This tendency is partially due to the lovely shape of your face.  btw you dont have jowls which removing the buccal fat doesn't help anyway. And more btw, you dont have any buccal fat which is why you have the joker lines. 
I wrote an article on the topic which you can find online

Is bichectomy appropriate for older patients? (Photo)

Answers (5)

Answer: Buccal Lipectomy

Answer: Buccal Lipectomy

Answer: Is bichectomy appropriate for older patients?

Answer: Is bichectomy appropriate for older patients?

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Everything you need to know about Buccal Fat Removal

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Is bichectomy appropriate for older patients? (Photo)

Answers (5)

Answer: Buccal Lipectomy

Answer: Buccal Lipectomy

Answer: Is bichectomy appropriate for older patients?

Answer: Is bichectomy appropriate for older patients?

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Recommended reading

Everything you need to know about Buccal Fat Removal

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