What happen to the cheek fat pads with aging? Do they drop/sag? is it just volume loss? Both?

Thank you for your question. As we age the cheeks lose volume and begin to sag. The gold standard remains a face lift to reposition the underling structures to lift the midface, tighten the neck, improve the jowls and give you face a more youthful appearance. If you have lost volume, fat grafting can be performed at the same time as the face lift. You should find a board certified plastic surgeon in your area who specializes in facial rejuvenation. Best of luck.

Thanks for your question!  The fact is that the face is made up of three structures, muscle, fat and skin.  As we age, we lose the fat/volume in our face.  That, along with drooping muscles and skin elasticity changes, all contribute to seeing ourselves differently as we age.  
Without photos, I can't address your particular case but in my practice I include the facial fat transfer procedure with the face lift to help address all three issues to give the freshest and most natural results.

Thank you for the great question. The reality is both, but for most patients, sagging is the predominant factor. In my opinion, a facelift procedure that allows for repositioning of the fat pads in the cheek and jowl region is essential. If this is accomplished, addition of fat or filler from other areas of the body is not needed for most patients. The exception to this is often two areas: 1) the temple hollow; and 2) the tear trough. For these areas, I use microfat which is placed at the time of the face and neck lift procedure. Best of luck moving forward!