Am I good a good candidate for buccal fat pad reduction surgery? I am looking to achieve a more defined appearance (25 male)

Question

Some more details: - The right side of my face is worse than my left. - The fatty/droopy lower face is there even when I lose a significant amount of weight. What do you suggest?

Omar Lazos, MD · Answer

You are a good candidate for both procedures

BFPR (Buccal Fat Pad Removal)
When
 a patient has a full and round face and despite weight loss the 
fullness persist or if the patient is in his normal weight and the 
chipmunk faces has stayed all the time, a bichectomy or buccal fat pad 
removal is useful. It´s true that with aging the buccal fat pad tends to
 diminish in volume do to atrophy, but if the volume is excessive a 
bichectomy will not hollow the cheek overtime. Many patients are happy 
with the results, a proper selection is a very important manner. Usually
 the procedure takes less than 10 min and you can go homethe same day. 
You'll be able to go back to work on the 3rd day post-op but 1 week off 
would be more comfortable. 
Submental liposuction or chin lipo

Is also done also in an office setting procedure, usually right after buccal fat pad removal. As in 
regular
 body liposuction, chin lipo involves removing the excess fat that gives
 the double chin appearance. Through a small stab incision in the 
submental crease a small cannula is used to infiltrate tumescent fluid 
(numbing solution) to prepare the fatfor aspiration. This is the 
uncomfortable part of the procedure, but it´s well tolerated by the 
patient. After the infiltrated area gets numb, the liposuction with 
aspiration is done. The amount of fat aspirated ranges 75-1200 cc, it 
varies from each person´s fatty deposits.The whole process lasts and 
average of 20 minutes. After the procedure is done a compression garment
 is placed (chin garment). The garment´s main purpose is to limit 
swelling and also to prevent skin sagging by attaching the skin back to 
the necks surface closing the gap made with 
the submental fat 
aspiration. Candidates are patients with a double chinwith good skin 
elasticity and quality, with an average age of 40. If these factors are 
present: extra skin, poor elasticity, lax muscles, 
loss of depth and
 youthful angularity, you would be better served by a neck lift. The 
potential complications from submental liposuction: undesirable result, 
contour irregularities, asymmetry, dimpling or puckering of skin, 
sagging, marginal mandibular nerve damage (very rare). For the final 
results remember that liposuction takes time for the skin to settle. The
 skin will continue to tighten over time and so you will get some 
immediate benefit, but the real benefit comes weeks or months later. 
Liposuction is limited by the structure you are born withsuch as the 
mandible and hyoid bone. Your result is not permanent, if you gain 
weight then you may regain fullness in your neck

Benjamin Caughlin, MD, FACS - Account Suspended · Answer

You have many options. It is all about fat (or volume) in the right places. In addition to facial cosmetic surgery I do feminization procedures in the transgender population and it applies to all sexes and orientations really. The key is Hot is HOT! Buccal fat removal and/or manipulation can be a great and transformational procedure in the right patient.  Oftentimes fat transfer or filler injection in conjunction with this procedure is able to give a more “ideal” heart shaped face. This can make a significant difference in patients as a combo. We are able to create shadows and sharpness where you want it. It may seem counterintuitive to add fat when you say your problem is chubby cheeks but what we do is add volume to the highest and most projected point of the cheek bone and taper it to the lower face. This helps to create a shadow just under the malar area.  This is especially helpful in thin patients and in combination with buccal fat pad removal is a powerful maneuver. Liposuction of the jawline and sculpting is also helpful in some patients. It really depends on your specific anatomy. All of this can be done in clinic with some calming medications and local anesthesia.
I recommend getting a consult with a surgeon who does this procedure frequently to get a full facial analysis to make sure your specific goals are addressed.
Hope this helps.
Best of luck.
DrC

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

John Mesa, MD · Answer

Patients with fullness of the lower anterior cheeks that are interested in achieving a more defined facial appearance are usually candidates for buccal fat removal. Buccal fat removal by removing the fullness of the lower anterior cheeks, helps to achieve a more sculpted look in patients with high prominent cheek bones (see video below)When patients have not good cheek bones, the results of the buccal fat removal are sub-optimal. Therefore, in my practice I always evaluate the patient's cheekbones. If they are weak, I highly recommend the patient to enhance them before or at the time of the procedure with soft tissue fillers like voluma. This allows to instantly enhance the cheekbones, with minimal down time. The duration of the fillers I use ( voluma) is up to 2 years.

Miguel Mascaro, MD · Answer

Thank you for your pictures and your question! Certainly you can be a little more aggressive (or conservative) on one side vs the other.  I usually go over the fine asymmetries with patients just to ensure that we approximate symmetry as much as possible.  In your frontal picture it appears as though there may be some masseter issues as well that would need to be addressed down the line with some botox/disport - again it'd be best to examine you in order to get a better idea of just how much improvement we can expect to see.  Once you get a good consultation, then you can decide what is what is best for you.  I hope some of this helps! Best of luck.

Philip K. Robb Jr., MD, FACS · Answer

Hello and thanks for your question!Buccal fat removal is an excellent procedure to narrow the lower face. It needs to be performed by an expert as there are several important structures in the area. I give my patients a choice on how aggressive they'd like to be in the removal (risk hollow appearance later in life). I'd recommend a consultation with an expert to see if it's the right procedure for you!Hope this helps and God Bless!Dr. Robb Jr.

Jonathan Kulbersh, MD · Answer

Buccal fat excision is an appropriate surgical procedure for patients that of overly full and wide cheek areas. In common terms, it is good for patients who have chipmunk cheeks. In reviewing your pictures, it is difficult to tell if you're a good candidate because your cheek area is slightly full but not overly full. You are a patient that would need an in person consultation for a complete evaluation and explanation of the positives and negatives of this procedure in your situation. I hope this helps.

Lawrence Scott Ennis, MD, FACS · Answer

The buccal fat pads are an often-overlooked portion of the facial aging process.  The buccal fat pads naturally sit in the upper portion of the cheek and are designed to help us suckle as an infant.  As we get older, the buccal fat pad descends into the jowl, giving the face a tired look.  I often see patients from outside facilities who have had a facelift and they present stating “their jowls are back.”  Typically, in these patients, the jawline still looks nice, but they have the “chipmunk cheeks” or what appears to be a “walnut” in their jaw, which is this buccal fat pad. Removal in a young person can be done in the right person but in the wrong person can cause early hollowing of the cheeks. 
This can be identified by pushing up on this small area just above the jawline and then releasing.  The skin will fall rapidly back into place, but you will typically see the fat pad descend back into the jowl slowly over 2- or 3-seconds as it refills this area.  This is indicative of a sliding buccal fat pad.
These are removed through a small incision inside the mouth.  Recovery is typically quick with minimal bruising.Dr L Scott Ennis, Md FACSPalm Beach, Boca Raton, Miami, Fl

Am I good a good candidate for buccal fat pad reduction surgery? I am looking to achieve a more defined appearance (25 male)

Answers (8)

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