38, cheek definition - buccal fat removal or mid facelift? (Photos)

Hi sensible. The buccal fat and midface lift are both options for you although they will address different areas of your face, so I'm not sure which would be better for you based on your desires. The buccal fat will primarily address some of that lower fullness that you can see. Surgeons can and should titrate how much buccal fat to remove depending on what you want, so if you mention that you are worried about getting too gaunt, they can minimize this. A midface lift could also be a good idea for you but would not necessarily address any volume changes as it would only move the volume superiorly, but you can see in your lateral pic that you have a bit of negative vector going on and a retruded maxilla, so adding volume to the midface will always help your facial features.

It does not seem that buccal fat removal would do much in your case. Doing nothing may sometimes be very good solution? It would be in your best interest to address these issues in person with a board certified plastic surgeon expert in facial rejuvenation.