Is there a procedure to reduce cheek fat other than buccal fat removal?

Question

I have a fuller face with chubby cheeks, not chubby enough for buccal fat pad removal but chubby enough that it bothers me. Is there a procedure (preferably non surgical) I can have to hollow out my cheeks? I'd like more defined cheekbones but fear that fillers will just make my face look fatter than it already is.

Jason Emer, MD · Answer

This is tough to answer without pictures. I have been using liposuction, kybella, rf treatments and ultherapy with good results for contouring, definition and lift. However, you may need a malar implant with buccal fat pad reduction for something permanent. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer.

Curtis Perry, MD · Answer

Yes. Liposuction and ThermiRF are two examples. Paradoxically adding properly adding volume with fat transfer canl make the face thinner. Without seeing you it is impossible to give specific advice.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek, chin, lip), liposuction and/or facelifts for over 30 years.  Non smiling photos of your face from the front and side would help in the evaluation.  If there is excess fat in your face, liposuction can reduce the fat and provide shape to the cheeks and face...but only if the underlying cheek bone is the proper aesthetic shape.  Non surgical procedures to melt the fat using fat dissolving injections or topical "energy based" methods to reduce the fat are very non specific and would provide the same degree of fat removal or shaping capability that facial liposuction can provide.  In addition, if your cheeks are flat or concave underneath the excess fat, this "weak chin" configuration will be revealed with fat removal and would require cheek augmentation.
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  Conversely, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

Is there a procedure to reduce cheek fat other than buccal fat removal?

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Is there a procedure to reduce cheek fat other than buccal fat removal?

Answers (3)

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