Fat redistributed or fat pads have dropped?

  Hi, What you are so aptly describing is the shift(sag) of facial fat and tissues off of the cheeks towards the corner of the nose (nasolabial folds) and the mouth (jowls and marionette lines).  This typically happens earlier (late 20's to early 30's) in faces that have flat or concave cheeks anteriorly (in the front).  Non smiling photos of your face from the front and side would help with the evaluation.    Cheek augmentation with cheek implants can shape the cheeks.  This is often combined with liposuction of the excess facial fat.  I have performed many of these procedures over the past 30 years and want to dismiss as inaccurate the notion that cheek implants or a dermal filler to the outside of the cheek will lift sagging facial tissues.  The size of the cheek implant required, or the volume and placement of the filler, to have that occur will surely distort the face.    If the jowls are prominent some form of a facelift can be added.  If you have "jowls" this is sagging facial tissues and an indication for some form of a facelift, not Cheek Augmentation. I have performed many Cheek Augmentations over the past 30 years and the notion that Cheek Implants or dermal fillers to the cheeks will lift tissues is an urban myth. Filler to the cheeks or cheek implants will not lift up the jowls. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:very small incisionsminimal tissue dissection = less bruising and swelling = rapid recoverycan be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Perlane) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opHope this helps.