29F Mini facelift, buccal fat removal, or something else for chubby cheeks? (photo)

Question

I have chubby cheeks even though I'm skinny, which makes my nasolabial folds very prominent. This cheek fat doesn't seem to go away with age—my sister (37) and my mom (62) have the exact same chubby cheeks, even though they’re both very fit. What would I need— a mini facelift, buccal fat removal, or some liposuction? Also, my neck looks a bit odd—it seems directly attached to my chin. I don't think there's much fat there; it feels mostly like skin, but without any noticeable laxity. I really have no idea what could be done for my neck.

Oliver Chang, MD · Answer

Just based off your side profile is limited in our assessment for all the things you listed you want to correct - ideally need frontal views, other side profile, bird's eye, oblique views.. But let's try to assess what we can from the limited photos. 
The cheeks have some fullness (can benefit from buccal fat removal), but buccal fat is more mid-cheek fullness that will be addressed. For your nasolabial folds - might need to have some mid face work done to address that (whether its fillers, fat grafting, or even a mid-face lift via different approaches). Again, its hard to assess with only views of one side of your face. 
As far as the chin, some liposuction and skin tightening can be a start, and then you see how you heal, if there's still skin laxity to your dislike, a neck skin lift might be needed where the incision is behind the ear and into the hair. Again, limited views to really give an accurate assessment. Explore your options, seek a few surgeons opinions before deciding what your risk tolerance is before executing on decision.

Lexie Wang, MD · Answer

Based on these photos and what you said about your mom/sister, my suspicion is that your family tends to genetically have smaller facial bones -- your jawbone (mandible) is clearly on the smaller side already and I suspect your maxilla (upper jaw bone) is also the same. That leads to more sagging of soft tissue bc the bone is not strong enough to hold up the soft tissue. You could try filler to try to simulate building up a stronger bony foundation (fat grafting can do similar) vs. doing a lift procedure but a lift procedure will likely only last for so long if you don't ALSO build up volume.

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