Consultation for lower facelift - do I need buccal fat removal? (Photos)

Question

I am in my 50s and recently had a consultation for lower facelift. The plastic surgeon recommended buccal fat removal in conjunction with the facelift. I’ve read that this is not recommended due to facial fat loss with age. He said my lower cheeks were too full and made my face look less contoured. Do you think BFR is a good idea in my case

Ali Riza Öreroglu, MD · Answer

During a deep plane facelift, the approach to the buccal fat pad is different from more superficial techniques.
When the deeper planes are released, the midface tissues are repositioned in a more natural and anatomical way. In this context, the buccal fat pad is typically preserved rather than removed.
In selected cases, it can be mobilized and redraped (repositioned) to help improve facial contour and support midface volume, instead of reducing volume by excision.
Especially in patients in their 50s, maintaining facial volume is important, as there is a natural tendency for fat loss with aging. Removing buccal fat in this setting may increase the risk of a hollow or over-skeletonized appearance over time.
For this reason, I generally favor preservation and redistribution of volume during deep plane facelift procedures, rather than routine buccal fat removal.
Final decisions are best made intraoperatively, based on the patient’s anatomy and the overall facial balance.

Brent Moelleken, MD · Answer

Buccat fat pad reduction is best when there is a disharmony between the cheekbone area and the cheeks themselves. Facial liposuction is risky for causing facial irregularities that can be difficult to repair, and may miss the actual problem, namely excess Buccat fat!

A well done facelift with bidirectional vectors can give predictable, natural results.

There is little need to remodel your bones in my opinion.

A well done facelift with bidirectional vectors can give predictable, natural results.

There is little need to remodel your bones in my opinion.

Darryl J. Blinski, MD · Answer

Based on your post photos my recommendation would be a mini upper mid face lift with lower neck lift combination and I am unsure unless you get a preoperative ultrasound of the BUCCAL area to see the amount of BUCCAL fat is present that I would combine the two if there is a finding of BUCCAL fat then I would combine the two procedures. So you understand a preoperative ultrasound of the cheek area to determine the amount of BUCCAL fat is required if you’re gonna combine the two procedures. Best of virtual consult with for better understanding fee for this type of surgery in full would be $15-$25,000. Again, best of virtual consult with.

Consultation for lower facelift - do I need buccal fat removal? (Photos)

Answers (3)

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