Q: I am impressed with the results I saw of yours on a patient that I ran accross on the internet while doing plastic surgery research. The patient had cheek implants and I think removal of buccal pads. I am 57 years old and have a lean face. I think this procedure is what I would need to achieve the results I am looking for. My buccal pads are more prominent with age and above the buccal pad area my cheeks are flat. I am not interested in filler because the buccal pad area, I believe, still needs to be addressed. Did you remove the buccal pads in this patient and insert cheek implants? I am thin so I do not think liposuction would be in order. I once asked a plastic surgeon about removing the buccal pads and he told me that would make me look dreadful. Please advise. Thank you for your time.
A: Cheek or midface augmentation can include several procedures depending upon the make-up of the anatomic problem. Implants for cheek and submalar augmentation, submalar or buccal fat removal OR augmentation, and cheek or midface lifts for sagging skin are all potential options. These procedures can be done alone or some combination thereof may be more ideal. But it all depends on an appreciation of the cheek bone anatomy and the soft tissue make-up around the cheek bones. Only through a pictorial analysis could I provide you with what may be beneficial for you.
That being said, a thin face almost never aesthetically benefits from a buccal lipectomy. I have a suspicion that what you may be seeing as buccal fat may be cheek tissue ptosis or sag. Rather than a buccal lipectomy, you may need a midface lift which resuspends the sagging cheek tissues which have fallen into the buccal triangle up back onto the bone. A midface lift may or may not be complemented by small cheek implants.
Dr. Barry Eppley