Q: Dr. Eppley, I had a chin implant and buccal fat removal several years ago to make my face less round. While that has provided some significant improvement, I still feel my cheeks are too fat. The fullness that bothers me is the fat pad below the buccal fat area. I have had several consultations with differing opinions. One surgeon suggested liposuction with a mini face lift while another recommended a deep plane facelift with removal of fat under the cheek muscle. I am confused.
A: The specific cheek area to which you refer is below the buccal fat pad and is known as the perioral mounds. This is a fat layer that is separate from the buccal fat pads and will not be affected by their reduction/removal. It is a common misconception that buccal fat removal will thin out this area as well. Perioral mounds can be reduced by small cannula liposuction done through a small incision inside the corners of the mouth. I have found that ‘chubby cheek reduction’ usually needs a combination of buccal fat pad reduction and perioral mound liposuction to get the best reduction possible. In some cases, small cannula liposuction also needs to be done above the level of the nasolabial fold at the subcutaneous level. While a mini-facelift may help with tightening loose jowl and neck skin, it will not make a significant effect on the thinning of your cheeks. Skin tightening will not make a dent in the thinning of full cheeks.
Dr. Barry Eppley
Q: Dr. Eppley, I am 25 years old and have a chubby face. I am slightly overweight but not as fat as my face makes me look. I am very self concious about my oversized cheeks. I also have a double chin which is very noticeable and unattractive. Do you think a buccal fat pad removal would help me? I have read on the internet that removing it may make your face look too thin down the road. However, I feel that I will always be stuck with a fat face and chubby cheeks as both my parents look the same way. Please advise on what you think would be the best way to help reduce the fatness in my face. Also, are there any less aggressive or non-surgical ways to lessen the fullness of my cheeks and chin? I have attached some pictures of me for your review.
A: In looking at your pictures, I can assure you that nothing short of surgery will help reduce the fullness in your face. I would recommend buccal fat removal, submental/neck liposuction and maybe even a small chin implant. These are some standard techniques in faces such as yours to make a visible difference. While these will not necessarily make your face, they will go a long way to reducing some fullness. It is also important to realize that buccal fat removal does not address all areas of the cheek region in reducing fullness. You will also benefit from liposuction of the perioral mounds and above the nasolabial fold, two areas that are full but lie outside any effects of buccal fat pad removal.
Dr. Barry Eppley