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