What Are These Pockets Of Fat On My Face And How Can I Get Rid Of Them?

Q: Hello, I am 27  years old and thin but have always had these little fat pouches that are positioned below the corners of my mouth. It’s hard to explain but it makes my cheeks look like they’re sagging (but they aren’t). If I put one finger in the inside of my mouth, and one on the outside and pinch that area, I can feel the distinct fat pocket. I have two questions. What is this fat called? I can’t find any similar cases online, and I’ve done lots of searches. And secondly, what can I do to remove this??  Thank you in advance.

A: It sounds like you may have a unique facial condition known as pseudoherniation of the buccal fat pad. This is where the normal buccal fat pockets, which lie right under the cheek bone, fall or prolapse through their containing fascia and create a low fullness opposite the corners of the mouth or even lower. While rare, this problem has been described in the plastic surgery literature before. Undoubtably the ‘ball of fat’ that you feel is a part of the buccal fat pad.

The treatment of this facial fat problem is to perform either removal of the descended fat pad (buccal lipectomy) or to resuture the fad pad back up into place. (like a hernia repair) Both are done from inside the mouth. Which approach is best depends on the shape of one’s face. A thinner face may benefit from it being repositioned back up so that one doesn’t develop a very gaunt facial look later. Since the fat isn’t being removed from the submalar area anyway, a more simple removal is usually done in most cases.
Indianapolis, Indiana