What Type Of Fat Removal Does My Face Need To Make It Slimmer?

Q: Dr. Eppley,  I’m emailing to consult on your ability to improve some concerns that has not been ameliorated through exercise and diet.  I am 5’10 and weight 172 pounds.  Specifically, my upper cheeks and face carry a significant amount of fat which appears to be genetic and gives my face a chubby look.  I have attached pictures and circled the areas of my concern. In addition, I’m curious what you can do for the fat in my chest and underarm area.  A number of military guys I have spoken with have mentioned a procedure known as “pectoral etching”.  What it sounds like is liposuction in this area with some contouring to create a more defined/chiseled pectoral look.

A: What you are demonstrating in your pictures is a zone of cheek and perioral subcutaneous fat, a layer that lies just under the skin. It should not be confused with deeper fat layers, such as the buccal fat pad, which it is not. These are very difficult areas to successfully reduce although its treatment is straightforward. Small cannula liposuction is used from a small incision inside the mouth and the bottom end of the nasolabial fold. In my experience I have seen good and mediocre results with this procedure. The hardest area to improve is that closest to the eye. The other  issue with facial liposuction in this area is some prolonged swelling. While this is very typical of liposuction anywhere, it is very visibly noticeable when it is in the middle of your face.

From a chest standpoint, you are correct about pectoral etching. There is nothing magical about this technique. It is the artistic use of liposuction to create a better pectoral definition, largely using reduction of the lateral pectoral triangle for its effect. I have used it frequently with overall chest liposuction in male gynecomastia liposuction surgery. 

Dr. Barry Eppley

Indianapolis, Indiana