Question: I am a 19 year old male and I am considering having buccal fat removal. I don’t want a lot of fat to be removed but I would like to have a slimmer facial appearance. Would I be eligible for this procedure?

Dr. Mesa’s Response: Young male patient who have chubby cheeks and good cheek bones are usually excellent candidates for buccal fat removal.
Buccal Fat Removal helps permanently corrects the fullness of the lower anterior cheeks ( chubby cheeks). In male patients who are young and have great cheek bones, the proceed helps  to achieve a more chiseled, V shape, more masculine facial look.

I have been long unhappy with my chubby cheeks. I am 33 yrs old now. I have researched in the last year concerning fat pad removal, however many doctors will state that the mid face will atrophy in your 40’s and can cause a hallowed out look, that then requires fillers, etc to correct the issue. This is a very prominent trait in my family both of my parents are in their 60’s with no signs of hallowing to their mid – lower face. Any suggestions would be greatly appreciated.

Dr. Mesa’s Answer: ​Chubby cheeks that usually run in the family are very often resistant to decrease in size with diet and exercise, even when passed the age of 40. Very common, chubby cheeks get worst with increasing of age.

Fat pad removal, also known as buccal fat removal, is the plastic surgery procedure that corrects chubby cheeks. When buccal fat removal is performed to achieve the patient’s specific needs (eg by not removing all the buccal fat pad that gives a hollowed look), it allows the patient to have a thinner fat that doesn’t look aged or hollowed, specially when in the 30s or older age. 
Patients interested in bucal fat removal with natural results should consult with a board certified plastic surgeon specialized in buccal fat removal.

My jaw/chin and the side of my face is huge and squishy. Not to mention my huge forehead and nose. I have no feminine jawline but my cheeks aren’t too bad when I’m smiling, they actually look lifted but the rest of my face and chin and under my cheeks are so big and wide. I hate the way it looks, can I fix it somehow?

Dr. Mesas Answered: Sliming the face usually involves decreasing the fullness of the lower face.
Fullness of the lower face is caused either by enlarged buccal fat pads or enlarged masseter muscles. 
Enlarged buccal fat pads causes chubbiness of the lower ANTERIOR CHEEKS. this fullness usually becomes more prominent when smiling. 
Enlarged masseter muscles causes fullness of the lower POSTERIOR cheeks and causes the jaw to look wider and more masculine. 
Enlarged buccal fat pads could be removed with buccal fat removal. 
Big size masseter muscles can be decreased in size with Botox to the masseter. This will require at least two high dose treatments followed my maintenance every 4 months. 

I am very insecure about my face. One side of my face appears bigger than the other especially when i smile which means i spend every day trying not to smile. Is there anything that could be done to fix this?

Dr. Mesas Answered: Some times patient have mild facial asymmetries to the point that one side of the face appears bigger than the other specially when smiling. The causes of this facial asymmetry could be secondary to differences in the soft tissues of the face (eg. asymmetric buccal fat pads) or asymmetries in the bony tissues ( one cheek more prominent than the other or chin mid point slightly deviated to one side of the face).
In cases of asymmetric chubby cheeks. asymmetric buccal fat removal could make the face thinner and help to achieve more soft tissue symmetry. 
In cases of facial bone asymmetry (cheek, chin, jaw), augmenting the smaller side with soft tissue fillers like voluma could help that side to match the contralateral larger size for better facial balancing and symmetry.

Hello doctors! I have fat in my lower cheek area as well as weak cheekbones which makes me look bloated and unattractive. My options: 1. Buccal Fat Removal (Cons: too subtle?). 2. Liposuction (Cons: possibly not permanent?) 3. Implants Is there anything else that could work for me?

Dr. Mesas Answered: To improve the lower third of the face to make the male face more attractive and more masculine, different plastic surgery procedures could potentially be performed to achieve this goal.

• Buccal fat removal removes the fullness of the lower anterior third (chubby cheeks) thus making the face more chiseled and more adult male looking in patient with good high cheek bones. 
• Liposuction of the chin (submental area) decreases/corrects the double chin, thus making the jaw and chin more define and more masculine in male patients
• Jaw implants, specially if placed at the level of the jaw angle will make the jaw to be more strong, more define and for sure more masculine , thus enhancing the bony structure of the lower third of the face

I am 18, 5’7 and 120 lbs. I have genetically full cheeks that make me self conscious about smiling. It is genetic, as my father in his 50s has a very wide and full face- so I’m doubtful it will go away with age for me. I’ve done masseter Botox and am pleased with the results. But the fat in my cheeks gives me a fullness and lack of structure I am not pleased with.

Dr. Mesas Answered: ​Young patients with family history of full cheeks that also have chubby cheeks are usually candidates for buccal fat removal. 
Chubby cheeks are caused by enlarged buccal fat pads. These pockets of fat on the cheeks usually run in the families. They also are resistant to decrease in size with diet and exercise. Not rarely young thin patients with normal weight for their height have chubby cheeks. 
Buccal fat removal permanently corrects chubby cheeks. It allows to have a more defined thinner facial look. 

I have been really self conscience about my chipmunk-like cheeks. Every time I smile, my face balloons to the point where it looks like I am carrying extra weight. I am a long distance runner and very much in shape (not overweight). Is there any procedures I can have to get rid of this extra fat on my cheeks (upper & lower cheeks) and around my jawline. Is buccal fat removal and facial liposuction effective? I am looking for a slimmer face. Does having thick skin effect the desired results??

Dr. Mesas Answered: Chipmunk cheeks are usually genetically determined, and are highly resistant to decrease in size with diet and exercise. Worst, they become bigger with weight gain. 
Buccal fat removal is the plastic surgery procedure that permanently corrects the chubby cheeks. Buccal fat removal by removing the buccal fat pads, accumulation of fat that causes the chipmunk cheeks, makes the face thinner and more chiseled in patient candidates.  
Also, accumulation of fat along the jaw line and under the chin makes the neck to look undefined, chubby and not very masculine in male patients. 
Chin liposuction is a plastic surgery procedure that removes the fat of the double chin. When it is performed in an extended fashion along the jaw line, it helps to define the jaw line and give a more masculine look to male patients. I commonly perform both buccal fat removal and extended chin liposuction under local anesthesia in the office setting. 
John Mesa, MD
New York City
Buccal Fat Removal and Chin Liposuction Specialist Plastic Surgeon

I can say that is more genetic than weight related and since i don’t want to undergo a surgery at this age I am looking for a non surgical procedure.

Dr. Mesas Answered: Patients with chubby cheeks and double chin could benefit from both buccal fat removal and chin liposuction respectively. 
Buccal fat removal is the plastic surgery procedure that permanently removes the chubby cheeks, thus giving a thinner V shape facial look. 
Chin liposuction corrects the double chin. Also, when performed along the jaw line it helps to define this area of the face/neck junction.
I routinely perform both procedures at once under local anesthesia in the office setting.

I ended up with chipmunk face with loss of volume on the side affected by the abscess (right in photo). I went again for buccal fat removal, but I am still unhappy with the asymmetry in my face. My left cheek (right in photo) it’s still much more smaller than the right side (left in photo). I would like to even out. I would like to know if superficial liposuction to my right cheek is an option. Or should I go for fat transplant/filler to the one that has lost volume?

Dr. Mesas answered: Infection is the number 1 risk of buccal fat removal or any other plastic surgery procedure. When an abscess forms in the cheeks, the gold standard treatment is drainage of it. 
Swelling of the cheeks post abscess drainage could last for at least 6 months. Therefore, the face may look asymmetric until then. Thus, it is no recommended to undergo any other cheek procedure (eg fat transfer) to achieve a more symmetric face until the swelling has been resolved.
Patients who are not completely satisfied with buccal fat removal are usually in their 30s and above, have not good cheek bones, and their cheek bones were not enhanced before or at the time of the buccal fat removal. High cheek bones are the key to have a great buccal fat removal result

I am considering getting buccal fat removal to thinner the lower part of my face but am concerned about whether the results could make it worst or not?

Dr. Mesas Answered: Patients who would like to thinner the lower part of their face could benefit from buccal fat removal. 
Buccal fat removal is the cosmetic plastic surgery procedure that decreases the fullness of the lower ANTERIOR cheeks ( chubby cheeks). When performed in patients with good cheek bones, the patients achieve a contoured V shape, chiseled facial look.
It is important to know that buccal fat removal does NOT decrease the fullness of the lower POSTERIOR cheek. In this area there is no buccal fat pads. Very commonly, the fullness of the lower POSTERIOR cheek is caused by enlarged masseter muscles ( chewing muscle). Botox treatment of the masseter muscle, makes these muscles to shrink, thus enhancing the results of the buccal fat removal.