My philosophy and techniques in facial plastic surgery have evolved over the years and now include facial sculpting using cheek liposuction and buccal fat removal at my NYC practice. By “sculpting” I mean that I remove volume from some places, and I add it to others. This is different from facial rejuvenation for an aging patient. Facial Sculpting is for a younger patient trying to achieve an image of beauty that they may not have genetically. In these cases, we are trying to refine the features that make anyone more attractive. Generally speaking, I remove fullness from the lower face and add it to the upper or mid-face. That’s because everyone wants high cheekbones and fullness in the midface. It’s a well-described sign of beauty, and much has been written about its importance in the plastic surgery literature (Owsley, J. Q. Lifting the Malar Fat Pad for Correction of Prominent Nasolabial Folds. Plast. Reconstr. Surg. 91: 462, 1993).
Removing Fat: Against the Grain
It is also very trendy to add more volume to the face with fillers or fat. The motto seems to be “More Volume. . . at any cost.” (Facial Contouring by Targeted Restoration of Facial Fat Compartment Volume: The Midface Wang, Wenjin; Xie, Yun; Huang, Ru-Lin; More Plastic and Reconstructive Surgery. 139(3):563-572, March 2017). I disagree. In order to create a more aesthetically pleasing face, the midface should be full with nicely contoured cheekbones, and the lower face should be more slender. The overall shape of a beautiful face resembles a triangle pointing downward. This is why people are more attractive when they smile as opposed to a mug shot without facial expression. I add volume to the midface (or upper cheek) all the time, but I now remove fat from the lower face too. My understanding of facial anatomy and beauty has taken years to develop, and this is now how I see it…
First: The Double Chin Problem Solved
Starting in 2008 or so, I began performing an increasing number of facial contouring procedures including chin liposuction, buccal fat removal, and microcannula liposuction of the cheeks. At first, it was the neck and chin liposuction procedure that took off. The advent of smartphone cameras combined with the rise in social media made patients much more aware of their double chins. Videoconferencing also started to become more available. Even “regular” people found that FaceTime and Skype didn’t necessarily show them in the best light. This prompted my writing about the Selfie Chin Solution and double chin removal at my NYC practice a few years ago. The procedure has become so popular that my before and after gallery has become one of the most popular on my website. The procedure itself is the most common operation in my office right now.
Next: The Chubby Cheek Problem
As I performed more and more SmartLipo of the chin and neck area, patients began asking about chubby cheek reduction. The selfie generation is requesting more refinement of the jawline and profile features. Women seem to want to be more petite with a more V-shaped lower face. Male patients are requesting more angular and masculine features. I had to find a way to please both of them. I turned several people away for buccal fat removal because current theory teaches that we want more fat in the face as we age—and I didn’t want them to age poorly. However, it also occurred to me that we don’t want “fat faces,” we want fullness in the upper midface. A round face may be cute for children, but it is never sexy. . . and most of us want more sex appeal, not less.
Furthermore, fat in the lower cheeks eventually starts to hang over the jawline and contributes to jowls as we age, and nobody wants jowls (The Mandibular Septum: Anatomical Observations of the Jowls in Aging-Implications for Facial Rejuvenation Reece, Edward M. M.D.; Pessa, Joel E. M.D.; Rohrich, Rod J. M>D> Plastic and Reconstructive Surgery: April 2008 -Volume 121 – Issue 4 – P 1414-1420). Therefore, if I remove lower cheek fat, the patients begin to develop that triangle, and they look better. And so, I began performing buccal fat removal surgery.
Solution 1: Buccal Fat Removal
I found the removal of the buccal fat pad to be a sort of fun procedure that was very satisfying technically (as the surgeon). I also found that the results tended to be fairly modest. The truth is that we only remove somewhere between 2.5 cc and 3.5 cc of fat in the vast majority of cases. And it is always from the same region of the cheek—just at the bite line where your teeth come together with your mouth closed. The effect is similar to what you might see if you suck your cheeks in between your teeth with your mouth slightly open.
I want to emphasize here that the effect is typically subtle. As a matter of fact, as time went by, I began to wonder if there was something I could do to more dramatically reduce the chipmunk cheeks of so many of my patients. After all, I work in New York City, and my patients expect Real Results!
Truly Chubby Faces Need Cheek Liposuction
Considering the problem at hand, I thought quite a bit about the anatomy of the face. I reflected on all the facelifts I’ve done and all the various techniques for facial rejuvenation that are out there. It is also worth noting that when I do a facelift, I sometimes liposuction the jowls, but not the chubby cheeks. Why couldn’t I liposuction the cheeks?
Well, there are all the motor nerves in the area that I don’t want to injure. There is also a risk of taking too much fat from the cheek and leaving someone with a dent. Okay, so how to avoid those two problems? First, I would need a very fine cannula. One so small that it would be difficult to remove too much fat from a single area even if I tried. Second, I would have to stay superficial and be sure not to injure any nerves to the face. This would require a new face liposuction technique that hadn’t really been popularized before. At my NYC practice, I call it, “Microcannula Liposuction of the Cheeks.”
How To Liposuction Cheeks
I don’t want to get too bogged down in the details of these procedures. Patients may not want to know, and I don’t want my competitors to know exactly what I’m doing, but . . . it sure seems to be working. With this method, I can remove about 10 cc from the entire lower face (NOT the cheekbone area, the lower cheeks only). Furthermore, the treated zone is broader than that with buccal fat removal.
In patients who have truly rounded lower faces, I can use both methods. Sometimes I’ll even throw in some chin liposuction or a chin implant. This creates an even more profound outcome. We get Real Patients with Real Results!
If you are considering facial contouring in the NYC area, you can contact my office online to request a consultation, or call my office at
(212) 249-4020 to schedule an appointment.
How much does this procedure cost?
We try to keep these procedures affordable. If you would please call my office at (212) 249-4020 they will give you a verbal estimate.
Can you do over the fone consultation since i am living far away
We can do a FaceTime video consultation if you send photos first to [email protected]
Sure, call (212) 249-4020. The girls will let you know cost depending on what you want to have done.
Hi, I’m a 27 yo male looking to get rid of my wide cheeks and fat from my chin and neck. I’m 6’2 163 and 9.7% body fat I just had checked. Very fit, fast metabolism, and it’s just genetics that I have sort of excess fat on my otherwise angular face, and I”m glad to look younger for my age, it’s something that is disproportionate and enough to make me want to look into getting something done. I have gotten down to the low 150s weight last summer and the facial fat finally went down and I was happy but it was too extreme a diet to maintain for someone like me who likes food and is happy with my current lifestyle and diet and just wants this facial aesthetics thing worked on. I did have a heart valve replacement a year ago, all going great and am on warfarin which I know is something to consider in all surgeries, though my understanding is this is a relatively minor risk in terms of studies, though I would want to thoroughly go through all this in considering what to do. Thanks
While I’m happy to take a look at your photos, I must say that a new heart valve and the need for blood thinners is a real issue on this one. Buccal fat removal is typically done through the mouth which actually has a whole lot of bacteria. If you somehow ended up seeding that valve with germs from the operation, it would be a disaster for you. Furthermore, your cardiologist and cardiac surgeon would object to taking you off the warfarin for the required time because of the risk that you might clog up that valve. Perhaps, in your case, we should consider some non-invasive or minimally invasive options. I’m happy to discuss it with you if you come by and let me have a look some time.
Hello! can you make a quotation? i need facial sculpting
That all depends on what exactly you’d like to have done. If you call my office, they can give you an idea. (212) 249-4020
i’m am soon to be 29 years old and have an extremely full chunky fat cheeks and a 2xl like almost triple chin/neck bassethound like and it’s awful. I am not asian,nor have any asian in me,but i have that round face shape & also my upper eyelids are a little fat i don’t have super hooded lids thankfully and my eyes are large,but i have a southeast asian maybe indonesian face large eyes,a little bit fat eyelids & very chubby face & jawline.How much approximately a range would a buccal cheek fat removal,facial liposuction & neck/chin/jawline liposuction sculpting cost? an approximation please,i also was looking into blepharoplasty for both upper eyelids,approximately how much does that procedure go for? I am interested in not filling the cheekbones i would not want the high cheekbones i don’t like the chipmunk cheeks of chrissy teigen,i heard a surgeon on a tv show say buccaneers cheek fat removal can be removed entirely for a gaunt face,i would like my face my cheeks and chin to be as narrow as possible without looking like a giraffe. I want more of a deer face shape. Honestly, i would love so many more procedures a rhinoplasty & orthodontic surgery (which i know you don’t perform) would be amazing too,but it’s all too much trauma for the face at once. How far apart would you recommend these procedures be done? or can a rhinoplasty be combined with blepharoplasty,buccal cheek fat removal,facial lipo & neck/chin lipo? It seems crazy to do them all at once like i wouldn’t be able to see,smell,sniff,nor eat & sip well for some days or a week.
Wow, you sure have a lot of questions! You know that we offer a complimentary 30 minute consultation for these particular procedures, right? It might be more practical to see you in person and answer your questions here in the office. Unfortunately, I’m not sure what your combination of procedure requests would run, but if you call the office at (212) 249-4020 my team will be happy to give you a range.
Hope to see you soon!
what is the cheek liposuction recovery like?
patients tend to be swollen for about 7 days after cheek Lipo. This is a little surprising because with chin/neck liposuction I find they are ready for public viewing in 4-5 days. It’s also worth noting that with buccal fat removal there is no significant swelling at all.
Hi, I had sliding genioplasty 2 years ago and have experienced sagging as a results. My chin sags especially when I’m smiling. I never had this issue prior to the surgery and would like to have it fixed. Do you have experience fixing chin ptosis and reducing chin pad tissue?
Whoever did the sliding genioplasty is going to be the best person to make this adjustment. I truly believe you should see your original surgeon.
I have two questions…
1. When you remove fat from the lower cheeks, does that “bring out” the definition of your midface? I had a consult with two surgeons. One said my midface was flat and wants to inject Voluma which I disagree with because I think that will just make my face look even bigger. The other surgeon suggested a more novel approach and wants to liposuction my lower cheeks and says it will bring out my midface which he does not see any problems with. I already had submental liposuction and a bilateral buccal lipectomy two years ago but my face still looks chubby so that is why I am looking into facial liposuction.
2. How does liposuction in the lower cheeks affect the lips and mouth shape once all that fat is removed from that area? Do the lips “spring up” into a more horizontal position? do the corners droop in any way due to a lack of support? or do the lips just look better overall once that excess fat is gone?
How much does a FaceTime consult cost? I would certainly like you to review my case before I schedule it.
In my experience, lower face liposuction helps make the features of the mid face “Pop” a bit more, yes.
I can’t say I’ve noticed much change to the mouth or lip area with lower face liposuction – sorry!
I’d be happy to FaceTime with you. Why don’t you call the office at (212) 249-4020 and set up a time?
I’m in my 20’s, in shape, have a nice jawline and my face shape is too. But I can’t get rid of my chubby cheeks. Would liposuction or buccal fat surgery work best ?
That depends on which part of your cheek you want to reduce and how much. Buccal fat removal will give you a nice contour depression at the level of the corner of the mouth just below the cheekbone. Liposuction will remove subcutaneous fat from the entire lower face and jowl region.
Seems that buccal fat removal would be best. As I get older, will there be some sort of defect detection in my face ? I’m curious to know if this surgery will take a toll on my face through the years.
It seems that is always the fear, but I haven’t actually seen anyone who it’s happened to. Have you?
Is it possible to have lower cheek liposuction after buccal fat removal if not satisified with the results of buccal fat removal?
Yes. I’ve done that several times for patients who wanted a more profound result than what they got with buccal fat removal alone.
I’m in my late 20s and I don’t like the appearance of my cheeks especially when I smile. There’s more fullness in my upper cheeks than my lower cheeks. Can this area be treated?
Hmmmmm, if I understand you correctly, you want me to remove upper cheek fat? Like below the eyes? That’s not something I am offering at this time. I’m happy to sculpt the lower face somewhat, but the area that we call the “upper mid face” is not something that one should reduce. You will likely regret it. Now, as for the lower cheeks, yes – I’m happy to do something for you in that region.
I am at 56kg, 5’5 tall currently , but have the genetic issue of quite a bit of heaviness and or chubbiness on the lower half of my face and a little around the jowl area too. I long for a more defined lower half of face. Does this procedure remove the fat permanently or can it go back to the exact way it was before if you gain weight ? I just don’t want to get my desired face and then lose it due to gaining a few pounds. I’m someone who gains facial fat if I gain overall bodyfat and I am saying this because with things like a future pregnancy, weight gain is inevitable.
As you know, I can’t give you a lifetime warranty on any of the work that I do. That said, I think it’s unlikely that you would ever need a repeated procedure to remove fat again from your face. Is that fair?