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While not a classic feminizing procedure, facial defatting or slimming can be a useful facial reshaping technique for those patients who have naturally rounder faces or chubby cheeks.  The three facial areas that can be successfully reduced by different techniques are the two primary cheek areas, the buccal fat pads and the perioral mounds, as well as that of the neck. Often all three are combined to maximize the amount of facial slimming that can be achieved.

The buccal fat pad is a relatively large collection of concentrated fat that sits right below the cheekbone that is easily accessed from a small intraoral incision in the cheek opposite the maxillary second molar. (buccal lipectomy) Its removal, either partially or totally, helps reduce upper cheek fullness. But it is important to know that its effects do not extend all the way down to the level of the mouth or the jawline. This is a common misconception that it does. For this reason perioral liposuction is a good complement to buccal lipectomies. This reduction in the thickness of the subcutaneous fat layer by the side of the mouth and down to the jawline creates a more complete cheek slimming effect. Done with a very small cannula from an incision just inside the corner of the mouth, this lower cheek area can be treated from the buccal fat area down to the jawline. This is a perfectly safe area to treat by liposuction due to the lack of any motor nerves that run in this area.

The dual effects of buccal lipectomies and perioral liposuction can create a noticeable slimming effect even in patients that don’t really have a round or fuller facial shape. In the right face these defatting procedures can make the cheekbones look more prominent. In combination with even smaller cheek implants, a substantially enhanced cheekbone definition can be achieved.

Dr. Barry Eppley

Indianapolis, Indiana

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