A frequent aesthetic facial request is the desire to reduce full or round cheeks. The most recognized procedure to do so is the well known buccal lipectomy. While removal of this encapsulated cheek fat is effective it is not a complete cheek reduction procedure. Tbere are other subcutaneous cheek areas around the buccal fat area that requires small cannula liposuction to reduce. For this reason combining buccal lipectomies and cheek liposuction is the most effective facial slimming procedure.
In some patients that present for facial slimming they may have cheek dimples. Such congenital dimples exist because of a defect in the underlying zygomaticus muscle. This causes a skin tether down into the muscle defect with a thinner subcutaneous layer. The interesting question is whether subcutaneous liposuction can disrupt the cheek dimple attachments and make it less visible after the fat removal.
Perioral or cheek liposuction is performed through a small incision inside the corner of the mouth. A small 2.0mm cannula is used to widely aspirate the subcutaneous fat between underside of the cheekbone down to the jawline and posterity back to the anterior border of the masseter muscle. Manual back and forth aspiration continues until no further droplets of fat are removed and there is only blood coming out.
Having performed hundreds of perioral./cheek liposuction with a fair percentage of some form of a cheek dimple (about 15%) I have yet to see or been told that their cheek dimples were eliminated or significantly reduced in appearance. In theory the reduction in the thickness of the subcutaneous fat layer should at least make the dimple less deep or apparent. But this appears to not be the case.
Dr. Barry Eppley
World-Renowned Plastic Surgeon