There are really two areas that are commonly referred to as the “cheek.” One area is the cheekbone, or malar area. The other is the actual soft cheek, also called the buccal area. The shape and size of both have a profound influence on the appearance of the face.
In general, it is aesthetically pleasing to have some fullness or prominence to the malar area (cheekbone). In contrast, less fullness of the buccal area (soft cheek) tends to be more aesthetically pleasing. The overall contour of the malar and buccal areas should be a gentle “S” shaped curve referred to as the “Ogee.” A beautiful contour is more about the balance of the two areas than the actual fullness or emptiness of either one.
For those individuals who have a lack of fullness of the malar area (cheekbone), augmentation here will improve the appearance and shape of the face. Similarly, for those individuals who have excess fullness of the buccal area (soft cheek), reduction will lead to a more pleasing look. Again, it is the balance between the two areas that is essential.
Our preferred method of augmenting the malar area (cheekbone) is through the use of fat grafting. In this technique, fat is harvested from another part of the body, usually the abdomen, sides, or thigh. The fat is then specially prepared in small syringes. The fat is then meticulously injected in multiple tiny and even layers throughout the malar area. The goal is to create an augmentation which is smooth, even and natural in appearance.
A buccal lipectomy is performed if the buccal area (soft cheek) has excess fullness. This can reduce the size of the cheek in selected cases. The fat is removed from an incision within the mouth. No external scars are created. The result is a modest reduction in the size of the lower cheek.
Done together, or separately, each procedure can achieve a subtle and enhanced appearance to the face.
There is some slight bruising associated with malar augmentation. Very little bruising, if any, is seen with the buccal lipectomy. Both procedures result in swelling. In general, most bruising will resolve over 2-3 weeks. Swelling takes an average of 3-6 weeks to resolve. No special garments or dressings need to be worn after surgery.
Most patients return to work in about 5 days. The bruising is usually camouglaged well with makeup by this point. Full activity can be resumed within 2-3 weeks.
This patient felt that her face appeared too round and full. She wanted to do something that would make her face look more thin. We performed a buccal lipectomy and liposuction of the neck. She also underwent a rhinoplasty. As you can see in the “After” pictures, the lower cheek area looks less full. This gives her face a more oval appearance. Her cheek bone is now accentuated because there is less fullness below it in the lower cheek area. Liposuction of the neck only magnified these results. She looks completely natural. These procedures improved the balance among her facial features.