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.

Techniques

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.

Recovery

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.

Results

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.

This patient felt that her face appeared too full and round. We analyzed her face and recommended cheek reduction and liposuction of her neck. The cheek reduction (buccal lipectomy) was performed through an incision inside the mouth. Liposuction of the neck was performed using small cannulas and minimal incisions in non visible areas. As you can see in the “After” pictures, her face appears less round. There is decreased fullness in the area of her cheek. There is also less fullness of her neck area. These pictures were taken approximately 1 month after surgery.

Additional before and after pictures are available in the office for review.

When we analyze a face, we examine each of the features and assess the relative proportions. Usually, a change in one feature will enhance the overall appearance of the face by reestablishing balance. Often, subtle changes in multiple features can be synergistic, creating an overall greater improvement. In some cases, performing a rhinoplasty, chin augmentation, cheek reduction, cheek enhancement or any combination of the above may dramatically improve the harmony among the features of the face. If you are interested in this, please request more information during the consultation.