What's an easy way to achieve a lower cheek reduction?

I never thought that I'd have the start of jowls at 29, but here I am. It's probably hereditary since my father has the same (but more obvious) sagging skin around his lower cheeks. I'm not sure buccal fat removal is what I need because it's more about skin laxity than removing fat, I guess. What do you think? Would fillers be a good idea or should I try something else?


F, 31, Connecticut

Tags:woman age 25-34 cheeks sagging reduction fat graft lower

It definitely sounds like buccal fat removal is not the right choice for you because it has way more to do with your fat deposits than it does your skin. I think that how you feel about your face right now is really going to decide which procedure you should have.

Fillers would definitely work on that area of your face, but it will also just fill them up. Many women that have jowls aren't super happy with the shape of their face because they tend to have chipmunk cheeks, but if you're fine with that then a filler is the right choice. When I started to get jowls I decided to get a facelift because I didn't like the extra fat on my face anyways.

What you decide will really depend on how you want your face to look moving forward.

I'm not a surgeon but I think that you could be a good candidate for a buccal fat removal. Having that area slimmed down a little bit would probably decrease the look of jowls and make you look much more streamlined. I haven't known anyone that has had this procedure done for that reason but I think that it would work really well for you.

I guess the only hesitation I have is that the skin on your face is already stretched out. If you have the fat removed, then your skin might just hang there and you'll need a facelift down the line. Like I said though, I’m not a surgeon, and I may be 100% wrong. You should definitely reach out to someone that you trust in the business to sit down and have a conversation about what is going to work best for you.

I had fillers injected about 9 months ago after I went in for a consultation to fix my jowl problem. I've had jowls since my early thirties and it had a huge impact on my level of confidence. During my consultation they discovered that it was due to a loss of fat and that a buccal fat removal was not the right option as it wouldn't correct the problem. Fillers were a painless process and it was the best choice I ever made. The jowls are gone, my skin's tighter and more youthful, and it's boosted my confidence level. Now my face looks better in my forties than it did in my twenties.

There are several ways to removal lower cheek fat and jowls.  The cheek fat can be removed surgically or injection fat dissolving or with the Agnes device.  My favorite is the Agnes device- it is a handheld radiofrequency microneedling device that can precisely be placed into the fat for heat ablation at the tip.  This heat will kill the fat and may tighten the skin.  Its done done under local anesthesia with around 4 days of minimal swelling and bruising.


Ken Oleszek, MD

La Fontaine Aesthetics

Denver, Colorado