There is a great deal of confusion among patients between buccal fat and jowl fat and their appropriate treatment, likely due to the complex shape of facial fat compartments. This blog post seeks to reduce that confusion. Seek a fellowship-trained facial plastic surgeon if you have concerns about your face. A consultation is essential to evaluate whether your concerns are related to your buccal fat, jowl fat, or both. A comprehensive, specific plan may then be developed to best address your concerns safely and effectively.
Is it My Buccal Fat or Jowl Fat That Needs Treatment?
Dr. Jeffrey Harmon
There are Superficial (e.g., Jowl) and Deep (e.g., Buccal) Fat Compartments in the Face
The face contains multiple compartmentalized fat pads that extend across the cheek as well as along the jawline. The fat pads along the jawline, like those in the cheek, droop with age, falling over the jawline. This results in jowling as well as the formation of marionette lines. There is little research evaluating the changes in size of the fat pads that form the jowls with age. This may be because studies of the volume of an area whose shape changes as it falls is difficult. It may also be difficult to account for other changes, such as weight gain or loss, over long periods of time when designing a study. However, plastic surgeons frequently observe that individuals experience enlargement of their jowl fat pads with age. I have found only one recent study – the only evaluating volume changes in the lower face with age – that supports what is widely seen clinically (1). This study identified thickening of the jowls with age. However, it should be cautioned that this study was limited by the fact that it simply compared a total of sixty women split into three age groups and did not follow them as they aged. However, it did account for things like body mass index (BMI) in each patient, thereby reducing the influence that overall weight has on the results. More and better-quality research is required to evaluate and characterize the changes that occur in the size and shape of jowl fat with age.
In contrast, the buccal fat is located deep in the face, much deeper than the jowls. It also sits superior to the superficial jowl fat. Buccal fat winds through deep structures in the cheeks in a complex shape, surrounding important structures such as blood vessels, a salivary gland duct, and branches of the facial nerve. The research is mixed as to whether buccal fat increases in size, decreases in size, or remains the same size as we age. Many surgeons feel the buccal fat remains approximately the same size with age or even enlarges. More research is required, however. This is why only a portion of buccal fat is removed with buccal fat removal surgery. This is also why buccal fat is removed in individuals who do not anticipate significant weight loss, though long-term weight loss is difficult to predict.
Treatment of Large Buccal Fat Pads Differs from the Treatment of Enlarged Jowl Fat
Treatment of enlarged jowl fat differs from the treatment of enlarged buccal fat. The aesthetic goals of treating each area differ as well.
Jowl fat sits closer to the skin and lower in the face compared with buccal fat. And unlike buccal fat, jowl fat falls over the jawline and forward towards the chin. The overall effect is that of making the jawline appear shorter and the face more bottom heavy. The best approach to treat the effects of falling jowl fat is through a facelift, specifically deep plane facelift surgery. Decreasing the size of jowl fat is more challenging in that the most appropriate treatment is not appropriate for most individuals. The size of jowl fat is commonly reduced using micro-liposuction, which is liposuction using a very small suction device. The jowl fat pad is small relative to fat removed using liposuction in other areas of the body, including the abdomen and thighs. As a result, the risk of “bumps” and other contour abnormalities is much greater with liposuction in this location. Therefore, only a small percentage of individuals who have very large jowl fat pads may see benefit from micro-liposuction when weighed against the risks. The more appropriate goal of treating the jowl fat is simply to bring it up closer to where it was when the patient was younger.
In contrast, buccal fat pad removal targets an area between the cheeks and jawline in the center of the cheek in individuals with very round, “cherubic” cheeks. The aesthetic goal of buccal fat pad reduction is to reduce the volume of the area between the superficial cheek fat and superficial jowl fat to make this area slightly more concave. This differs greatly from the aesthetic goal of reducing the volume of the jowl fat pad. As always, a consultation is required to determine whether an individual is a good candidate for buccal fat removal. However, there is significantly less risk of contour abnormalities with buccal fat removal when compared with micro-liposuction of the superficial jowl fat pad.
Trust Your Face to a Facial Plastic Surgeon
It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck.
Request a Consultation
Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more.
References
- Guo Y, Wen L, Wang X, Zou H, Liang W, Wang J, Zhu X. Analysis of age-related changes in lower facial fat compartments and of the course of blood vessels using computed tomography. Plast Reconstr Surg. 2023 Apr 4.
This blog post is for educational purposes only and does not constitute direct medical advice. It is essential that you have a consultation with a qualified medical provider prior to considering any treatment. This will allow you the opportunity to discuss any potential benefits, risks, and alternatives to the treatment.