Why Cheek Fat Pad Elevation can give a better outcome during Face or Cheek Surgery

Cheek Surgery and Fat Pads during a Facelift

Face and Cheek Surgery can include elements such as Cheek Augmentation, Buccal Fat Surgery and Malar Fat Pad Elevation to improve the look of your mid-face area.

Dr Richard Sackelariou is a leading facial plastic surgeon for Cheek and Facelift surgery, he operates in both Melbourne and Sydney helping patients seeking a younger, more refreshed natural look. With over 20 years of experience, he is a calm, caring and precise surgeon.



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The Ageing Face and Cheek Surgery

The size of your cheekbones and overlying fat and tissues have a great impact on your facial appearance. This includes ageing perceptions. Younger individuals typically have good fat distribution over their cheekbones. As you age, your cheeks may begin to look sunken or less prominent as the cheekbones atrophy and the skin starts to sag. The good news is that a plastic surgery procedure involving a full facelift including cheek fat pad elevation can not only help augment your cheeks but also restore firmness and improve projection over your mid-face region.

What is a Cheek Fat Pad?

The term “cheek fat pad” actually refers to a number of different sections of fat in your cheek anatomy. The different sections of your cheek fat pad anatomy including the malar fat pad, buccal fat pad and also SMAS (superficial musculoaponeurotic system)

The Malar Fat Pad is located in the Cheekbone area, near the eyes

  • The malar fat pad sits near your cheekbone
  • It is located close to your eye area

The Buccal Fat Pad is located deep within the SMAS  Superficial Musculo-Aponeurotic system

  • The SMAS makes up the bulk of your cheek region
  • The buccal fat pad is located deep within the SMAS structures

Full Facelift Surgery procedures are very complex and require expert surgical skills for a good result.

During a full SMAS facelift, the cheek pads are also elevated. This not only restores volume but also projection in that area for a natural-looking facelift result.

Why Cheek Fat Pad Elevation can give a better outcome during a Facelift or Cheek Surgery

  • As you age, gravity, skin, muscle laxity, and cheekbone atrophy, can cause your cheek fat pads to move.
  • This is particularly the case when it comes to the position of your malar fat pad.

The Malar Fat Pad can be relocated or enhanced during a Full Facelift

Over time, your malar fat pad can droop down and forward, away from your eyes and cheekbone.

  • This can cause bulges in your cheeks near the nose and mouth.
  • It can sometimes cause your mouth to droop a bit, as well.

Buccal fat pads are often an issue for people who have fuller-looking cheeks.

  • The SMAS makes up the bulk of the muscle and fat in your cheeks.
  • As you age, changes to the buccal fat pads and SMAS often leads to drooping of the mouth, face and jowls.
  • Sometimes the drooping of those sections of the face is quite severe; in this scenario, you may find yourself unhappy with your appearance and want a lift of those sections of your facial anatomy and skin, this can in turn lead you to research your Facelift options.

Procedures for facial rejuvenation, that do NOT involve manipulating these specific areas of the face and cheeks, don’t tend to have very long-lasting results.

How is Cheek Fat Pad Elevation Performed?

  • For the SMAS, some surgeons choose to position or anchor it to itself, with sutures.
  • Other Surgeon’s “remove” and stitch it back together to resculpt the face.
  • Still, other Surgeons may lift and reposition the SMAS entirely during a Facelift.
  • It all depends on the ageing of your face as well as the results you desire.

Options for Buccal Fat Pad Re-Positioning During a Facelift

  • The buccal fat pad is sometimes repositioned higher on the face, during a facelift procedure.
  • This can help make the face appear fuller in a patient whose face has taken on a gaunt, lean or elongated appearance.

A fuller face is associated with a youthful look, and hence, a facelift that includes SMAS/cheek fat redistribution techniques is typically going to get a better result on selected patients.

  • But some patients, who have a very full face and want a leaner look, may be better off having the buccal fat pad removed entirely.
  • The malar fat pad is generally returned to its original position near the cheekbones, smoothing out the bulges and lines.
  • Different Plastic Surgeons choose to manipulate fat pads in different ways, therefore surgeons with different skills get patients with different ‘signature looks’.

Cheek Fat Pad Elevation and Facelift incisions

  • Depending on your surgery, incision points may be made near your ears.
  • These incisions usually extend along your hairline and behind your ear crease.
  • This allows your Surgeon to disguise, or strategically hide, any scarring as best as possible while still getting a good face lifting and facial rejuvenation result.
  • After making incisions along with those areas of your face, your Surgeon will carefully work to re-position the required areas of your facial tissues. They will smooth out both your facial lines and bulges for a firmer look.
  • Furthermore, a good facelift or cheek fat pad elevation procedure can reduce the ageing appearance of your face by several years.
  • Read the TIME article on a scientific study of how much younger people looked after having a facelift.

Who Is Suitable for Cheek Fat Pad Elevation Surgery?

  • If you have moderate to advanced facial ageing, you may be a good candidate for Cheek Fat Pad Elevation.
  • Most traditional Facelift and Neck Lifts, especially in older patients, involve the repositioning of the fat pads as otherwise, the result would not be as pleasing, natural-looking or as long-lasting.
  • If you’re a younger patient around 35-45 years in age, more concerned with mid-face ageing than lower facial ageing of the jowls, you might be recommended to pursue a mid-face facelift.
  • Anyone who is generally healthy, and concerned with ageing of the mid-face area – including younger patients, women, men and people with good skin laxity are likely to be good candidates for Cheek Fat Pad Elevation surgery.
  • Older patients or those with skin laxity issues might need to pursue a more traditional facelift to also correct excess skin issues.

Elevation of the midface by manipulating the fat pad is a relatively simple technique in the hands of skilled plastic surgeons like Dr Sackelariou.

Using the natural cheek fat pad, rather than a cheek implant, allows for a more natural-looking face. It also requires fewer surgical sessions to achieve your desired result.


About Dr Richard Sackelariou Plastic Surgeon

Dr Richard Sackelariou MBBS FRACS(Plas) is a Specialist Plastic, Cosmetic and Reconstructive  Surgeon in Melbourne, Victoria and Sydney, Australia.

Dr Sackelariou is a highly sought-after Plastic Surgeon for precision procedures like nose reshaping, tummy tucks, breast surgery including transaxillary incision methods, implant removal/replacement and Breast Lift procedures.

His signature surgeries include – neck lift, facelift and eyelid rejuvenation procedures. He also performs expert cosmetic injections for facial rejuvenation.

Patients love his caring manner, his dedication to excellence and his extensive expertise in surgical planning for a natural-looking, harmonious result.

What’s Next

Book a Consultation with Dr Sackelariou in Melbourne or Sydney. A caring discussion with a Plastic Surgeon about all your options can really help. The best thing is to start with a phone enquiry and consider having a Consultation with Dr Sackelariou. Try the Free Nose Simulation Tool.


If you are considering cosmetic plastic surgery then Dr Richard Sackelariou is the specialist plastic surgeon for you.

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Dr Sackelariou can assist you in achieving your desired body image, helping restore you to a more youthful and confident self.

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