Can a thread lift help sagging deep cheek fat (buccal fat)?

If your deep cheek fat has moved down and the area beside the corners of your mouth now bulges, a thread lift may be considered to lift the sagging cheek tissue and hold it in place. If the bulge comes from simply having a lot of buccal fat, some fullness may remain even after lifting. And if your cheeks are already hollow, reducing fat needs careful thought, so the first step is working out which situation you're in.

Where deep cheek fat sits

Deep cheek fat is the pad of fat deep in the cheek, below the cheekbone and outside the corners of the mouth. Its medical name is buccal fat. Several ligaments anchor it toward the upper jaw and cheekbone. As those ligaments and the membrane around the fat loosen with age, the fat can move downward.

(Evidence: Chinese anatomy study of 22 hemifaces, 2002)

In a study that compared MRI scans of the same people taken at least four years apart, this fat compartment lengthened downward over time. The researchers concluded that this change deepens the folds beside the mouth.

(Evidence: Taiwanese MRI comparison study of 63 people, 2021)

Signs of sagging deep cheek fat

• A bulge you didn't used to have has appeared below and outside the corners of your mouth.
• Lifting the cheek below your cheekbone up toward your ear with your fingertips makes the bulge almost disappear.
• It's less visible when you lie down and more noticeable when you look down.
• The folds beside your mouth and the front of your jawline look lower too.

In these cases, the fat has moved out of place rather than increased, which makes a thread lift worth considering.

When other options are discussed

• Your cheeks have been full since you were young, and the volume stays the same when you lift them. You likely just have more fat, so your doctor will also talk about ways to reduce volume.
• The area below your cheekbone is already slim and shadowed. Removing deep cheek fat here could make your face look more hollow as you age, so reduction is approached with caution.
• If you have both sagging and extra fat, the plan is staged: what to lift, what to reduce, and in which order.

There's no way to say in advance which approach is better, because the same bulge can have different causes.

What to know after a thread lift

• Swelling and bruising can last a few days.
• You may feel tightness for a while when you open your mouth wide or chew.
• Rarely, skin dimpling or a height difference between the two sides can occur.
• How much change you see and how long it lasts vary from person to person.

(Evidence: comprehensive US review of thread-lift literature, 2019)

What to bring to your consultation

Deep cheek fat that has sagged and deep cheek fat you've always had can be hard to tell apart from how your face looks today. Sharing the following beforehand helps.

• Front and profile photos from your 20s and 30s
• Any weight changes over the past few years
• Records and dates of any past treatments to reduce or add cheek fat
• The angle that bothers you most (front, profile, or looking down)