By Carla Walsh

Losing weight may help to sculpt the face. But you can rock a slim bod yet still have a round or broad face, because facial fat behaves differently from body fat. If weight loss fails to slim the face, how then do we get rid of stubborn lower cheek fat and flaunt an oval v-line face or a chiseled look? The answer lies in identifying and targeting the offender. Our cheeks are made up of skin, fat, muscle and bone. An excess of any of these tissues may contribute to the roundness of the cheeks. More than often, there are more than one culprit at play, and correctly identifying and targeting them is the answer to facial slimming.
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FAT
There are two types of fat within the cheeks. The deeper buccal fat, often the responsible for the “chipmunk” appearance, and the outer fat under the skin, which contributes to the heaviness of the cheeks. Thankfully, both can be dealt with.

Buccal fat removal is a “scarless” clinic-based procedure. The fat is extracted from inside the mouth through a 1.5 cm cut. Mild swelling is expected, usually lasting under a week. Many describe it as tolerable, likened to a simple dental procedure.

Doctors have 3 clever ways to target the outer, more superficial fat. The fastest way to remove fat is by liposuction. Combined with the use of ultrasonic waves, Vaser liposuction chisels the cheeks away by emulsifying fat (to aid removal) and tightening skin at the same time.
Profound RF, which stands for RadioFrequency, is one of the most effective tightening device available in the market, without going under the knife. Using micro-needles, Profound delivers radiofrequency energy into the cheeks. Radiofrequency waves boost new elastin, collagen and hyaluronic acid in the skin. But it doesn’t stop there. It also has a fat-melting function, as the energy is delivered into the fat layer under the skin.

Finally, an injection that actually dissolves fat! Lipodissolve contains the active ingredient deoxycholic acid, which is clinically proven to break down fat. A few sessions are usually required to achieve the desired effect. Any fat evacuation procedure, like Lipodissolve, will benefit from skin tightening to sculpt the skin over the newly deflated cheek. More on that later.
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MUSCLE

The masseter muscles nested at the sides of the cheeks and jaws add to the squareness and fullness of the cheeks. Derived from the Greek word masathai, meaning “to chew”, the masseter muscle is a powerful muscle built for a lifetime of chewing, which explains its bulk. Botulinium toxin, or Botox, injection is a well-known solution for weakening muscles and softening wrinkles. For the masseter, it has an additional benefit of shrinking the muscle. The result of masseter muscle reduction is flattening of the cheek and reduction in the angularity of the jaw.
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SKIN
A taut cheek is definitely more slimming than a saggy cheek. Without “defatting” the cheek, you will find that skin tightening and lifting devices alone will also help to slim the cheek. The latest skin tightening devices use either ultrasound or radiofrequency (RF) to deliver energy into the deeper layers of the skin for collagen remodeling. It is not surprising that many ultrasound and RF devices are running amok in aesthetic and beauty clinics. It is crucial, though, to choose reliable and effective devices, with an excellent safety record. The Thermage RF system, now at its improved 3rd generation, renews skin collagen effectively and safely. Ulthera, another FDA-approved treatment, delivers ultrasound energy to a deeper layer of the skin, for tightening and lifting.

Thread lift will lighten and sculpt heavy cheeks. Threads are armed with cogs, barbs or cones to suspend the skin upwards. Some threads are made of “biostimulating” materials such as PDO. This means that even though the threads dissolve over time, the thread material inserted stimulates collagen production and increases the tone and firmness of the skin.
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BONE

The lower jaw, or mandible, is the deepest layer of the lower cheek and the top cause for a square lower face. After addressing the fat, muscle and skin, the cheek may still look broad if the underlying bone is the main cause for a wide face. In angle reduction, plastic surgeons reduce the broadest part of the jaw (the angle) surgically. Another clever way to slim cheeks is to reshape the chin. A chin that is augmented, either with fillers, fat graft, chin implants or bone surgery (genioplasty), can give an illusion of slimmer cheeks.

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