You are absolutely right that smoking does cause you to age faster, so congratulations on kicking that smoking habit! From the photographs (which are limited) it appears that you have rather heavy cheeks. However, I find it difficult to give suggestions to you based on pictures without a complete clinical evaluation in person. I can give you a few pointers on some of the treatments that you mentioned.
Ultherapy is an excellent ultrasound based device for tightening of the facial skin and stimulating collagen for facial rejuvenation. However, it is not used to get rid of fats. Tightening of the face can help to lift the cheek tissue hence reducing the appearance of the sag. Buccal cheek fat removal is a simple day surgery procedure where we can remove the buccal fat through a small stab incision from the inside of the mouth.
The buccal fat lies between the angle of the mouth and the jaw muscles. It is common referred to the fat that causes the chipmunk cheeks. From some of the photos, it seems that you may benefit from this procedure. The other option would be liposuction of the face and this can be done with a very fine liposuction cannula to reduce the cheek fats. I believe mesofat injections are not allowed in Singapore anymore as there is no evidence to support its indications. I hope this answers your question. Have a great week ahead and all the best!
Dr. Terence Goh
Plastic Surgeon
The information provided is purely for educational purposes and does not constitute medical advice or create any physician/patient relationship. Results may vary between individuals.