Buccal Fat Removal: Procedure, Results & Risks

Buccal fat removal is a cosmetic surgery that reduces fullness in the cheeks, creates a slimmer facial appearance, and makes the cheekbones more prominent. In some cases, it may also be performed to correct chewing problems.

During the procedure, the surgeon makes small incisions inside the cheeks. The buccal fat pads, also known as Bichat fat pads, are then partially or completely removed.

Buccal fat removal is generally a simple and relatively quick procedure performed under local anesthesia by a plastic surgeon or an oral and maxillofacial surgeon. Certain precautions are necessary after surgery to support healing and recovery.

Who may be a candidate

Buccal fat removal may be considered to:

• Improve facial contour

• Reduce fullness in the lower cheeks

• Create a slimmer, more defined facial appearance

• Make the cheekbones appear more prominent

Buccal fat removal may be performed alone or as part of a broader facial contouring plan.

A related but different reconstructive procedure may use the buccal fat pad as a flap to close an abnormal opening between the maxillary sinus and the oral cavity. This procedure does not involve cosmetic removal of the fat pad.

Anyone considering buccal fat removal should consult a board-certified plastic surgeon or a qualified oral and maxillofacial surgeon for an individualized evaluation.

How to prepare

Before undergoing buccal fat removal, discuss any questions about the procedure with the surgeon, including the expected results, recovery process, and possible complications.

The surgeon should also be informed about all medications, supplements, and herbal products that are used regularly.

People who take anticoagulants, commonly known as blood thinners, may be instructed to temporarily stop taking them several days before surgery to reduce the risk of excessive bleeding. However, these medications should never be stopped without specific instructions from the prescribing provider.

People who smoke may also be advised to stop smoking before the procedure. According to the American College of Surgeons, smoking increases the risk of problems during and after surgery, while quitting before surgery can significantly reduce wound complications.

How it is performed

Buccal fat removal is usually performed by a board-certified plastic surgeon, facial plastic surgeon, or oral and maxillofacial surgeon in an accredited outpatient surgical facility or office-based operating room.

Depending on the patient and whether other procedures are performed at the same time, local anesthesia, IV sedation, or general anesthesia may be used.

To perform buccal fat removal, the surgeon generally follows these steps:

1. Administers anesthesia
2. Makes a small incision inside each cheek
3. Carefully removes a portion of each buccal fat pad
4. Closes the incisions with stitches, which are often dissolvable

Buccal fat removal is generally an outpatient procedure, so the patient can usually go home the same day without an overnight hospital stay.

Recovery time

Recovery from buccal fat removal typically takes about 1 month, although most people can resume normal daily activities within a few days. The procedure usually causes only mild pain.

The surgeon may recommend pain relievers or anti-inflammatory medications to help reduce pain and discomfort.

After surgery, it is normal for the face to remain swollen for some time because of inflammation in the facial tissues. The swelling gradually improves as the tissues heal.

In general, the stitches inside the cheeks dissolve naturally within about 1 week.

Care measures

During recovery from buccal fat removal, the following precautions are important:

• Apply cold compresses to the face for 15 to 20 minutes at a time, 3 to 4 times a day during the first week to help reduce swelling.
• Sleep with your head elevated until the swelling has gone down.
• Follow a soft-food diet for the first 7 to 10 days to avoid irritating the incisions.

Most people can return to work within 1 to 3 days after surgery, depending on the extent of the procedure and the nature of their job. However, strenuous exercise, heavy lifting, and prolonged sun exposure should be avoided until the surgeon advises that it is safe to resume these activities.

Buccal fat removal before and after

Before buccal fat removal, the cheeks or cheekbone area may appear fuller or more prominent. After the buccal fat pads are removed, the face generally appears slimmer and more defined.

To compare the appearance before and after the procedure, the surgeon will usually take photographs before surgery. The results are irreversible because the buccal fat pads are removed either partially or completely.

Possible risks

Buccal fat removal is a relatively simple procedure, but complications can occur. According to the American Society of Plastic Surgeons, possible complications include:

• Infection at the surgical site
• Injury to branches of the facial nerve, which may cause temporary or permanent facial muscle weakness
• Salivary duct injury
• Facial asymmetry

To reduce the risk of complications, the procedure should be performed by a qualified plastic surgeon or oral and maxillofacial surgeon. It is generally recommended for people with naturally full cheeks who are considered suitable candidates after a thorough evaluation.

Read more about how to lose weight in your face without surgery.