Buccal Fat Removal (Cheek Reduction Surgery)

Full, round cheeks may be adorable on children, but their appeal often lessens into adulthood when a softer mid-face can make the face appear ill-defined. Boston female plastic surgeon Dr. Alannah Phelan offers buccal fat removal to help sculpt facial contours.

What is buccal fat removal?

Buccal fat removal, also called “cheek reduction surgery,” is a surgical procedure Dr. Phelan uses to reveal more of your natural cheekbones by reducing buccal fat—the naturally occurring fat pad within the cheeks. Buccal fat removal has gained popularity with patients of all ages due to its ability to eliminate “chubby cheeks” and create natural-looking definition and a more angular facial structure. It is important that patients are carefully selected for this procedure to avoid premature aging due to the creation of an overly angular face.

Ideal candidates for buccal fat removal

Dr. Phelan may recommend buccal fat removal if these indications are true for you:

  • You have naturally round or full cheeks and seek a slimmer facial appearance
  • You are planning on a facelift and have prominence of buccal fat pads (pseudoherniation of buccal fat)
  • You are in good overall health with realistic expectations about the outcomes of the procedure
  • You are an adult with a stable body weight and fully developed facial structures

Who should not get buccal fat removal?

Buccal fat removal may not be the best procedure to achieve your facial contouring goals if you have any of the following characteristics:

  • A very thin face: Buccal fat provides cushioning and support to the facial muscles and bones, so removal could result in a gaunt appearance if you already have limited facial fat.
  • Loose skin in the mid-face or jaw area: Buccal fat helps support the skin so removing it may exacerbate skin laxity. Buccal fat removal can be combined with a Boston facelift to define the cheekbones and remove excess skin. 
  • Certain medical conditions: Some medical conditions can complicate surgery or healing; Dr. Phelan will discuss your medical history to confirm surgery is safe for you. 
  • Unrealistic expectations: The goal of buccal fat removal is to highlight your natural bone structure, not to significantly alter your appearance.

In these cases, Dr. Phelan will recommend alternative treatments.

Your consultation with Dr. Phelan

The first step is a thorough consultation with Dr. Phelan so she can assess your facial structure, discuss your aesthetic goals, and determine if buccal fat removal is the right procedure for you. 

The buccal fat removal procedure

Anesthesia

Dr. Phelan performs buccal fat removal under local anesthesia with or without sedation. If your surgery plan includes other procedures, such as a facelift, then you’ll be under general anesthesia to ensure you’re comfortable during the procedures. The procedure typically takes about 30 minutes to an hour, depending on your unique case.

Incisions 

Buccal fat removal incisions are very small and made inside the mouth on the inner cheek area. From here, Dr. Phelan meticulously removes a small portion of the buccal fat pad, being careful to maintain symmetry and create results that appear natural. 

Once Dr. Phelan makes the adjustments needed to achieve a slimmer facial profile, she closes the small incisions with dissolvable sutures.

Buccal fat removal recovery & aftercare

Most patients report only minimal discomfort and mild swelling after buccal fat removal surgery. Tenderness and swelling quickly resolves within a few days to a week. Typically, over the counter pain relievers are all that is needed to manage the temporary discomfort. 

For the first week after surgery, you’ll gently swish with mouthwash 4 times a day to help prevent infection. The stitches will dissolve on their own within 1-10 days for most patients. 

If buccal fat removal is the only procedure in your surgery plan, you may return to most normal activities and work immediately, keeping in mind you will need to prioritize a quick break or two to use mouthwash throughout the day.

Tips for a smooth recovery after buccal fat removal

  • Follow all post-operative care instructions provided by our team
  • Choose softer, easy-to-chew foods for the first few days
  • Delay strenuous activities for about a week to avoid unnecessary swelling
  • Sleep on your back and keep your head elevated for the first week to reduce swelling and limit tenderness
Key Benefits
  • Removes buccal fat pads to achieve a more angular and defined facial structure
  • Improves cheek definition by reducing the fullness of the cheeks, making cheekbones appear more prominent
  • Results are permanent, providing long-term enhancement of facial contours.
Glossary
  • Cheekbones: Cheekbones are the prominent bones below the eyes.
  • Jawline: Jawline refers to the lower contour of the face.
  • Buccal fat removal: Buccal fat removal is a cosmetic procedure that involves the extraction of fat pads from the cheeks to slim the face.
  • Buccal fat pad: Buccal fat pad is a mass of fat in the cheek area that is targeted during buccal fat removal to reduce facial fullness.
  • Plastic surgery: Plastic surgery encompasses various procedures, including buccal fat removal, aimed at improving or restoring the appearance and function of body parts.
  • Fat pads: Fat pads in the cheeks, specifically the buccal fat pads, are removed during buccal fat removal to achieve a slimmer face.
  • Cheek reduction surgery: Cheek reduction surgery, or buccal fat removal, is a procedure that reduces the size of the cheeks by removing fat pads.
  • Liquid diet: Liquid diet might be recommended after buccal fat removal to ease the recovery process and avoid discomfort while chewing.
  • Facial plastic surgeon: A facial plastic surgeon is a specialist trained in procedures like buccal fat removal to enhance facial aesthetics.
  • General anesthesia: General anesthesia, in which patients are completely asleep, may be used during buccal fat removal to ensure the patient is comfortable and pain-free during the procedure.
  • Plastic surgeons: Plastic surgeons are medical professionals who perform surgeries, including buccal fat removal, to alter and improve physical appearances.
  • Cheek hollows: Cheek hollows can be accentuated through buccal fat removal, giving the face a more contoured look.
  • Smile lines: Smile lines can appear more pronounced after buccal fat removal due to the reduction of cheek volume.
  • Face shape: Face shape can be altered by buccal fat removal, leading to a slimmer and more defined appearance.
  • Cosmetic procedure: Cosmetic procedures like buccal fat removal aims to enhance aesthetic appeal and improve facial contours.
  • Hollow area: The indented area in the cheeks that can be created or accentuated through the removal of buccal fat pads.
  • Potential complications: Potential complications of buccal fat removal include infection, asymmetry, and prolonged swelling.
  • Facial structure: Facial structure can be enhanced by buccal fat removal, making features like the cheekbones and jawline more prominent.
  • ASPS member surgeons: ASPS member surgeons are board-certified plastic surgeons who perform procedures such as buccal fat removal.
  • Liposuction: Liposuction is another fat-removal technique but differs from buccal fat removal, which targets specific fat pads in the cheeks.
  • Lipectomy: Lipectomy is the surgical removal of fat, similar to the process involved in buccal fat removal.
  • Face-lift: Face-lift is a different procedure that tightens and lifts facial skin, sometimes combined with buccal fat removal for enhanced results.Risks: Risks of buccal fat removal include bleeding, infection, and dissatisfaction with cosmetic results.

Buccal Fat Removal FAQs

Yes, once the buccal fat pads are removed, the results are permanent. That said, remaining fat cells in the face can expand with weight gain.

No, buccal fat removal incisions are made inside the mouth so there are no visible scars on the face.

You’ll likely see immediate results, which will become more apparent as the swelling subsides, typically within a few weeks. Full results are visible within three to six months.

You can choose to combine buccal fat removal with other facial rejuvenation procedures such as:

Dr. Phelan would be happy to discuss adding additional procedures to your surgery plan if desired.

The cost of buccal fat removal in Boston varies based on your unique procedure plan. We provide a detailed cost estimate during your consultation and offer financing options to help you manage the cost of your procedure.

You’ll likely see immediate results, which will become more apparent as the swelling subsides, typically within a few weeks. Full results are visible within three to six months.

Yes, buccal fat removal can be suitable for both men and women who wish to achieve a more chiseled cheekbone appearance.

You can help maintain your results with a stable weight and following a healthy lifestyle. Fillers can be used to enhance your results further by adding natural-looking volume to just the cheekbone area, highlighting the contoured look of the rest of the mid-face.

No, reversing the exact removal process is not possible. However, fillers or fat transfer procedures can add volume back into the cheek area.

No, Dr. Phelan carefully removes the fat pads without disturbing the muscles and structures responsible for facial expressions.

Non-surgical options like injectable fillers can contour the face, but they cannot remove buccal fat. Surgical removal remains the most effective method for reducing cheek fullness.

No, buccal fat removal targets cheek fat and does not directly address a double chin. Procedures like liposuction or Kybella injections are better suited for treating a double chin.

Avoid hard, crunchy, or spicy foods that can irritate the surgical site, like chips and pizza. We recommend choosing softer foods until your stitches fully dissolve.

You may experience temporary changes in speech due to swelling, but these resolve as you heal and do not affect speech long-term.

References »

Pokrowiecki R. Extended buccal lipectomy (bichectomy) for extreme cheek contouring. International Journal of Oral and Maxillofacial Surgery. 2022 Jul;51(7):929-932. doi: 10.1016/j.ijom.2021.09.003. 

Matarasso A. Buccal fat pad excision: aesthetic improvement of the midface. Annals of Plastic Surgery. 1991 May;26(5):413-8. doi: 10.1097/00000637-199105000-00001. 

Davis B, Serra M. Buccal Fat Pad Reduction. 2022 Nov 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. 

Moura LB, Spin JR, Spin-Neto R, Pereira-Filho VA. Buccal fat pad removal to improve facial aesthetics: an established technique? Medicina Oral, Patologia Oral, Cirugia Bucal. 2018 Jul 1;23(4):e478-e484. doi: 10.4317/medoral.22449. 

Traboulsi-Garet B, Camps-Font O, Traboulsi-Garet M, Gay-Escoda C. Buccal fat pad excision for cheek refinement: A systematic review. Medicina Oral, Patologia Oral, Cirugia Bucal. 2021 Jul 1;26(4):e474-e481. doi: 10.4317/medoral.24335. 

Hanson SE. The Future of Fat Grafting. Aesthetic Surgery Journal. 2021 May 18;41(Suppl 1):S69-S74. doi: 10.1093/asj/sjab130. 

Crowley JS, Kream E, Fabi S, Cohen SR. Facial Rejuvenation With Fat Grafting and Fillers. Aesthetic Surgery Journal. 2021 May 18;41(Suppl 1):S31-S38. doi: 10.1093/asj/sjab014. 

Dayal A, Bhatia A, Hsu JT. Fat grafting in aesthetics. Clinics in Dermatology. 2022 Jan-Feb;40(1):35-44. doi: 10.1016/j.clindermatol.2021.08.010.

Schedule a consultation to learn more

If you would like more defined cheekbones and a pleasing angular shape to the mid-face, schedule a consultation with Dr. Alannah Phelan to discuss if buccal fat removal is right for you. Please call Boston Plastic Surgery at (617) 786-7600.

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