What Is Buccal Fat Removal? A Complete Guide

A sharp jawline and chiseled cheekbones seem to be all the rage these days. And while these coveted features can be the result of genetics, there is another — albeit lesser-known — way to get permanently contoured bone structure: an under-the-radar cosmetic procedure called buccal fat removal. To learn more about the facial surgery and why it's become all the rage in Hollywood, we tapped two plastic surgeons for their professional insight.

Keep reading for our expert-approved guide to buccal fat removal.

What Is Buccal Fat?

"The buccal fat pad is an isolated fat pocket residing just below the cheekbone on each side of the face almost directly above the lower lip," explains Dr. Corey Maas, a San Francisco-based plastic surgeon and President of the American Academy of Facial Plastic and Reconstructive Surgery.

He explains that the removal of this fat pad is done to define the cheekbone, or as doctors call it, the zygomatic arch. "It's been popular for many years in rounder faces that would like more definition," he says.

What Does Buccal Fat Removal Do?

The purpose of buccal fat removal (also referred to as buccal lipectomy and cheek reduction surgery) is to provide a defined, contoured look without the need for makeup, explains Dr. Smita Ramanadham, a New Jersey-based plastic surgeon. "Removal of this fat results in thinner cheeks and creates a hollow below the cheekbones," she says. "It essentially creates that contour appearance through surgery."

What Does the Buccal Fat Removal Procedure Involve?

Buccal fat removal can be accomplished under local or general anesthesia, depending on the doctor's preference and whether or not it's being performed in conjunction with other procedures. Dr. Maas prefers using general anesthesia as he finds it easier to control saliva and comfort.

If done under local anesthesia, Dr. Ramanadham says that "typically, a numbing medication, such as lidocaine, is injected inside of the cheek and a small opening is made." The fat can be accessed through this small incision and is gently teased out and removed. She says this is done on both sides and dissolvable stitches are placed to close these incisions.

From start to finish, the procedure can take anywhere from 30 minutes to one hour to complete. After that, it's all about rest and recovery.

What's the Recovery Process from Buccal Fat Removal Like?

Dr. Maas says recovery is quite simple. Just know that the results may not be immediate — they'll gradually appear throughout the recovery period. "Immediately after the procedure, it's normal to have swelling in the area," says Dr. Ramanadham. "You'll be given a special mouthwash to keep the area clean and a soft diet is recommended. The swelling will gradually improve over the following weeks with final results typically seen at six months to one year."

Is Buccal Fat Removal Safe?

According to both doctors, this procedure is generally safe, but as with anything else, it comes down to seeing a board-certified plastic surgeon and following post-surgery care instructions. Take it from Dr. Maas. "Finding the right physician to perform any procedure should be a patient's priority. Make sure the physician is qualified, experienced, and board-certified in the procedure that you are considering."

If you're seeking a surgical procedure on the face, the AAFPRS recommends that you select a surgeon who is trained specifically in procedures of the face, head, and neck, such as those certified by the American Board of Facial Plastic and Reconstructive Surgery.

While finding a qualified surgeon is paramount, Dr. Ramanadham says that there are still risks involved. That's why it's important to talk it through with your doctor ahead of the surgery. "The buccal fat pad lies in between our facial muscles and facial nerve branches. Additionally, it's adjacent to salivary glands and ducts that drain these glands. All of these structures can be damaged if knowledge of the anatomy is not well known," she says. "Prolonged swelling, temporary or permanent facial muscle weakness, fluid accumulation, numbness, and infections are some of the potential risks."

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Who's the Ideal Candidate for Buccal Fat Removal?

Dr. Ramanadham says that the ideal candidate for buccal fat removal is anyone who has full, round cheeks and desires a thinner, more contoured look. More specifically, though, it's anyone who's in good health. "They should be at a healthy weight," she says. "Typically, as we age, we lose fat naturally in the face, so older patients are not ideal candidates."

Dr. Maas agrees. He cautions against undergoing buccal fat removal if you already have well-defined cheekbones. "Like any procedure, buccal fat removal is not for everyone," Dr. Maas says. "The best candidates have a round-to-oval facial contour with puffy, bloated, or 'cheeky' fullness below the zygomatic arch." He also makes a point to mention age. "The person should be mature, and fully developed with no baby fat," he says. "This is not a procedure for teens."

How Much Does It Cost to Get Buccal Fat Removal?

The cost of this procedure varies, but Dr. Ramanadham says you can expect to pay anywhere from $3000 to $5000 depending on the geographical location and surgeon's experience.

How Does Buccal Fat Removal Affect Your Face as You Age?

Here's the thing about facial fullness, even though it might be a concern for some people, it's often associated with youthfulness. That's why some people are hesitant to undergo this procedure — they worry it will lead to a gaunt, sallow appearance over time. According to Dr. Ramanadham, that's not necessarily the case. She says it all comes down to the skill and experience of the surgeon you go to.

"As we age, we naturally lose fat in our face. We also see changes such as the descent of tissues resulting in nasolabial folds and jowls, for example," she explains. "Buccal fat removal over time can result in a very thin and sometimes gaunt appearance as people age. It can accentuate the changes we already see with aging. This underscores the importance of consulting with a board-certified plastic surgeon to ensure that you are a proper candidate and that a conservative amount of fat is removed."

Is Buccal Fat Removal the Only Way to Address Facial Fullness?

No, other treatments can address concerns with the contour of the cheeks and the jawline. However, there's no magic formula or universal fix. As with anything else, it's all dependent on individual anatomy and goals.

"If patients have a full round cheek and wide face, buccal fat pad excision may address their concerns," Dr. Ramanadham says. "If they have thin or moderate faces, however, fillers added to the cheeks or jawline may create that contoured cheek appearance by creating more definition in the face. Liposuction to the double chin can also define the face and neck. These procedures can be added to buccal fat pad excision if needed."