Buccal Fat Removal
The buccal fat pad is a deep fat compartment, located between facial muscles just below the cheekbones. Most infants and young children have very prominent buccal fat pads — those adorable “chubby cheeks”. As the facial skeleton grows to an adult size, the buccal fat pad remains relatively unchanged and for many adults, does not play a major role in facial appearance. However, some people will keep those “chubby cheeks” throughout adulthood, and others experience enlarged and droopy buccal fat pads as they age. Excess buccal fat affects the silhouette and balance of the midface causing the cheek bones to appear less prominent while the lower cheeks become enlarged and heavy and can even contribute to the appearance of the jowls. This can cause patients to appear overweight, even if they are fit and have a normal BMI.
Buccal fat removal surgery removes fat from the lower cheeks and is a good procedure for those who feel their face is overly round or chubby. Depending on the patient’s anatomy and goals, this can be a stand-alone procedure to improve the contour of the midface but is often done in combination with dermal filler to the upper cheeks to create a contoured and sculpted appearance, or with a mini facelift, neck liposuction, or chin implant to help contour the jawline and balance the face.
Buccal fat removal is performed through an incision inside the cheek, so there is no visible scar. The buccal fat is carefully teased out from surrounding structures and approximately a walnut size amount of fat is removed in one piece, however, this will vary based on patient’s anatomy and goals. The incision is closed with dissolvable sutures. Patient goes home the same day as the procedure. This procedure can be done under local anesthesia, sedation, or general anesthesia.
After surgery, there will be swelling, like having wisdom teeth removed, so the result is not immediately visible. The swelling resolves around 3 weeks, but it can take several months to see the final result, as the overlying skin must settle into the newly created hollow area. As fat is surgically removed, the results are permanent. However, a plumper face due to weight gain can obscure the results, so it is best to maintain a relatively stable weight.
Buccal fat removal is the procedure of choice to create a slimmer, contoured and more defined lower third of the face in appropriate candidates. Liposuction is not appropriate to treat this area, as this is a deep fat pad, and there are important nerves in this area that must not be damaged. Another cause of having a “wide” lower cheek can be masseter muscle hypertrophy, which is treated differently. Interested patients should consult with a Facial Plastic Surgeon to assess their anatomy and treatment recommendations.