Buccal fat removal surgery removes fat from your lower cheeks, to contour the midface and make the cheekbones look more defined.
Also known as buccal lipectomy, cheek reduction surgery, or face thinning surgery, this minimally invasive surgery can create a more mature, sculpted facial contour in adults who still have a rounded, “baby face” look.
The buccal fat pad gets its name from the Latin word bucca, which means “puffed cheek." It’s sometimes also called the Bichat fat pad, so you may also see this procedure called a bichatectomy.
“Buccal fat removal is a nice procedure for patients who feel that their face is overly round or chubby,” says Dr. Lara Devgan, a plastic surgeon in New York City. “It creates a slimmer, contoured, and more sculpted lower third of the face,” she explains.
The buccal fat pad sits between facial muscles, in the cheek hollows just below your cheekbones. The size of these pads varies from person to person, regardless of weight. Large buccal fat pads are often a genetic feature, with rounded cheeks running in families.
These fat pads can thin as you age, but there is no natural solution for buccal fat removal: they can't be reduced by diet or exercise, which is why this minor surgery has become increasingly popular.
Liposuction isn’t the best option for cheek fat reduction because it can damage facial nerves, but buccal fat removal can be paired with lipo in other areas of the face and under the chin, to further slim and sculpt the facial features.
Buccal fat pad removal can also be paired with cheek implants or injectable dermal fillers, to create more sharply defined cheekbones, or with other cosmetic surgery procedures like a mini facelift or chin implant, to reduce a double chin and contour the jawline.
Related: Chrissy Teigen Revealed She Had Buccal Fat Removal
RealSelf Tip: Patients who are concerned about the size of their cheekbones can consider cheekbone reduction surgery, aka zygoma reduction or cheek shaving surgery.
See board-certified plastic surgeon Dr. John Mesa react to real buccal fat removal patient experiences and results.
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- This procedure to reduce cheek fat can significantly enhance your facial appearance, giving you a slimmer face with more defined cheeks. “When done properly, buccal fat removal gives the face a model-esque look,” says Dr. Devgan.
- Cheek reduction surgery leaves no visible scarring, since the incisions are made inside your mouth.
- Results are permanent, even if you gain weight.
- Cheek fat removal is a relatively fast surgical procedure, typically taking about 20 minutes.
- Downtime is minimal. Most patients can return to their normal activities after three days.
- A majority of RealSelf members who've had buccal fat removal surgery say it was Worth It, with many citing a subtle improvement in facial contour and improved definition.
- You’ll have swelling for a couple of weeks before it subsides. RealSelf members have described it in their reviews as having “chipmunk cheeks,” similar to after having dental work done.
- Your buccal fat pads naturally shrink over time, so your cheekbones could look too hollow as you age. There's a lack of published data on how results evolve, but some surgeons avoid performing cheek fat removal on patients in their 20s and 30s because of this risk.
- If the surgeon removes too much fat or you lose weight post-procedure, your face may look overly gaunt as you age.
- If your surgeon doesn’t extract the right amount of fat from each cheek, you may be left with asymmetry that needs to be corrected via a revision procedure (at additional expense).
- Beyond the usual risks of surgery, this procedure carries additional risks in inexperienced hands. These include damage to your salivary ducts, hemorrhaging, and (rarely) facial-nerve damage that may lead to facial muscle weakness. The best way to mitigate these risks is to find a board-certified plastic or facial plastic surgeon (not a dentist) who understands the entire facial anatomy intimately and has safely performed hundreds of cheek reduction procedures.
Related: Buccal Fat Removal—and the Debate Dogging the Insta-Famous Fix
- Average Cost:
- $500 - $7,000
Buccal fat removal costs depend on your surgeon’s credentials, level of experience, and location.
Combining cheek reduction surgery with complementary procedures will increase your cost, particularly if you're also having a facial plastic surgery procedure that requires general anesthesia.
Cosmetic procedures are not covered by insurance.
See our complete guide to buccal fat removal costs
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Ideal candidates are healthy nonsmokers within 20 pounds of their goal weight, who have chubby cheeks or a round face due to buccal fat pads. Both men and women can benefit from the surgery, though male patients may be more interested in pairing it with cheek, chin, and jaw implants, to create even more sharply defined facial features.
If you already have a thin face, buccal fat removal may not be a good idea: you run the risk of looking too skinny and gaunt without these naturally occurring fat pads, especially as your face ages.
During your initial consultation, your provider will examine your face to ensure it’s the buccal fat pads that are causing the roundness. People who have wide cheeks from overdeveloped jaw muscles will have a better result from Botox or another neuromodulator, which can relax the masseter muscle and slim the face over time.
RealSelf Tip: Buccal fat pad removal can help reduce the appearance of jowling. Excess cheek fat can push the skin downward, and removing it can create a slight lifting effect (though the change won't be as dramatic as if you'd had a mini facelift).
Just keep in mind that any degree of sagging skin can become more obvious once excess fat is removed. If you're concerned that your skin may not have enough elasticity to bounce back (usually only a concern for patients in their 40s or beyond), talk with your doctor about skin tightening treatments.
Buccal fat removal has a 91% Worth It Rating from RealSelf members, and it can create a slimmer, more contoured face in the right candidate.
“Chubby face gone forever!” reports one RealSelf member, who says having buccal fat surgery created an ideal version of her face and boosted her confidence, especially in selfies. “I don't even consciously suck in my cheeks anymore. I just smile naturally and love my face in pictures.”
For a successful result (and avoiding buccal fat removal gone wrong), choose a surgeon who is:
- experienced in removing buccal fat and can accurately assess if you’re a good candidate
- judicious about how much fat they remove
Some providers remove the entire buccal fat pad in every patient, to create the most dramatic results.
The result of removing buccal fat from your midface is permanent, and some RealSelf members regret having the procedure, saying it left them looking overly hollow and prematurely aged. “I look like a 20 year old with the cheeks of a 70 year old,” says one RealSelf reviewer.
As you're choosing your surgeon, pay close attention to their before and after photos, looking for these four signs of good buccal fat removal results.
Cheek fat removal will make you look older and more mature, but if you’re a good candidate and your surgeon is careful about the amount of fat they remove, the immediate result should still look youthful.
However, some plastic surgeons express concern about how well buccal fat removal results hold up over time, as patients age. Researchers point to a lack of studies of the long-term implications of buccal fat removal surgery, so how patients will look 10 years later is a hotly debated topic among plastic surgeons.
It’s also not known how much buccal fat persists or diminishes as we age (it’s an area of debate, according to a recent study).
“Some doctors are against buccal fat pad reduction or removal because as we age the face loses volume, and having a reduction in facial fatty tissue may lead to a gaunt look over time,” says Dr. Matthew Richardson, a facial plastic surgeon in Frisco, Texas. For this reason, many think it’s not a good idea to perform buccal fat removal on patients who already have a slim face and just want more definition.
Related: Buccal Fat Restoration is Now a Thing. Here’s How Doctors are Fixing Gaunt Cheeks.
“I recommend that patients achieve the look they are going for now, and enjoy their looks for as long as they can," says Dr. Richardson. "If several decades pass and volume loss is an issue, there are many ways to deal with this, and there may be even better techniques and technologies in the future.”
Dermal fillers can offer a temporary solution for gauntness. Just keep in mind that a lifetime of replacing the fat that was removed with facial fillers is (literally) a high price to pay for buccal fat surgery gone wrong, so facial fat transfer can be a more cost-effective solution over time.
The surgery starts with a topical anesthetic and possibly oral sedation, if you’d prefer to be in a light sleeplike state. General anesthesia is also an option, but it's usually not necessary unless you're also having other procedures in the same operation. (It's also much more expensive and carries some additional risks.)
The surgeon then makes a small incision, about a half-inch long, on the inside of each of your cheeks to access the buccal fat pads.
“We use fine-tipped surgical tools to tease out and dissect a walnut-size amount of fat,” says Dr. Devgan. The incisions are then closed with dissolvable sutures.
“Most people tolerate the procedure very well and compare it to a dental procedure where you’re hanging out with your mouth open,” says Dr. Devgan.
You’ll be sent home with a chin strap for support, antibiotic medication, and a medicated mouthwash to prevent infection.
The procedure itself shouldn't be painful: your cheeks should be fully numb from the anesthesia. Most RealSelf members who discuss the procedure in their reviews say it wasn't uncomfortable, but at least one did experience significant pain (and poor results).
If you don't feel fully numb as your surgeon begins the procedure, let them know immediately, so they can administer additional local anesthesia.
Any discomfort you feel during recovery will likely be mild, but it can be alleviated with ice and over-the-counter pain medication like Tylenol.
If pain is a major concern, talk with your provider about prescription pain medication for the first few days of your recovery.
Most patients need a week of buccal fat removal recovery time.
During that time, you can expect significant swelling and some discomfort. In fact, it's likely that your face will look fuller during your recovery than it did before your procedure.
You'll be physically fine to go about your normal activities, but most people take three or four days of social downtime while the worst of the swelling goes down. Most of the swelling should subside within three weeks.
Here’s how to reduce swelling after buccal fat removal:
- Stick to a soft-food diet and avoid anything too hot or spicy for at least 24 hours, to avoid irritating the incisions.
- Follow a regular icing regimen (as directed by your doctor), to reduce the swelling and help alleviate discomfort. “Apply light ice packs to your cheeks for the first three days and drink ice water,” says Dr. Devgan. Wear a chin strap at night for the first two weeks, to give your facial skin some extra support as it heals and retracts into the newly created hollows. This helps prevent new skin laxity.
- Sleep on your back with your head elevated for at least the first week.
My cheeks were very swollen for the first week, but everyone at work thought I had my wisdom teeth removed.”ashemeterio
You’ll see your initial results in about three weeks, once most of the swelling has gone down.
However, it can take as long as three or even six months to see your full results, as your skin settles into your cheek hollows.
Buccal fat pad removal is permanent. Even if you gain weight, the buccal fat pads won’t grow back.
However, weight gain can make your face look plumper as the remaining fat cells in other areas expand. This can mask your results, so it's still a good idea to maintain a healthy weight.
When it’s performed by an experienced, board-certified plastic or facial plastic surgeon, buccal fat removal is regarded as a safe, relatively straightforward procedure.
That said, it does come with a few risks that your surgeon should discuss with you during your initial consultation.
- As with any surgery, there’s a risk of infection, bleeding, scarring, and injury to surrounding tissue and structures.
- Studies show that possible buccal fat removal complications include hemorrhaging, trismus (lockjaw), and facial-nerve damage, which can lead to numbness, other changes in sensation, and (in rare cases) partial facial paralysis. These changes are usually temporary, but they can be permanent.
- An inexperienced surgeon can also damage your facial ducts or the salivary glands.
Finding a board-certified plastic surgeon or facial plastic surgeon (not a dentist) who has extensive experience with this cosmetic procedure is crucial to avoiding a botched buccal fat removal procedure.
“You want to see someone who’s capable and qualified to do a proper facial analysis and who understands your unique facial structure, as well as the results you’re hoping to achieve,” says Dr. Devgan.
A few noninvasive, temporary treatments can make your cheekbones appear more contoured.
Injectable fillers like Voluma, a hyaluronic acid–based filler that’s FDA-approved for cheeks, can create the appearance of more contoured cheekbones and even lift sagging skin around the jowls. Cheek augmentation with filler typically costs $1,000, and results last for nine months to a year.
Some doctors achieve this result with fat transfer too. “It may seem counterintuitive to add fat when you say your problem is chubby cheeks, but we can add volume to the highest and most projected point of the cheekbone and taper it to the lower face,” says Dr. Benjamin Caughlin, a plastic surgeon in Oakbrook Terrace, Illinois.
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Benjamin, Martin, and Richard G Reish. “Buccal Fat Pad Excision: Proceed with Caution.” Plastic and Reconstructive Surgery. Global Open, Wolters Kluwer Health, 16 Oct. 2018.
Moura, L-B, et al. “Buccal Fat Pad Removal to Improve Facial Aesthetics: an Established Technique?” Medicina Oral, Patologia Oral y Cirugia Bucal, Medicina Oral S.L., 1 July 2018.
Published November 11, 2020 Updated September 12, 2022
"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.Does buccal fat return after removal? ›
Buccal fat removal is considered a long-term solution to reducing excess fullness in your cheeks. Once the fat is removed from your body, it does not come back. However, patients should keep in mind that buccal fat may increase with future weight gain.Does buccal fat removal give you cheekbones? ›
Buccal fat removal creates a slimmer face and a more concave angle in the cheeks that gives your cheeks and jawline more definition. (It is sometimes called “cheek reduction” surgery.) Your surgeon may also be able to improve your facial symmetry using this procedure.Does buccal fat removal change your smile? ›
At 5 days post op, of course the recovery of buccal fat removal can affect the smile. It is totally normal to have booth cheeks or one side o the face swelling at this point. The maximum swelling post procedure lasts for about 2-3 weeks. The final swelling resolution takes place within 12 weeks.Why should I not get buccal fat removal? ›
You may not be a good candidate for buccal fat removal if your face is narrow or if you're over a certain age, as buccal fat naturally diminishes with age. Buccal fat removal surgery is usually performed by a healthcare provider with special training in plastic surgery procedures such as a licensed plastic surgeon.At what age should you get buccal fat removal? ›
What's the Right Age for Bucca Fat Removal? Because the fat pad continues to grow until our twenties, it's usually recommended to wait until after 20 for buccal fat removal surgery.What celebrities got buccal fat removed? ›
Surgeons sound off on why the trendy sculpting surgery isn't for everyone. These days, it seems like everyone is doing it — buccal fat removal, that is. Chrissy Teigen may be the only celebrity that has gone public on social media about her sculpting solution.How will I look after buccal fat removal? ›
Q: What Should I Anticipate After the Procedure? A buccal lipectomy patient may experience facial swelling following surgery. However, the swelling will dissipate on its own within about two to three weeks. After the swelling stops, the cheeks will start to look thinner and more contoured.Does buccal fat cause jowls? ›
However, for many people, the jowl is a combination of sagging skin and buccal fat.Can I do buccal fat removal twice? ›
Answer: Buccal fat pad removal can only be done once
The buccal fat pad is a distinct collection of fat in the cheek.
Is the procedure painful? Since Buccal fat pad removal is a soft tissue procedure, discomfort is mild. Though pain is rare, patients are given pain medications to take home in case you need them.Does buccal fat affect jawline? ›
Buccal fat and double chin often appear together, causing an undefined jawline, soft cheekbones, and an overall soft, round-faced appearance. The cause of buccal fat and double chin are well-known, as much research has narrowed the causal factors to two main variables: genetics and body weight.Is buccal fat surgery worth it? ›
Buccal fat removal has a 91% Worth It Rating from RealSelf members, and it can create a slimmer, more contoured face in the right candidate.Does buccal fat affect cheeks? ›
In some patients, the buccal fat can cause unwanted fullness and, in more extreme cases, has been shown to pseudoherniate and result in the appearance of a sagging mass within the cheek.How long does buccal fat removal last? ›
Are my results permanent? As long as you maintain a healthy weight by eating right and following an exercise regimen, your buccal fat pad removal results will last a lifetime. Gaining over 20 pounds, however, might cause your cheeks to bulge slightly.How long does it take to see buccal fat removal results? ›
How long does it take to see results? Results can be seen two weeks after surgery when swelling begins to subside. However, it is important to note that it can take anywhere from two to four months after the buccal fat excision to see the full results.Does buccal fat removal leave scars? ›
Buccal fat pad removal is an excellent procedure for those with rounder, more cherubic faces who want a more chiseled appearance. This surgery is simple, quick, and easy, and since all incisions are made inside the mouth, it leaves no visible scars.Can you reduce buccal fat naturally? ›
You cannot typically get rid of the Buccal Fat pad naturally. This fat does not interfere with age. It also does not atrophy with weight loss. The key is it's a deep fat pocket that leads to the lower third fullness in the cheek.How much does it cost to reduce cheek fat? ›
Buccal fat removal surgery can cost $5,000 to $20,000. Factors that influence the cost include the surgeon's experience level, facility fees, anesthesia type, and geographic location. Most insurance providers do not cover the cost of cheek-thinning surgery, since this is considered a nonessential cosmetic procedure.Is facial fat transfer worth it? ›
If your main concern is loss of fullness in theface, facial fat grafting (also known as fat transfer) is likely a better choicethan facial fillers, especially if more volume is needed around the eyes,cheeks, and jawline. Fat grafting has been shown to last longer than fillers interms of maintaining fullness.
Studies have shown that by the age of 35, the natural aging process causes us to lose about 10% of the fat in our faces, and we lose an additional 5-10% of your facial volume every 5-10 years thereafter.Is buccal fat removal safe? ›
Buccal fat removal is generally considered safe. However, like all procedures, there's a risk for unwanted side effects. Possible complications include: excessive bleeding.What should you not do after buccal fat removal? ›
Following your surgery, NO strenuous activity or exercise should be performed for the first two weeks. Light mobility is encouraged and is vital to your recovery. Take short, frequent walks around your house to decrease the chances of any complications, avoid developing a leg blood clot, and maintain good circulation.Can you brush teeth after buccal fat removal? ›
Yes, though you should be careful. Brush your teeth gently and be careful to avoid the incision areas. Also, do not rinse your mouth with anything, including water or mouthwash until okayed.Should you massage after buccal fat removal? ›
Most patients have a significant amount of swelling for 3-5 days and the tissue can feel dense. We have you start massaging the area of removal starting at day 5 to help sculpt the tissue, reduce swelling, and help the tissue heal. After 1 week, most of the noticeable swelling is gone.Can buccal fat removal fix jowls? ›
By removing the oral mucosa and buccal fat pad simultaneously, this pressure is released, and the bulki- ness disappears from the cheek and jowl, aesthetically improving the cheek and mandibular border.Does buccal fat cause double chin? ›
Buccal fat pads are small masses of fat that sit within the cheek and create facial roundness in certain people. These fat pads exist in everyone, but they appear much more pronounced in some people than in others. This can cause you to look heavier, and it can also create the appearance of a double chin.Can buccal fat removal prevent jowls? ›
In general, the removal of the buccal fat pads will not prevent future jowling. The jowls are formed by descent of the nasolabial folds down to the jawline and are best treated with a facelift.How long does buccal fat removal last? ›
Are my results permanent? As long as you maintain a healthy weight by eating right and following an exercise regimen, your buccal fat pad removal results will last a lifetime. Gaining over 20 pounds, however, might cause your cheeks to bulge slightly.Which celebrities had buccal fat removal? ›
These days, it seems like everyone is doing it — buccal fat removal, that is. Chrissy Teigen may be the only celebrity that has gone public on social media about her sculpting solution.
Absolutely. Buccal fat removal can also help remove a double chin and contour your face into a more mature, slim, and streamlined version of yourself.Does buccal fat removal prevent jowls? ›
By removing the oral mucosa and buccal fat pad simultaneously, this pressure is released, and the bulki- ness disappears from the cheek and jowl, aesthetically improving the cheek and mandibular border.How will I look after buccal fat removal? ›
Q: What Should I Anticipate After the Procedure? A buccal lipectomy patient may experience facial swelling following surgery. However, the swelling will dissipate on its own within about two to three weeks. After the swelling stops, the cheeks will start to look thinner and more contoured.Can you do buccal fat removal twice? ›
Answer: Buccal fat pad removal can only be done once
When removed, it is removed in its entirety and will not grow back.
You'll have swelling for a couple of weeks before it subsides. RealSelf members have described it in their reviews as having “chipmunk cheeks,” similar to after having dental work done. Your buccal fat pads naturally shrink over time, so your cheekbones could look too hollow as you age.How much is a buccal fat removal? ›
Buccal fat removal surgery can cost $5,000 to $20,000. Factors that influence the cost include the surgeon's experience level, facility fees, anesthesia type, and geographic location. Most insurance providers do not cover the cost of cheek-thinning surgery, since this is considered a nonessential cosmetic procedure.Does buccal fat removal define your jawline? ›
Buccal fat pad removal is a minimally-invasive surgical procedure intended to reduce cheek puffiness and define the jawline and the cheekbones.Can you suck the fat out of your cheeks? ›
Surgical Technique for Facial Liposuction
It's about the same thickness as a needle and is used to remove the unwanted fat. This tube is inserted under the skin and breaks up the fat. It's then sucked up out of the same tube.
3 to 5 cc of the fat pad is then gently teased out of the buccal space. Hemostats are then used to clamp the fat pad and the level of the mucosa, while a 15 blade or surgical scissors are utilized to excise the fat pad.Does buccal fat cause double chin? ›
Buccal fat pads are small masses of fat that sit within the cheek and create facial roundness in certain people. These fat pads exist in everyone, but they appear much more pronounced in some people than in others. This can cause you to look heavier, and it can also create the appearance of a double chin.
You cannot typically get rid of the Buccal Fat pad naturally. This fat does not interfere with age. It also does not atrophy with weight loss. The key is it's a deep fat pocket that leads to the lower third fullness in the cheek.Are jowls the same as buccal fat? ›
Answer: Jowls vs. buccal fat. Buccal fat is what the public calls "chubby cheeks". Jowls are the sagging fat everyone gets as they age along th lower jaw just in front of the beginning of the chin.