Everything You Should Know Before You Try Buccal Fat Removal Surgery

These days, it seems like almost every celebrity has chiseled cheekbones with a jawline that looks like a safety hazard. Head over to Instagram, and you'll see plenty of ordinary folks with the same look, crediting buccal fat removal surgery for their newly defined features.


This trend has encouraged many young people of all genders to consult with plastic surgeons about getting their buccal fat removed, all in pursuit of those chiseled features and the perfect Instagram selfie.

According to board-certified plastic surgeon Steven Levine's website, buccal fat removal has become incredibly popular in recent years. Back in 2019, facial plastic surgeon Sarmela Sunder said that she got around 10 inquiries for buccal fat removal surgery per week, and most of them came from young women in their 20s and 30s. She deduced that people's interest in the surgery was largely due to the media's portrayal of the perfect face shape, consisting of a chiseled jaw and cheekbones.

However, not everyone wants buccal fat removal surgery because they want to look like a Hollywood celebrity. Some simply feel insecure about their fuller cheeks and see surgery as a way to boost their self-confidence. If you're reading this, chances are you're curious about the procedure and if it's the right decision for you. While the answer might be complex, we've put together a list of everything you should know before you try buccal fat removal surgery. Let's dive in.


What is buccal fat, and why do we have it?

Buccal fat is actually kind of cool. No, really. It's not just fat sitting in your cheeks with no purpose; it actually plays a vital role when you're an infant, according to plastic surgeon Steven Levine's website. Buccal fat helps infants to suckle and aids chewing in adults. It's described as a gliding pad that's located between your masticatory (chewing) muscles.


While most assume buccal fat only forms part of the cheek, this is not true. Yes, buccal fat forms part of your lower cheeks, more specifically the hollow part under your cheekbones (via Medical News Today) but it extends all the way to your jaw and your temples. Unlike other fat, buccal fat actually doesn't change much over time, plastic surgeon Alan Matarasso explains.

While some doctors seem to disagree with this statement, several studies have proven that buccal fat basically remains the same throughout a person's life. A 1990 study published in Plastic and Reconstructive Surgery looked at the amount of buccal fat in six cadavers over 60. Researchers found that their buccal fat pads didn't shrink over time but instead stayed pretty much the same as that of a younger person's, even in people who were fairly skinny, Matarasso says. However, the size of buccal fat pads in different people can vary, and that's why some people have fuller cheeks than others. For some, this isn't ideal, and they end up considering buccal fat removal surgery to slim their face.


What is buccal fat removal surgery?

If you're reading this, chances are you've considered buccal fat removal surgery, and you might be curious about what exactly it entails.

The good news is that it's a fairly simple procedure, which consists of the surgeon removing part of your buccal fat pads to create a slimmer, more contoured face. Babak Azizzadeh, a board-certified plastic surgeon, told Allure that buccal fat has a really big impact on how a person's face is shaped. Board-certified facial plastic surgeon Andrew Jacono agrees, saying that removing buccal fat can help people with fuller cheeks achieve that slim, chiseled look.


The surgery basically consists of making an incision on the inside of the patient's cheek, from which the buccal fat (which Jacono describes as looking like a walnut) is then extracted. This means that there won't be any scarring on your face. Most plastic surgeons won't remove all of the buccal fat, Jacono says, adding that doing so might result in a very hollow, unnatural look. Azizzadeh agrees and actually prefers to reposition the buccal fat instead of removing it from the face. "Instead of removing it, my technique is to move it to other areas that have lost volume over time and suspend it into place, such as in the upper cheek and deep nasolabial fold," Azizzadeh explains.

If you are considering buccal fat removal surgery, you can discuss which route would be best for you with your doctor.


Who can have buccal fat removal surgery?

Buccal fat removal surgery might be simple, but there's a catch: It's not for everyone. You'll have to tick a few boxes before you're allowed to undergo the procedure.

First of all, if you're fond of cigarettes, you'll have to kiss them goodbye, according to Healthline. You also have to be physically healthy and not overweight. Ideal candidates for buccal fat removal surgery are those who have a round and full face or have weak buccal fat pads that cause a rounded fat mass in their cheeks, a condition known as pseudoherniation. Patients who want to undergo buccal fat surgery in pursuit of facial feminization are also good candidates, granted that they meet the abovementioned requirements.


Samuel J. Lin, M.D., a board-certified plastic surgeon, told Byrdie that age is also a factor. Patients ideally need to be between the ages of 20 and 40 to undergo the surgery. He also explained that the reason why surgeons typically don't perform the procedure on overweight patients is that it might make no difference at all. In these cases, the buccal fat pads are usually not the culprit and patients won't see much of a change. Those who have very narrow faces also aren't good candidates since the removal of buccal fat could cause sunken cheeks when you get older, making you look twice your age, which, let's be honest, is the last thing anyone wants.

What to expect during buccal fat removal surgery

If you're seriously considering buccal fat removal surgery and meet the requirements, your next question will probably revolve around the procedure and what you can expect to experience during it.

First of all, buccal fat removal surgery doesn't require heavy sedation. Board-certified plastic surgeon Andrew Jacono told Allure that twilight or local anesthesia is usually sufficient. The surgery itself isn't very invasive and takes all of 30 minutes to complete. You also won't have to go to the hospital. This surgery can be performed in an in-office operating room or licensed ambulatory setting, according to board-certified plastic surgeon Michael Horn, M.D.


Once the anesthesia kicks in, the surgeon will make an incision on the inside of each cheek, per Byrdie. Then, they will "search" for the buccal fat pads in your cheeks until they locate them. Once they do, they'll simply pop them out. Yup, that simple. A little disturbing, yes, but not complicated at all. A good plastic surgeon is also very careful not to disturb the area too much. On board-certified plastic surgeon Steven Levine's website, facial plastic surgeon Sagar Patel is quoted saying that he practices caution when extracting the buccal fat. "I only take what your body gives me. If I tug gently and nothing more comes out, that's it—I don't go digging for more," he said.

Once the buccal fat pads are removed, the surgeon will close the incisions with sutures.


The recovery process after buccal fat removal surgery

Buccal fat removal surgery might take all of 30 minutes, but the recovery process isn't nearly that fast.

First things first: Don't panic if you don't immediately see a difference. Plastic surgeon Corey Maas told InStyle that you'll start to see the difference as your body starts to heal. Immediately after the procedure, your face will be pretty swollen. (Heck, you just had your cheeks slit open, remember?) Plastic surgeon Smita Ramanadham says that the swelling can last a while, but that it will disappear in a few weeks' time. The final results of the procedure can take a while to become visible. Ramanadham says it can take anywhere from six months to a year. Patience is key.


You might experience soreness and bruising after the procedure, which is completely normal. For the first few days after the surgery, you'll have to stick to a liquid diet or foods that are very soft, according to Medical News Today. You will also have to keep the site of the surgery as clean as possible. This is done by rinsing your mouth with a special mouthwash. Your doctor might also prescribe medication to speed up the healing process. Usually, you'll have to schedule a follow-up appointment so the doctor can make sure the incisions are healing as they should.

What are the risks associated with buccal fat removal surgery?

As with any surgery, there are certain risks associated with buccal fat removal, and it's important to take all of them into consideration before you make a final decision.

The most common risks to take into account are infection, bruising, swelling, and bleeding, according to USA RX. Plastic surgeon Smita Ramanadham told InStyle that the location of the buccal fat pads presents some more serious risks as well. "The buccal fat pad lies in between our facial muscles and facial nerve branches," she explained. "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 added that some patients could experience weakness in their facial muscles, which can either be temporary or permanent. Numbness is another risk, as well as fluid accumulation.


There are also more serious risks, like permanently losing feeling in your jawline and cheeks, according to the U.K. Health Centre. Developing an asymmetrical and gaunt appearance is another risk, which would require additional plastic surgery procedures. You might also experience skin puckering. Damaged blood vessels that result in hematomas are also a possible outcome of the surgery, as well as seromas. Medications prescribed after the procedure also pose some risks, like the loss of eyebrows and eyelashes.

Before you decide to undergo the procedure, make sure you discuss the risks with your doctor first to ensure they don't outweigh the benefits of the procedure.

How will buccal fat removal surgery affect your face as you age?

As with any other surgery that alters your appearance, it would be good to keep in mind how buccal fat removal surgery might affect your face as you age.

You might not like your fuller cheeks now, but they might be the reason you maintain a youthful appearance as you get older. Plastic surgeon Smita Ramanadham told InStyle that it's common for people to worry that they won't age well if they undergo the surgery. This is understandable since it's quite natural for people to start losing fat in their faces as they get older. This typically results in jowls and nasolabial folds, which give the face an aged appearance. "Buccal fat removal over time can result in a very thin and sometimes gaunt appearance as people age," Ramanadham says. "It can accentuate the changes we already see with aging." According to Byrdie, some doctors prefer not to perform the surgery on people in their early 20s for this very reason.


Ramanadham says that it's very important for prospective patients to consult with a qualified plastic surgeon who knows their stuff to prevent any regret in the future. The surgeon will be able to tell you whether you're a good candidate for the procedure or not. And if they tell you that you aren't, it would be best to heed their advice, even if you feel like your face could be a little less chubby.

Questions to ask your doctor before undergoing buccal fat removal surgery

Choosing the right doctor to perform buccal fat removal surgery is paramount. You're about to let someone permanently change the appearance of your face. That in itself is nerve-racking enough; you shouldn't have to worry about whether they'll mess it up or not.


The American Society of Plastic Surgeons suggests you make sure the doctor you are working with is a board-certified plastic surgeon. Then, you'll want to ask them a couple more questions to ensure you're with the right doctor for this specific procedure. Healthline recommends you ask all your questions during your first consultation.

A few good questions to ask the doctor is how many years of experience they have doing plastic surgery, or more specifically, buccal fat surgery. It's also important to ask them if you might be at risk for certain complications associated with the procedure and what the healing process is like. Don't be shy to ask them if they have before and after pictures of previous patients – if they're proud of their work, they'll most certainly let you see it. It's also a good idea to ask them about the surgery technique they plan to use and how they would handle any complications, should they arise. Another good question is what you can expect your face to look like after. One last important thing to ask them is what you can do if you're not happy with the end result.


Is buccal fat removal surgery the only way to reduce facial fullness?

Before you opt for a very permanent procedure like buccal fat removal surgery, you might want to consider whether there are other tactics that could address your facial fullness.

Speaking to InStyle, plastic surgeon Smita Ramanadham said that while people with a wide face and round cheeks might best benefit from surgery, those with narrower faces can opt for fillers in their cheeks and jawline to create a more defined look. Sometimes, liposuction to the chin can also make a difference.


According to Byrdie, you can also play around with makeup to give your face a more defined look. Contouring your cheeks can help your cheekbones stand out while contouring your nose can actually make your other features appear a tad longer. If you have a rounder face, this could really make a difference.

Another great tip is to arch your eyebrows. This simple change can lift your entire face, making it look younger and slimmer. To get the best results, let a professional create that arch for you at your next salon appointment. Another makeup trick that can lengthen your face is applying blush. Look for one that has a bit of a brown undertone; these work best to define the face and create a slimmer look.


Tying your hair into a high ponytail can also create the illusion that you have a slimmer face, as well as using a root-lifting product to give your locks some extra body.

What does buccal fat removal surgery cost?

Buccal fat removal surgery might be a fairly quick procedure, but you're still going to have to cough up a fair amount of dollars to get it done.

So, how much can you expect to pay for the surgery? According to Healthline, anything between $2,000 to $5,000. The price typically depends on various factors, like the type of anesthesia given to you during surgery, as well as the prescription medications you have to take afterward. The surgeon's experience can also bump up the price.


The downside to all of this is that health insurance doesn't cover cosmetic procedures like buccal fat removal, so you'll have to pay for everything yourself. Make sure you know what the total cost will be before you undergo the procedure — you don't want any nasty surprises afterward — and ask if there is a possibility to pay for the surgery in installments.

Do doctors recommend buccal fat removal surgery?

Now for the tricky question: Do doctors actually recommend removing your buccal fat pads? In most cases, the answer is no.

Something plastic surgeons seem to notice is that most people who want buccal fat removal surgery, don't need it. "For every five patients I see who want their buccal fat pads removed, only one really needs it. Oftentimes, it's not excess fat that causes fullness but something else entirely," board-certified plastic surgeon Rod Rohrich told the American Society of Plastic Surgeons. He added that sometimes patients have an overactive masseter, which is a muscle that lifts the jawbone and moves it forward. Usually, he treats it with botox. He further added that facial fat is precious and that leaving it untouched is usually best.


Board-certified plastic surgeon Steven Levine agrees with Rohrich. "If you're talking about doing this surgery on a 25-year-old looking for that whistle look—I'd advise against that in almost all cases," he says, adding that the outcome is very unpredictable, not to mention that knowing exactly how much buccal fat to extract so patients will see a difference without taking too much is a challenge in itself. Levine admits that he's made exceptions for some younger patients in the past, and he's not entirely sure how their faces will look a couple of years from now. "If you were to ask me if I'm worried about [how] those patients [will look] in 20 years ... yeah, I guess I am," he said.