Last updated date: 16-Jun-2023

Medically Reviewed By

Written by

Dr. Anas Walid Shehada

Originally Written in English

Buccal Fat Pad Excision


    Buccal fat is a fat pad found in the cheek beneath the buccinator muscle that serves as a gliding surface for the muscle. When expanded, it can generate fat cheeks that blunt the face and jawline. Buccal fat pad excision is suggested as a way to get a more attractive midface.


    What is Buccal fat pad excision?

    Buccal fat pad excision

    This cosmetic operation, also known as a buccal lipectomy, minimizes the appearance of significant fat in the cheek area, which may be causing you to feel like you have "chubby cheeks" or "chipmunk cheeks." This chubby cheek condition is caused by an abnormally big buccal fat pad, which is frequently inherited. Buccal fat pad excision produces a pleasingly angular facial look with a defined contour.

    Because buccal fat pad surgery is typically a less invasive operation, it can be coupled with other cosmetic surgeries to get the desired overall result. It is frequently used with the following procedures:

    Heister identified the buccal fat pad as a glandular tissue in 1732. Xavier Bichat popularized and classified the structure as fat tissue in 1802. It is often assumed that celebrities such as Bella Hadid and other models had the operation to get their high, sculpted, and chiseled cheekbones. In Spanish, the treatment is also known as cheek fat reduction, buccal fat removal, or bichetomia. The American Society of Plastic Surgery does not keep procedure statistics.


    What is Facial Fat?

    Facial Fat

    Facial fat is made up of many fat compartments that are organized into deep and superficial layers. They are divided by connective tissue and form distinct anatomical units known as 'fat pads.' Their purpose is to offer insulation and structural support to the soft tissues of the face.

    Adipose compartments fluctuate during age, with some prone to deflation (fat atrophy) and others gaining volume (fat hypertrophy). These volumetric changes are mirrored in the contours of the face and will influence how individual areas age.

    The buccal fat pad is a deep fat compartment that runs from the upper mid-facial to the bottom of the face (next to the mouth). It is prone to a downward volume shift within the compartment due to its elongated design. This can lead to fat buildup and a bulge in the lower cheek around the mouth.

    Although liposuction is not indicated for buccal fat pad removal (because to the risk of damaging nearby nerves), Buccal Fat Removal is occasionally combined with Liposuction to other facial regions to shape and better define the entire face.

    Buccal Fat Removal is sometimes combined with other enhancing facial treatments such as Dermal Fillers to accentuate cheekbones, liposuction to the neck to sculpt the jawline, or liposuction under the chin to remove a 'double chin.'


    Am I a good candidate for Buccal Fat Removal?

    Buccal Fat Removal

    Buccal Fat Removal is an excellent technique for people who believe their face is too round or obese. It makes the lower portion of the face smaller, contoured, and more sculpted. Candidates that are optimal are within 10kg of their optimum weight.

    Even if you have chubby cheeks or an abnormally round face shape and are not overweight, you must ensure that the roundness is caused by buccal fat pads rather than fat under the skin from weight increase.

    Many patients who desire this operation express concern that their round features make them appear overweight or 'baby faced,' therefore they want a more adult and sculpted appearance. Combining Buccal Fat Removal with a Facelift can significantly improve Facelift outcomes.

    Overdeveloped jaw muscles can also cause wide cheeks. Muscle Relaxant Injections to Slim the Masseter Muscles may be a preferable alternative if it is the problem.

    On the other hand, if you already have a thin face, removing the Buccal Fat Removal may make you seem excessively gaunt without the 'fill' from the naturally-occurring Buccal Fat Pads.


    What are the pros and cons of Buccal Fat Removal?

    pros and cons of Buccal Fat Removal

    The Pros: 

    • You’ll have no visible scars from the cheek reduction as the removal is done from the inside of your mouth. 
    • When done properly, Buccal Fat Removal gives the face a ‘model-esque’ look!
    • The final results are permanent, even if you gain weight. 
    • It’s not a long surgical procedure: cheek fat removal typically takes just over 1 hour.
    • Downtime is relatively minimal and most patients return to work after 3 days.
    • This cheek-slimming surgery can create a more mature facial contour in adults who still have a ‘baby face’ look.

    The Cons:

    • Because your Buccal Fat Pads naturally diminish with age, your cheeks may seem hollow. In order to prevent hollowing down your cheeks too much, our Surgeon merely removes a little pocket of fat.
    • If you lose weight following surgery, your face may appear overly haggard.
    • Because most people have somewhat differing cheeks, this technique may highlight any pre-existing asymmetry.
    • You’ll have temporary swelling for a couple of weeks. Some patients liken this to having ‘chipmunk cheeks’ after dental work. 


    Steps in surgery

    Steps in surgery

    Intraorally, a tiny needle is used to numb the area just above the lower second molar. The fat is then expressed and removed through a quarter-inch incision. A resorbable suture is used to close the wound.

    Buccal fat pad excision is frequently performed as a stand-alone operation. In certain cases, it is paired with chin and neck liposuction to enhance the jawline and thin the neck area. In certain cases, it is paired with a facelift treatment to create a more attractive facial shape.

    IV general anesthesia is used for this buccal fat removal operation. An incision is performed within your mouth to remove the buccal fat pad. The effects should be visible right away, and they will continue to improve as the swelling subsides and your skin adjusts to the new facial shape.

    The buccal fat pad is often removed by an incision in the mouth, at the rear of the oral cavity, around the second upper tooth. The buccinator muscle is next met, and the fibers are separated without creating an incision until the buccal fat is seen. Once the buccal fat has been identified, a thin casing over the fat is opened and the fat is gently pulled out while external pressure is applied. The fat is then cauterized and removed from the base. The remainder of the buccal fat pad is then sutured back to its anatomic location, and the oral mucosa is sutured close to the two incisions. The treatment usually takes around 30 minutes to complete. 



    Recovery Buccal Fat

    When you go home, you'll need to use cold compresses on a regular basis to decrease swelling and pain. Apply ice packs to your cheeks for three days and sip icy water on a daily basis. Because the incisions are on the inside of your cheeks, you should eat soft foods and avoid anything hot or spicy for at least 24 hours.

    Swelling is normal, and you'll probably have a fuller face during your recovery than you did before your procedure because the body usually fills the empty space with fluid. This fluid collection is a normal part of the healing process, and most of the initial swelling will go away within two weeks. However, it can take up to three, or even six months, to see your final results after your skin has settled into the space created by the fat removal.


    What are the Risks of Buccal Fat Pad Excision?

    To reduce risks, like with any face plastic surgery, a thorough understanding of facial anatomy is essential. Injury to the buccal branch of the facial nerve poses a concern; because the buccal branch nerves that may be impacted govern facial functions, such injury may result in partial facial paralysis, regional face numbness, loss of taste, and so on. Damage to the parotid duct may also develop in men and women whose parotid ducts go deep into the buccal fat pad, resulting in a salivary fistula or saliva accumulation.


    Is Buccal Fat Removal permanent?

    Buccal Fat Removal permanent

    When the fat pads go, they vanish forever! The outcomes are lasting. Even if you gain weight, your buccal fat pads will not return. A plumper face as a result of weight gain, on the other hand, can mask the results of your Buccal Fat Removal procedure.


    What is the cost of Buccal Fat pad excision?

    Cost of buccal fat pad excision

    The cost of isolated buccal fat pad excision is between 3500$ and 4500$. When coupled with additional treatments, the cost is determined by the combination.



    Buccal fat removal surgery is a quick treatment that is performed under local anesthetic via an in-mouth incision. It is quite painless, and patients can return to work the next day. Buccal fat pad removal patients want to enhance their facial features by having a more prominent cheek area, a more defined jawline area, and a slimmer face line.