Buccal Fat Pad Repositioning/Removal

The buccal fat pad is a distinct, encapsulated fat deposit deep within the cheeks, several layers below the skin. It extends from the temple down to the sides of the mouth and jawline, contributing to the roundness and jowling of the face. The buccal fat pad cannot be liposuctioned and is distinct from the fat layers attached to the skin. By removing or repositioning prominent fat from this area, your surgeon can slim and improve your facial contours, significantly impacting the face’s overall appearance.

The size and location of the buccal fat pad naturally differs among individuals. For some, the fullness of this area feels excessive, creating the appearance of an overly rounded face. For others, it may be atrophied, leading to a more gaunt look.

As a result of this natural variation, not everyone is a candidate for buccal fat surgery. If you have naturally narrow and thin cheek contours, undergoing this procedure could result in an excessively hollow appearance. A consultation with a highly qualified surgeon is crucial to develop the best solution for your specific concerns.

The procedure is typically performed by your surgeon making a small incision inside the mouth and then removing or repositioning the buccal fat. The incision is closed with dissolvable sutures and leaves no visible scar. (Note that techniques may vary to suit your individual anatomy and aesthetic goals.) Potential risks include temporary numbness, facial weakness, swelling, and asymmetry. Your surgeon should have specialization in plastic surgery or facial plastic surgery to ensure safe and effective outcomes.

Buccal fat removal is typically performed in a scarless manner, involving small incisions inside the mouth that allow your surgeon to access and remove the buccal fat pads. Alternatively, the procedure can be done through facelift incisions.

This surgery requires an extensive understanding of facial anatomy, specifically the deeper facial structures; the buccal fat pad is surrounded by the facial nerve, so the procedure requires utmost precision and safety. Unlike many other surgical procedures, there are no viable alternative treatments for prominent buccal fat pads, as it is exceedingly difficult to liposuction the buccal fat pad or use fat-dissolving agents like Kybella® (deoxycholic acid) with precision.

It is essential for your surgeon to adopt a conservative approach and avoid removing too much buccal fat. Often, only a portion of this fat should be removed to achieve a natural-looking result. Excessive removal can lead to sunken cheeks, particularly in individuals with minimal fat or significant skin laxity.

While the removal of the buccal fat pad is generally irreversible, it is possible to correct unsatisfactory results, to some extent, with facial fillers and fat grafting. However, it’s important to note these will not fully replicate your pre-surgery state.

Depending on your personal goals, other procedures might be recommended in conjunction with or instead of buccal fat pad removal. For individuals with a round face and recessed chin, your surgeon may suggest combining buccal fat reduction with deep neck contouring, facial liposuction, fat grafting to the cheeks, or chin augmentation to create a more angular appearance in both the face and neck. If you have excess tissue laxity and jowling, a facelift may also be required to address sagging cheeks, jowls, and deep folds.

The best procedure or procedures for you will depend on your unique anatomy, preferences and goals. Be sure to discuss realistic outcomes, as well as benefits and risks, with an experienced surgeon who can tailor a treatment plan to your needs.

Before you go

Emphasis on conservatism and safety is paramount in buccal fat pad surgery, necessitating thorough pre-operative assessments to ensure optimal outcomes.

During a consultation for buccal fat pad surgery, ask about the surgeon’s experience, success rates and potential risks; also review before-and-after photos of their previous patients. Your surgeon will assess your facial anatomy, discuss your aesthetic goals and review your medical history. They will also explain the procedure, recovery process, and expected outcomes. They may also recommend complementary procedures to improve the ultimate definition of your facial shape.

During the procedure

Buccal fat pad removal or repositioning is usually performed under local anesthesia with sedation, so you will be pain-free. If you are undergoing additional procedures such as chin augmentation or a neck lift, your surgeon may recommend using general anesthesia or twilight sedation. Regardless, you can expect to go home the same day.

The surgeon begins by making a small incision on the inside of the cheek, through which the buccal fat can be either removed or repositioned. After the fat is removed or shifted, the surgeon will close the incisions with dissolvable sutures; there is no visible scarring given that the incisions are usually made within the mouth.

This surgery is not time-intensive, often lasting less than an hour.

Buccal Fat Pad Repositioning/Removal Aftercare 

Recovery typically involves managing minor discomfort and swelling. The swelling can sometimes be significant in the first few days, akin to what happens after a molar removal. It typically resolves within one to two weeks. It’s crucial to follow your surgeon’s post-surgery guidelines for oral hygiene and diet to ensure proper healing and avoid infection or other  complications.

Most people resume some daily activities within 24 hours and return to work and social activities in seven to ten days. Final results can take several months to become fully apparent, as healing takes place.