Buccal Fat Removal
Cheeks that sit a little less full, with the contours along each side of your face looking slimmer and more defined — so when you look in the mirror, you see yourself, a touch more refined and at ease.
Is this right for you?
Buccal fat removal is surgery to take out part of a pad of fat that sits deep inside the cheek — in medical terms, the Bichat fat pad, which lies below the cheekbone and above the jawline. When part of this pad is removed, the cheek below the cheekbone looks slimmer, and the contours along each side of your face become more defined. Because this involves a fixed pad of fat rather than the surface layer that changes with your weight, whether it suits you depends a great deal on the structure of your face. Here is how to picture whether you fall into the group this is right for.
This may be a good fit if
- You are 18 or older and in stable general health.
- The cheek below your cheekbone is full, which makes your face look rounder or fuller than you would like, and that fullness sits deep inside the cheek rather than only in the layer of fat just under the skin.
- You want the cheek area to look slimmer and more defined, and you understand that the final result takes several months to show as the swelling fully settles.
- You hold realistic expectations: a moderate change that suits your face, not a different face.
- Your oral health is stable, with no active infection inside the mouth.
This may not be right if
- Your face is already slim, your cheek hollows are already defined, or you have little cheek fat — removing more in that case can leave the cheeks looking hollow and older over time, so your surgeon will usually advise against it.
- The fullness in your cheeks comes mainly from the cheekbone structure, from muscle, or from loose skin rather than from the Bichat fat pad — in that case, removing buccal fat alone will not address it, and your surgeon will talk through other options.
- You have an uncontrolled medical condition, a bleeding disorder, or an active infection in the mouth or teeth.
- You expect your face to change fully and instantly right after surgery, rather than accepting a gradual recovery and swelling that lingers.
How it works
It all begins with an examination and consultation. A specialist in Plastic and Aesthetic Surgery — the same person who will perform your surgery — assesses the proportions of your face, the fullness of your cheeks, how much fat you have, and works out whether that fullness comes from the Bichat fat pad or from bone, muscle, or loose skin. This step matters, because it decides whether buccal fat removal is truly right for you. You also have routine pre-surgery tests and a review by the anaesthetist.
There are a few things to prepare before the day of surgery. You will be guided to stop certain medicines that can cause bleeding, such as those containing aspirin, for a set period before surgery. In most cases, the procedure is done under local anaesthetic, meaning only the cheek area is numbed and you stay awake; some cases also use sedation or general anaesthetic, especially when you have it alongside another surgery.
The incision is made inside the mouth, on the inner surface of the cheek, so it leaves no scar on the skin of your face. Through a small incision, your surgeon exposes the Bichat fat pad and removes part of it. This is the heart of the matter: your surgeon removes a measured amount, enough to slim the cheek while keeping it in balance, rather than taking all of it — because removing too much can leave the cheek hollow later on. The surgery is usually short, or longer if other procedures are done at the same time.
Throughout, your surgeon works carefully around the important structures that sit near the cheek fat pad — including a branch of the facial nerve that controls the movement of the facial muscles, and the parotid salivary duct that carries saliva into the mouth. Once the fat is removed, your surgeon stops any bleeding and closes the incision inside the mouth, usually with dissolving stitches, so you do not need to return to have them taken out. You usually go home the same day.
Realistic expectations
This procedure aims to slim the cheek below the cheekbone and make the contours along each side of your face more defined, by removing part of the Bichat fat pad. So that you hold the right expectations, here are a few things it does not set out to do.
What this will not do
- It will not give you a face that matches a photo or looks like someone else — the result depends on your own bone, muscle, and soft tissue.
- It will not address fullness caused by the cheekbone, by muscle, or by loose skin; if the main cause lies there, removing buccal fat will not resolve it, and your surgeon will discuss other options.
- It will not stop the natural ageing of your skin and soft tissue over time; your face will keep changing with the years, and the cheek that had fat removed may look more hollow as you grow older.
- It will not show you the final result the moment you leave the operating room — the cheek area needs many months to settle as the swelling fully resolves.
Recovery
Recovery after buccal fat removal is usually gentler than after facial bone surgery, but it still takes time and patience. Because the incision is inside the mouth, in the first few days you may notice mild swelling, tightness, and some discomfort when eating. The milestones below are a rough guide — everyone heals at their own pace, and if you have additional surgery at the same time, your progress may be slower.
- The first few days
- You usually go home the same day. The cheeks may swell and feel tight, sometimes with light bruising. You take pain relief and antibiotics as prescribed, eat liquid or soft food, and keep up oral hygiene as directed, since the incision is inside the mouth.
- Around the first week
- The most noticeable swelling begins to ease. The stitches inside the mouth usually dissolve on their own or are checked at your follow-up visit. Many people consider returning to work during this period, depending on the nature of their work and how much swelling remains.
- Around 2 to 4 weeks
- Swelling eases considerably, and eating gradually returns to normal. Your two cheeks may not be fully even at this stage because swelling settles unevenly, and that is normal.
- Around 3 to 6 months
- The last of the deeper swelling gradually resolves and the cheek contours show clearly. This is when the result is considered final.
Risks & safety
Most buccal fat removal carried out by sound principles goes smoothly. But this is surgery in an area with an important nerve and salivary duct nearby, so there are risks worth knowing about beforehand — and knowing them clearly helps you decide well. Your surgeon will talk through them with you in detail.
- Removing too much fat can leave the cheeks hollow, looking thin or older, and this can become more noticeable over time as you age.
- Injury to a branch of the facial nerve, which can affect the movement of the facial muscles, usually temporarily and rarely for longer.
- Injury to the parotid salivary duct, which sits near the surgical area.
- Bleeding or a haematoma, meaning blood that collects within the cheek.
- Infection, particularly since the incision is inside the mouth.
- Cheeks that are not fully even, or cheek slimming that falls short of what you hoped for, sometimes needing a revision later.
- Risks related to local anaesthetic, or to general anaesthetic in cases that call for it.
How we do it
Buccal fat removal is surgery in an area where a branch of the facial nerve and the salivary duct sit close by, and the key lies in removing just the right amount — not so little that the cheek stays full, not so much that it grows hollow later. For this reason, the surgery should be performed by a specialist in Plastic and Aesthetic Surgery who is trained in this technique, at a hospital licensed for aesthetic surgery. These conditions are tied to your safety; they are not minor details.
At The Gioi Dep, the person who examines and advises you is also the one who performs your surgery, so what the two of you discuss about the fullness of your cheeks and its cause goes straight into the plan. Your surgeon will be honest about whether buccal fat removal is truly right for your face — even when the answer is that you should not have it. Before surgery, you are seen by an anaesthesiologist for a pre-anaesthesia assessment, a step that helps reduce the risks that can arise during anaesthesia.
Frequently asked questions
Will it leave a scar on my face?
Usually not. The incision is made inside the mouth, on the inner surface of the cheek, so it leaves no visible scar on the skin of your face. Your surgeon will explain the exact incision in your case during the consultation.
Does it hurt a lot?
In the first few days the cheeks may feel tight and a little uncomfortable when eating, since the incision is inside the mouth. Most people manage this well with the medication their surgeon prescribes, and it eases noticeably as the swelling begins to go down.
How long will I need off work?
Many people consider returning to work in about a week, depending on the nature of their work and how much swelling remains. Because the cheeks may still be a little swollen in the early stage, you should plan for a comfortable amount of time off.
Will the result look natural?
The aim is a slimmer cheek area with more defined contours that suit the rest of your face, not a different face. The result depends on your own structure and only shows gradually as the swelling fully settles. Removing a measured amount of fat is exactly what helps the result look natural.
Will my cheeks look hollow when I get older after buccal fat removal?
This is a real concern and deserves serious thought. As you age, your face naturally loses some fat, so if too much buccal fat is removed, the cheek can look more hollow later on. For this reason, your surgeon removes only part of the pad and in a measured way, and will advise against the procedure if your face is already slim.
Should I have buccal fat removal if I am slim?
Usually not. If your face is already slim or you have little cheek fat, removing more buccal fat can leave the cheeks hollow and looking older. Your surgeon will assess this during your examination and talk it through honestly with you.
How long until I see the result?
The most noticeable swelling usually eases within the first few weeks, but the final cheek contours take longer to show, often around several months as the deeper swelling resolves. This is something that calls for patience.
Will I have local or general anaesthetic?
In most cases you have local anaesthetic, meaning only the cheek area is numbed and you stay awake. Some cases also use sedation or general anaesthetic, especially when you have it alongside another surgery. The anaesthetist will discuss this with you beforehand.
How should I eat after surgery?
In the first few days you eat liquid or soft food and keep up oral hygiene as directed, since the incision is inside the mouth. Returning to normal eating happens gradually, following your surgeon's guidance.
Am I too old for this?
There is no hard age limit. What matters more than the number is your overall health and how much cheek fat you have — because an older face has often already lost some fat naturally, so this approach is not always suitable. Your surgeon will assess this during your examination to consider with you whether it is worth doing.
The next step
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The content on this page is for reference only and does not replace a direct examination and consultation with a specialist physician. Surgical outcomes vary from person to person.