Possible to Reverse Buccal Fat Removal?

I had buccal fat removal and botox jawline reduction a month ago. Now my lower cheek looks really gaunt and my upper cheek looks really out of proportionly full. I wonder if there are any ways to reduce some fat from my upper cheek without surgery to even out the difference and also to add more fat in the lower cheek to balance everything. Thanks.

Doctor Answers 12

How to reverse buccal fat pad removal

Hi 2574anon,


Thank you for sharing your concern.


In general, revisions tend to be complex and delicate.

The quick answer to your question would be a "yes"; buccal fat pad removal can be reversed and good results will be obtained ONLY if done by an extensively experienced surgeon.


Time should be given for the healing process to take place. Only then, an examination will enable the surgeon to determine the best procedure that will fit the patient.


Usually, the long lasting approach is the one based on injecting autologous fat (harvested from the patient) into the depressed areas sculpting the buccal region and restoring the patient's natural features.

Best of Luck.

Dr. Sajjadian

Orange County Plastic Surgeon
5.0 out of 5 stars 178 reviews

Fat injections can correct your appearance

Reduction of facial fat is not recommended in most cases. If you were a good candidate for buccal fat removal and you do not like the results, it can be corrected with autologous fat injections.It is like sculpting your face by adding, not removing. When done properly, the results will be nice.

Luis A. Vinas, MD
West Palm Beach Plastic Surgeon
5.0 out of 5 stars 15 reviews

Buccal fat pad removal now a problem; later even more of a problem.

Reducing facial volume is generally a bad thing, since this happens naturally as we age. The loss of facial volume is further worsened by the loss of collagen and elastic fibers in our skin, causing sagging, jowl formation, looseness in the neck area, and deepening of the nasolabial and subcommissural folds (marionette lines). You didn't state your age, but removing fat from your upper cheek only gives you more of the same problem you already have! (And, how do you do that without surgery, by the way?) Dr. Aldea is right, if you don't like how things look now, right after your ill-advised procedure, you will REALLY not like how things look as years go by and volume decreases more and skin sags more.

You may need judicious and expert fat grafting to restore volume, and may also need facelift to tighten and lift the facial tissues to a more youthful position. Seek an experienced, board-certified plastic surgeon for more information; more than one consultation may be helpful in clarifying advice.

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 196 reviews

Fat transfer (fat injections) works well for gaunt cheeks.


Don't do anything for three months, because things will change. But then, your facial contour can probably be improved with skilfully done fat transfer.

If you do not want surgery, Juvederm injections may also help.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Consequences of Buccal Fat (Bichat's) Pad Removal

I truly hate to tell you this but if you do not like the way you already look only a month after the procedure, you would likely be extremely unhappy with your appearance in in 10-20 years.

As we age, we all lose facial bone mass AND we lose facial fat resulting in a massive facial deflation with sagging of the skin and deepening of the folds (nose to mouth (Nasolabial) and Puppet (Drool) Lines).

Your options are fat grafting or Sculptra. Fat grafting if successful would greatly improve your appearance but greatly depends on the survival (IE take) of the graft). Sculptra lasts over 2 years but needs to be administered in sessions spaced 4-6 weeks apart.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 83 reviews

Reverse Buccal Fat Removal

Facial fat grafting (or facial fillers), which is performed by taking fat from somewhere else on your body, can be performed to replace the missing fat if you do not like the aesthetic result of your buccal lipectomy.

Gary Motykie, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 43 reviews

Gaunt Appearance after Buccal Fat Removal

Altering the fatty compartments of the face can be done subcutaneously (below the skin) or submuscularly (below the muscles of the face). The removal of the buccal fat pad consisted of removing the submuscular fat, with the goal of diminishing the volume in the midface (cheek) and highlighting the zygoma (cheek bones).

Non-surgical options do exist to add volume or augment the area, which is now “gaunt.” These include fillers and fat grafting.

A Board Certified plastic surgeon can evaluate you and determine the degree of deficiency in your lower cheek area. Fillers can be used to temporarily improve the gaunt look. Fat is a more permanent option, but does require the use of incisions to harvest fat from another area of the body.

Trying to reduce the fullness of the “upper cheek “ requires a different approach. Any attempt to reduce the fullness of the upper cheek is difficult. It may best to fill in the lower cheek and then re-evaluate your appearance. It is possible that simply restoring fullness to the lower cheek may correct your problem.

John Diaz, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 28 reviews

Yes but be careful

I find that many patients fall into this trap of surgery after surgery after surgery... And eventually look far worse than what they initially looked like. I would recommend using temporary #Fillers with a surgeon to see if you like what the correction looks like before you commit to fat grafting.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Reverse Buccal fat pad reduction

Buccal fat pad reduction is a procedure that is not commonly performed but can make sense in the right patient.  It is important to understand the anatomy before undergoing the surgery so that you are well informed.  Normal aging reduces the buccal fat pad volume.  It is true that some people have more volume in their cheeks than others.  However, it is also universally true that that volume will decrease and descend over time.  Removing too much buccal fat can cause premature aging.  It is also important to remember that replacing fat that has been removed is extraordinarily difficult if not impossible.  The main reason is the location of the buccal fat pad.  It usually resides underneath a large muscle that is responsible for majority of the power motions of your chewing.  Once that fat is removed that space collapses.  Once collapsed it is very difficult to find the exact space and to reinsert a substance such as a filler or better yet fat.  One potential solution is to use something like Sculptra.  While I generally do not advocate buccal fat pad removal, I understand why somewhat would want procedures such as this.  I tried to choose my patients very carefully and I also tried to be conservative in the amount of fat that is removed.  Surgeons who trivialized this procedure simply don’t understand how difficult it is to correct deformities that may occur.  The cost of the procedure can run anywhere from $3000-$7000, depending upon your geographic locale.  Please visit with an experienced board certified plastic surgeon.  My best advice is to always be conservative with any buccal fat pad reduction.

Fat injections to reverse buccal fat removal

Buccal fat pad removal is rarely performed anymore and discouraged because facial fat is lost occurs with the natural aging process. An aging face has very little fat in it and we do not wish to accelerate the aging process by removing fat. Fat from another part of the body could be injected to the buccal fat pad space to build up that area, although this will probably take several procedures over a period of time to get an excellent result.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 72 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.