{"id":22741,"date":"2023-07-20T09:35:32","date_gmt":"2023-07-20T16:35:32","guid":{"rendered":"https://www.realself.com\/news\/?p=22741"},"modified":"2024-02-16T09:44:49","modified_gmt":"2024-02-16T17:44:49","slug":"buccal-fat-restoration","status":"publish","type":"post","link":"https://www.realself.com\/news\/buccal-fat-restoration","title":{"rendered":"Reversing Buccal Fat Removal is Now a Thing. Here\u2019s How Doctors are Fixing Gaunt Cheeks."},"content":{"rendered":"

Buccal fat removal<\/a> entered our collective consciousness several years ago, after the procedure exploded on Instagram, giving us a new feature to scrutinize: our cheek hollows. Of course, as with most social media “discoveries,” the procedure was nothing new. Plastic surgeons have forever been tinkering with buccal fat, to quietly sculpt lower faces during facelift<\/a> surgery. Regardless, viral fat-extraction videos and celebs endorsements and changed appearances (Chrissy Teigen<\/a> raved about her results, selfies of Lea Michele sparked rumors galore that she had the procedure done) elevated buccal fat removal to something of a plastic surgery phenomenon—and its popularity continues to soar. According to the latest stats<\/a> from The Aesthetic Society, its members performed 68% more buccal fat excisions in 2021 than they had the year before.<\/p>

As anyone who’s mastered the pronunciation of buccal<\/em> (buh-kl<\/em>) no doubt knows, a fair amount of controversy surrounds this famous fat pad and the prudence of mining it for supermodel-caliber, Bella-Hadid-inspired angles—largely because “there is insufficient long-term data<\/a> … as it pertains to any possible future consequences of buccal fat removal on facial aging,” explains Dr. Danny Soares,<\/a> a board-certified facial plastic surgeon in Fruitland Park, Florida. Doctors aren’t entirely sure how buccal fat–subtracted cheeks may fare as people get older, when the myriad tissues of the face inevitably deflate, erode, and descend.<\/p>

Buccal fat removal<\/strong> regret is real<\/strong><\/h2>

It’s important to first understand exactly what buccal fat is and the purpose it serves in the overall facial structure. “When surgeons remove buccal fat, they’re taking only a portion of fat from the lower cheek,” adds Dr. Soares. But that yellow glob<\/a> you’ve seen plucked from countless influencers’ mouths on TikTok videos (or the roundness you see in the mirror) hardly captures the true bounty of buccal fat. The buccal fat pad (aka Bichat’s fat pad) is actually made up of several deep and superficial segments, or lobes, situated throughout the cheeks and extending back toward the jaw and up into the temples. Beyond lending copious volume to the midface, it serves as a sort of shock absorber, helping muscles move with ease and buffering underlying nerves and vessels. <\/p>

Many surgeons insist that when buccal fat reduction is done conservatively, in good candidates—“younger adults with a normal BMI but an overly round face due to excess fullness of the lower cheek region,” notes Dr. Soares—that satisfaction rates are high and regrets are unlikely. These patients notice a “subtle but significant difference,” he says, and often wish that even more fat could be removed.<\/p>

But some plastic surgeons are starting to see a bit of blowback from the buccal removal craze—prematurely wizened cheeks that can be difficult to restore to their original proportions. While the short term effects of the cosmetic surgery may be exactly what patients want, the longterm results of buccal fat removal aging are very real. “I see it a lot in patients who are somewhat older and had [buccal fat reduction] done when they were young and now look much older than they are, as their face is depleted,” says Dr. Rod J. Rohrich<\/a>, a board-certified plastic surgeon in Dallas. Sometimes buyer’s remorse surfaces far sooner. “I recently saw a Hollywood star who had buccal fat pad removal a year ago and is now distraught [because] he looks 10 years older and gaunt,” Dr. Rohrich shares.<\/p>

Do you naturally lose buccal fat as you age?<\/strong><\/h2>

In a word, yes, which is why not every patient aiming to beef up their buccal hollows has had fat surgically extracted. For some, age has sculpted their cheeks in unwanted ways. Beverly Hills, California, board-certified facial plastic surgeon Dr. Sarmela Sunder<\/a> says that while she has seen “several patients wanting to restore an area of previous buccal reduction,” the majority of folks seeking buccal augmentation are aiming to reverse age-related changes, not surgical side effects. <\/p>

Similarly, Dr. Steven R. Cohen<\/a>, a board-certified plastic surgeon in San Diego, tells us that about 25% of people who come in for facelift surgery have “extensive losses in the buccal region”—again, due to natural aging. He tends to see it more in Slavic patients with pronounced cheekbones. He adds, “I’m not sure it’s 100% related or just accentuated”—the peaks of their facial topography making the adjacent valleys appear extra cavernous. We should note, there is debate among doctors as to how the buccal fat pads change over time. Do they truly atrophy—or do they just drop? If they shrivel, how much volume is lost? The answers are likely unique to the individual, with some people having persistent buccal bulges for life (those genetically prone to so-called ‘chipmunk cheeks’) and others developing gaunt hollows due, in part, to disappearing buccal fat.<\/p>

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