Buccal Fat Removal a Good Option for Slimmer Face?

Buccal fat pad excision in the right patient is an excellent procedure.
My fine colleagues are absolutely correct to worry about using the procedure willy nilly in every young patient with an overly full face in whom the natural history of their faces would eventually produce a beautiful face.
However many patients simply have overly full faces in the lower cheek region. And they will have this for most of their life. The bulging buccal fat pads simply prevents their face from being pretty. Often one of their parents has the same feature, even in advanced age. They and their parents suffer with the "chipmunk cheek" look well into advanced age.
The natural history of the buccal fat pad is that it shrinks with age. In younger patients it is full. In older patients it is much smaller. In elderly patients it is often almost absent. In fact as patients age we often see what is left of the buccal fat pad slightly bulging out through the disappearing SMAS layer. This is routinely addressed in facelifts in older patients by fixing the SMAS layer on top of the buccal fat pads, a shadow of what they used to be.
So where is the shrinkage that supposedly occurs if the fat pad had been removed if the buccal fat pad disappears anyway?
By the time the patient has "burned through" their facial fat, fat in the entire face has diminished, both in the buccal fat pad as well as the cheeks and face as a whole. Are we avoiding the surgery on the buccal fat pads that would have an instant and huge benefit (see pictures below) so people can look good when they are 80?
One of the features of a beautiful face, both in women and men, is a juxtaposition of the cheekbone area to the cheeks. The cheekbone area is fuller than the cheek area. The S-shaped curve on the 3/4 view is attractive and in fact defines the most beautiful faces of our era.
It is possible to augment cheeks, either with fat injection, LiveFill(TM) or cheek implants. However in faces that aesthetically would not benefit from further widening in the cheek area, is that the right choice?
Our practice has been a champion of retaining volume in the face with LiveFill(TM) grafts and 100% SMAS preserving facelifts. However, not all volume looks good in all patients. Fat underneath the chin looks bad. Should that be kept so that when the patient gets older they have some spare fat? Should we start a "Save the double chin foundation"?
It is simply not beautiful when the cheeks are overly full. In such patients, buccal fat pad removal can be an immediately and profoundly satisfying procedure.

You are a great candidate for Buccal fat removal procedure. This procedure helps create the desired V-shaped face, making the cheekbones and jawline more prominent. You can definitely have more defined and slimmer facial features after this procedure. Best of luck to you.

Treatment of ‘chubby cheeks’ cannot be achieved alone with buccal fat pad removal; a fact that I encounter time and time again when seeing patients in consultation for lower facial sculpting. My approach is to use a combined protocol that redefines aesthetic contours of the face. This includes the following: 
  
Buccal Fat Pad Removal Non-surgical Muscle-Fascia Tightening Venus Legacy or Venus Viva Ultherapy Submental Liposuction or Coolsculpting   
The combined approach is ideal. Buccal fat pad removal is a exceptional procedure that can remove excess fat from the cheek pads. Using an intraoral approach, a small incision is carried through the mucosa to remove a small fat pad within the cheek. Closure of the incisions is minimal with an absorbable suture and patients will experience some swelling post-operatively. We use SwellX tablets post treatment. Once healed, the contour of the cheek is improved and we begin Non-invasive tissue tightening to further enhance results. 
  
Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Buccal Fat removal is a good, actually an excellent plastic surgery procedure to slim the face. Chubby cheeks or fullness of the lower anterior cheeks is commonly caused by enlarged buccal fat pads. Buccal fat removal by removing the buccal fat pads permanently, makes the face less full, more thin and/or chiseled in patient candidates. The video below helps to understand who could be a candidate for buccal fat removal. 

From your picture, it appears buccal fat pad reduction could be an option for you. However, you should keep in mind that you are young and these fat pads, along with all of the other fat pads in the face, will atrophy and become smaller over time without intervention. For this reason I would recommend only conservative reduction in the size of the fat pads, and not complete removal. Other options, such as Botox to the masseter muscle, can provide slimming of the lower portion of the face without the need for permanent tissue removal. I would advise you to consult with a facial plastic surgeon for an in-person evaluation to assess your concerns and make recommendations on which procedure or procedures are likely to give you the best result.
Best wishes,

As with any surgical procedure a patient has to be a good candidate.  Buccal fat extraction should be avoided in cases where a patient does not have excess fullness in the cheek region as it will create and aged and gaunt appearance.   In patients that have excess fullness in the buccal region buccal fat surgery can create beautiful results.  I prefer to be conservative in the majority of cases.  

There are several options to slim the face. The key is to perform the correct procedure for the correct patient with fullness in the correct place. Facial slimming options include liposuction, Botox to the masseter muscle, buccal fat reduction, (counterintuitively) even adding filler to certain areas judiciously, and many more. You appear to be a good candidate for buccal fat reduction, however it would be helpful to see more views of your face, and certainly have an in person examination.There seems to be some concern about the risk of buccal fat reduction in prematurely aging patients who have the procedure done. Again, this is why it is critical to perform the operation in the appropriately selected patients, and to take out the correct amount of fat. Not too much, not too little! For this reason, it is critical that you seek the advice of a surgeon who is certified by the American Board of Plastic Surgery and has extensive experience in buccal fat reduction and facial contouring.
 I wish you the best,
 Dr. Gabbay.

Hi, 
When performed with careful consideration and restraint, buccal fat removal can help to slim the central face. If done aggressively or inappropriately it will result in a gaunt appearance. A possible alternative to buccal fat removal may be botox/dysport to the masseter muscle to slim the lower face. I recommend a consultation with a facial plastic surgeon to go over all of your options.
Best,
Mehdi Sina, MD

Based on your description, you seem like a reasonable candidate (already thin but with a fuller face and cheeks).  The buccal fat pad is located immediately below the cheek bone and just in front of the biting (masseter) muscle.  Removal produces a more sculpted look to the face.  The results are usually subtle and never dramatic but can be an extremely useful tool in the right situation.  

You are possibly a candidate for buccal fat pad removal. Often times fat transfer in conjunction with this procedure is able to give a more “ideal” heart shaped face. This can make a big difference in patients as a combo. It may seem counter intuitive to add fat when you say your problem is fat cheeks. What we do is add fat around the cheeks to the side of the highest and most projected point of the cheek bone and taper it to the lower face. This helps to camouflage overly chubby cheeks.  This is especially helpful in thin women and in combination with buccal fat pad removal is a powerful maneuver. All of this can be done in clinic with some calming medications and local anesthesia.

I recommend getting a consult with a surgeon who does this procedure frequently to get a full facial analysis to make sure your specific goals are addressed.

Hope this helps.

Best of luck.

DrC

Thanks for your question. I find buccal fat pad reduction to be a great procedure in the properly selected patient. Fullness in the lower cheeks or "chipmunk cheeks" can be treated this way. Liposuction or skin tightening technologies will not be the right choice when buccal fullness is apparent. The buccal fat pad sits deeper in the cheek under muscle. This is different from skin fat that can be liposuctioned. Proper diagnosis is important. Also, this fat pad may get smaller when we are elderly giving a hollow look in this area I have many happy patients with this procedure. Careful selection and counseling are key. Results evolve nicely over a period of weeks to months. Please talk to an board certified surgeon experienced in buccal fat reduction to see if you are a candidate.