Buccal Fat Removal a Good Option for Slimmer Face?

Would I be a good candidate for buccal fat removal? I am a slim 26-year-old: 5'5" tall at 113 pounds. I am seeking options to slim my lower face.

Please look at my picture and share any thoughts. Thank you.

Doctor Answers 19

Buccal fat pad excision is an excellent choice in the right patient

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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.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Caution against Buccal Fat Removal

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Having a full face and round cheeks is a sign of youth. Simply do a bit of research to see what concerns women in their 30's and 40's are looking to correct...Volume Loss is at the top of the list. You will find that over the next 5-15 years your cheeks and lower face will thin and you will have the desired (more chiseled) look you are wanting. If you choose buccal fat removal in your early 20's, you may be happy with the result for the next few years- BUT you will be faced with a more aged and thin look in your face in your early to mid thirties. I have a patient in my practice that is facing this exact issue. At 35 she is attractive, youthful and vibrant...but her face looks a bit tired and "deflated". She had her buccal fat removed by another surgeon when she was 22 and now, at 35, she is seeking to volumize her face with fillers such as sculptra and radiesse which will cost her approximately $3,000-$5,000 every 5 years. Although this may not be the answer that you are looking for- you may find that a visit to a professional make up artist to learn the trick to contouring facial features with blush and bronzers will get you through the next few years.  I hope this helps you make your decision.  Best of luck, Dr. Clevens


Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Buccal fat pad excision

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I amnot a big fan of buccal fat pad excisions in the majority of patients, because it can cause a gaunt look as you age.  This will make you look older than your actual age.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Buccal fat removal will slim your face

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You are a good candidate for a buccal fat removal. It will slim your face between the cheeks, lips and jaw. It will give you the apperance as if you were sucking lightly on a straw.

Luis A. Vinas, MD
West Palm Beach Plastic Surgeon
4.8 out of 5 stars 30 reviews

Creating the Ogee curve

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Indeed, you have a rounded face. The short answer to your question is "yes". You are a candidate for buccal fat pad removal. It would help to create the "ogee" curve of the cheek that is aesthetically ideal. However, as you have already read, removal of the buccal fat at an early age may hasten an older appearance as you age. If you decide to proceed, make sure that the removal is performed conservatively, i.e. not the entire pad is removed, only it's outer segment. Discuss the options of liposculpture of your cheeks with your surgeon as well. Good luck!

Candidates for Buccal Fat Pad Removal will have quick and slimming facial results

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Hi Cupcake26,

Buccal fat removal in your case will slim your round face, help sculpt your cheeks and better reveal your facial features while enhancing your overall aesthetic beauty. The goal of the surgery is to provide the right candidate with the Ogee Curve.

It is of no secret that Buccal Fat Removal is a delicate procedure and so it should be performed conservatively to preserve natural looks.

Therefore, choosing a qualified surgeon with extensive training in facial surgery is a key element especially when considering the natural fact that buccal fat pad will atrophy with age.

Nonetheless, many patients with round face could be a good candidate for such a procedure, especially the ones with excessive buccal fat that are not prone to be toned down by the natural course of aging.

Best of Luck.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Buccal Fat Removal Best Done Subtly

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Buccal fat removal can remove some of the volume of the mid face. It should be performed conservatively so that an overly guant apearence is avoided.The results are subtle and you must be accepting of this. In my opinion liposuction of the face does not yield smooth results and really should be limited to the jowl and neck.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 114 reviews

Is buccal fat removal a good option for slimmer face?

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Not really.

Buccal fat pad excision - or as we refer to it as the fat pad of Bichat - is indicated in people who have moon like faces (as you may see with some Koreans and Chinese) as well as in people with Cushinoid faces. In such individuals, only the removal of the fat pads gives the face the more attractive, upside down pear or tapered look.

The problem is that with time, we ALL LOSE FAT IN OUR FACES. We begin to have exposure of the lower rims of the eye sockets and our cheek bones become hollow as well. People who had the Bichat fat pad removed look much older and sicker much earlier. The "look" is of one who is dying of AIDS. NOT A PRETTY PICTURE.

Personally, I think that in your case it is too extreme.

I hope this was helpful.

Peter A Aldea, MD, FACS

Peter A. Aldea, MD
Memphis Plastic Surgeon

Would recommend patient wait a bit longer

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Hi there, at age 26 I would recommend waiting another 18 to 24 months to see if any aging occurs that results in the slimming of the face. It is possible for a young patient's face to change dramatically in a two year period as they approach age 30. Right now, your face looks youthful with excellent skin quality and a unique feminine look. I would highly encourage you to wait and/or experiment with makeup application to highlight/contour the cheekbones before making this surgical decision. A consultation with a hair/makeup artist can help make this transition period easier. Then, if by the time you are 30 or close to it, you feel your  face hasn't slimmed out enough, I would consider a very conservative procedure. 

Buccal Fat Removal

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Yes, you appear to be a good candidate for buccal fat pad removal. Just make sure to see an experienced surgeon to evaluate you options, goals and facial features prior to making a final decision about having this type of surgery.

Gary Motykie, MD
Los Angeles Plastic Surgeon
4.3 out of 5 stars 67 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.