Am I a Candidate for a Buccal Fat Pad Trimming?

Buccal fat Pad Removal is a "C" grade procedure in most cases because it leads to a hollowed look that ages poorly. You would be better advised to seek other options.

Young patients with chubby cheeks and sagging of the facial skin (e.g evident because presence of marionette lines) very likely have enlarged buccal fat pads and weak cheek bones. Buccal fat removal alone will only address the chubbiness but will NOT correct the marionette lines.To improve the saggy facial skin and marionette lines, very likely the patient requires upper cheek enhancement ( generally with fillers). The results of buccal fat removal depends on the cheek bones. 

You have many options. It is all about fat (or volume) in the right places. Buccal fat removal and/or manipulation can be a great and transformational procedure in the right patient.  Oftentimes fat transfer or filler injection in conjunction with this procedure is able to give a more “ideal” heart shaped face. This can make a significant difference in patients as a combo. It may seem counterintuitive to add fat when you say your problem is chubby cheeks. What we do is add volume to 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 patients and in combination with buccal fat pad removal is a powerful maneuver. Liposuction of the jawline and sculpting is also helpful in some patients. It really depends on your specific anatomy. 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.

Buccal fat pad removal is where a surgeon, typically from an inside the mouth approach, removes a specific encapsulated area of fat located in the cheek.  The goal is to contour the face and avoid bottom heaviness and emphasize cheekbones.


It is very difficult to ascertain if a patient is a good candiate for buccal fat removal based on a photograph.  Patients must be selected properly for buccal fat pad removal, as chosing an inappropriate candidate can lead to a premature gaunt look in the face.




Critera to see if candidate for buccal fat pad removal:




1.  Family history of "full" faces-  Families with full faces who age with full faces are likely to benefit from buccal fat removal.  Families whose fuller faces eventually turn gaunt should avoid this procedure
2.  Buccal fat excess-  There are multiple fat pads in the face.  The key is to determine if buccal fat pad removal is beneficial

Dear Annabelle81,

 

Buccal fat pad removal when performed accurately will give the patient a slimmer and an ideal midface contour. Conservative approach in your case will help deal with "marionette" folds.

 

Nonetheless, I encourage you to have a physical examination with a surgeon of ample experience who will advise you on supplemental procedures to give you the ideal midface contour.

 

The main goal is to spare you from developing a hollow face as you age but at the same time to preserve your natural looks and enhance your facial beauty.

 

Thank you for your inquiry.

 

Dr. Sajjadian

Based on your pictures and young age, you don't need much but what you need must be very targeted.  There is fullness in the cheeks, and with such a thin neck, it's not from obesity.  Buccal fat will help, but re-allocation of facial fat with fat transfer or dermal fillers will go along way.

Buccal fat pad reduction is a useful procedure for the right patient. It can achieve a more sculpted look for the middle third of the face. It is recommended for patients with a very full cheek look to start with. It is not, however, a substitute for a facelift nor mini-facelift. 

It is important that you match the procedure to your goals and needs. Buccal fat pad reduction is specifically for thinning the cheeks right below the cheek bone. It will do nothing for jowls nor the lines you don't like on your face. A mini-facelift would be the minimum needed to address that area. One procedure really does not impact the other. I certainly would not choose one as an alternative to the other. They do different things.

I hope this info helps!

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.

Conservative buccal fat excision would help you out.  The key is not to remove too much buccal fat.  You are probably too young for a facelift of any type.  You may also benefit from a conservative amount of under chin and neck liposuction.  In summary, go for a conservative amount of buccal removal and neck liposuction, wait 4-6 months and then analyze for face. 

Regarding: "Am I a Candidate for a Buccal Fat Pad Trimming?
I am a 29 years old female and have 2 marionette folds on my chin. I've had them since I was a child but they're becoming more prominent with age and I really want to do something as I believe they giving me a 'bulldog cheeks' look. I've made several enquiries and mini facelift seems to be the best solution. I was also told about buccal fat pad trimming as an cheaper and less invasive alternative. Would you recommend it in my case and if not,- what in your opinion would be the best procedure?"

Removing the Buccal Fat Pad (of Bichat) is NOT a substitute for a Facelift. It is a procedure that MAY be suitable in moon faced individuals but it is a rather poor operation with permanent deleterious long term consequences. The youthful face is FULL of volume, operations which remove volume cause premature aging. This procedure often leads to a "sucked in" appearance as is seen in the elderly with exposure of the malar bone. I would advise you to research this very carefully. It may be a very serious mistake for you.

Dr. Peter Aldea