Why Are Doctors Against Buccal Fat Pad Removal?

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  This procedure is also not commonly performed so many surgeons may feel uncomfortable with it.  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.

Hello, hope you are well. I think it is a misperception that plastic surgeons are categorically opposed to buccal fat removal, but your question is understood. The most important consideration, as with anything, is making sure the procedure is applied to the appropriate patients. Buccal fat removal is a simple office procedure that is performed under local anesthesia in less than an hour with minimal downtime. It reduces fullness around the lower cheeks to help contour and provide a slimmer shape. It can accentuate the cheekbones and jawline. However, if someone is already volume deficient in this area, buccal fat removal would not be advised. I also caution very young patients (teens and twenties) because their facial shape is still maturing and the change in shape created by buccal fat removal may not age well. This is a very individualized evaluation, but your concerns are commonly voiced by those seeking this procedure and you would probably be a good candidate. Hope this helps!
Best,Dr. Tower

Reduction of the buccal fat pad is a common cosmetic procedure that is performed in order to slim the lower third of the face. This procedure is commonly performed under a light sedation, and is usually associated with minimal bruising or swelling, resulting in very little downtime.  Some doctors are against buccal fat pad reduction or removal because as we age, the face loses volume, and having reduction in facial fatty tissue may lead to a gaunt look over time. I recommend that patients achieve the look they are going for now, and enjoy their looks for as long as they can. If several decades pass and volume loss is an issue, there are many ways to deal with this, and there may be even better techniques and technologies in the future! Because certain patients are not good candidates, you should seek a surgeon who is very familiar with this procedure to see if you meet the criteria.Be sure to see an expert.
All the best,

Like all procedures that plastic surgeons offer, not all of them are right for every patient. The ideal candidate is a person that has "chipmunk cheeks" that can be seen in multiple generations without loss of significant cheek fat decent as they age. As a try before you buy approach we evaluate the external appearance with the patient half-biting their inner cheek. This allows the surgeon to evaluate how much buccal fat to remove. This procedure is not for everyone but as long you meet the criteria then this may be an option for you! Good Luck!

Great question!  Buccal fat removal is a very good procedure for someone like yourself that desires a more slimmer and contoured face.  It can also create a more defined jawline and sharper contours.  I think it is a great procedure for the right patient, depending on your goals and you seem to fit the right criteria.  The reason some doctors do not like this procedure is that as we age, we loose facial volume.  Often times patients come in to get fillers or fat grafting to add volume, so the act of removing facial volume does not sit well for some surgeons.  However, I feel like its more about facial balancing, removing volume from the correct places can create a more attractive appearance.Best of luck and hope this information helps!- Dr. Roger Tsai  @DrRogerTsai

Reduction of the buccal fat pad can be a great procedure for slimming the lower face, but requires careful selection of the appropriate patient. As we age, fat compartments in the face tend to atrophy, or become smaller, and this is part of what causes a more aged appearance. Some doctors are concerned that buccal fat pad removal will therefore automatically contribute to this gaunt, aged appearance, but in a patient who has a family history of round, "chipmunk" cheeks that stay full even as they have aged, reduction of the buccal fat pad can be safely performed without as much risk of creating a prematurely aged appearance. If you are not a good candidate for this procedure, other options may include augmenting the upper cheeks with filler, fat, or implants to give you that heart-shaped, inverted triangle facial shape that is considered youthful and attractive without needing to remove any tissue. I would advise you to schedule a consultation with a facial plastic surgeon who can evaluate you in person to determine which options would be most likely to give you the best result.
Best wishes,

But not always!Removing the buccal fat is one of my favorite procedures. It's painless, recovery is light and easy, and the procedure is able to be done on patients fully awake in the office and doesn't take long. They key is 1. to make sure you're a good candidate and 2. to go to someone who performs facial surgery regularly as there are important structures (nerves and ducts that carry saliva to the mouth) in that area. Another main key is that the resection of fat isn't over aggressive- as we age, our fat deposits shrink and this can make us look a bit scary in our elder years if over resection of fat was performed. We don't want that. I hope this helps and God Bless,Dr. Robb

When done properly, buccal fat removal is an excellent way to contour your face and refine your cheeks. It is particularly effective in those who have full cheeks despite moving beyond their teen years, weight loss with diet / exercise, etc.. There is the theoretical concern that taking out too much of the buccal fat may result in hollowing of the cheeks as you age. The important thing here is to perform the operation properly, taking out only enough fat to give a an excellent result, however not too much as to prematurely age somebody. This is where experience matters! Another important detail is that even if you feel hollowed with time, it is easy to transfer fat back into the cheek to continue to refine and enhance the face as you age. Facial contouring is a very delicate and very thoughtful procedure that should be done by an expert who understands all of the intricacies necessary. 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.

Doctors that are "against" buccal fat removal are very likely unfamiliar with the procedure or do not perform the procedure frequently enough to understand how rewarding the procedure is  for patients seeking to correct chubby cheeks and/or achieve a chiseled face.One of the most common reasons of some doctors to be against buccal fat removal is because they think "buccal fat removal will make the face look older".  Buccal fat removal won't make the face look older if the patient have good cheek bones.Therefore, the root of this misbelieve  that buccal far removal will leave an aged look is that doctors that not familiar with the procedure do not evaluate the cheek bones at the time of the buccal fat removal consultation. The prominence of the cheek bones are crucial to achieve non-aged appearance with buccal fat removal.  If buccal fat removal is performed in patients with poor cheek bones, and the poor  cheek bones are not corrected or enhanced, the patient end up looking aged ( because the face will sags like in older people).In my practice I always evaluate the cheek bones during buccal fat removal consolation. If the cheek bones are poor I highly recommend to enhance them with either soft tissue fillers or implants. If patients with very poor cheek bones refuse cheek bone enhancement, I won't perform the surgery because it will deliver and aged look. Patient that enhance their cheek bones before or at the same time of the buccal fat removal, they all end up having a chiseled V shape face that is not aged looking at all. Even "old people" ,eg. patient in their 50, end up looking younger with buccal fat removal if their deficient cheek bones are enhanced peri-operatively. The link bellow explains in detail the above mentioned concept with clinical illustrations. Patients interested in buccal fat removal to correct heir chubby cheeks should seek for a board certified plastic surgeon specialist in buccal fat removal. 

When a patient has a full and round face and despite weight loss (usually patients seeking Bichat removal are overweight) the fullness persist. If the patient is in his normal weight and still the cheek protrudes, a bichectomy is useful. Its true that with aging the buccal fat pad tends to diminish in volume do to atrophy, but if the volume is excessive a bichectomy will not hollow the cheek overtime. Many patients are happy with the results, a proper selection is a very important manner. 

Removing the buccal fat pad is a relatively simple and reliable way of reducing fullness in the lower face/cheek area.  This give a much leaner look to the face.