Why Are Doctors Against Buccal Fat Pad Removal?

I have such fat round cheeks. All my life I have been made fun of. I had Vaser LIpo on my cheeks and I still feel i need buccal fat removal. I look like a bulldog. I have a very round face. Isn't buccal fat removal ok for some people? i feel i am one of them. i want a slim face. is that so bad?

Doctor Answers 13

Buccal fat pad reduction

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.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 66 reviews

Cheek (Buccal) Fat Pad Removal - Cautionary Tale

As we age we lose fat and volume from our faces and our face sags resulting in the familiar deflated, sagging facial aging familiar to all. Fat loss is particularly seen in the Cheek Fat Pad (of Bichat) which results in accentuation of the cheek, temple and side of the eye socket bones and a sick, malnourished appearance (compounded further by illness).

While there is room for performing a Bichat fat pad removal in extreme, "moon face" round faces, we do so knowing that these patients may also have accentuated bony faces later in life. In milder cases of accenuated facial fat pad presence the likelihood of a long-term substandard result is so great that we generally avoid doing this operation in most patients.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 97 reviews

Buccal Fat Removal

Buccal fat removal, in the right candidate, can really slim down the face.  It needs to be performed judiciously though to avoid taking out too much and giving a gaunt appearance, which is usually not flattering.  Please consult with a board certified specialist in the face who can assist you with achieving the results you seek.  3-dimensional computer imaging can also help you visualize what you may look like afterwards and serve as a useful communication tool with your surgeon. 

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Buccal fat pad removal

Some people are candidates for this procedure.  It should be done only in carefully selected patients to avoid creasting facial deformities.  Perhaps, what you are really hearing is that you are not a candidate, and perhaps you should hear that.

Problems with buccal fat removal

There are 2 problems with buccal fat removal and they are that the short term results are not very dramatic and the long term loss of facial fat and volume can leave you gaunt looking if you had buccal fat removal when you were younger.

Must be conservative with buccal fat pad removal

Doctors aren't against buccal fat pad removal but the resection must leave some fat behind so that the cheeks don't look gaunt as the person ages.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 43 reviews

Buccal Fat Pad

Buccal fat pad, like any other surgical procedure, must be the right procedure for you.  The challenge is determining if you are going to be a good candidate.

  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

The technical challenges of buccal fat pad removal are to be non disruptive to the surrounding structures.  I prefer to remove the buccal fat pad in the office under local anesthesia with a minimal intraoral incision for the following reasons:

  1. Patients can see the buccal fat removed-  
  2. Quicker recovery than general anesthesia
  3. Able to tolerate foods earlier with less intraoral swelling

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.7 out of 5 stars 138 reviews

Buccal Fat Pad Removal a good choice for many

Hello Sharpie,


Buccal fat pad removal is not a bad choice for the right candidate. When approached conservatively by a surgeon of ample experience, commendable results will be attained.


Because of the natural atrophy of the buccal fat pads due to aging, this procedure is of a delicate nature but could provide the ideal midface contour.


I encourage you to seek a consultation with an extensively experienced surgeon who will guide you to make an informed decision. Unfortunately, without a photograph it is hard to give specifics about your case.


Thank you for the inquiry.

Best of Wishes.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 186 reviews

Buccal Fat Pad Removal: 40 % Approval rating

Buccal fat pad removal leads to a skeletonized appearance of the face over the long term,  counter to the fuller, more volumetric faces that most people consider aesthetically pleasing.  Buccal fat pad removal has become a seldom used technique for good reason.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 79 reviews

Buccal fat extraction

This is not  a well know procedure and not all sugeons offer this treatment.  The procedure is generally performed by facial plastic surgoens, oral surgeons and plastic surgeons. The results of the procedure are not completely predictable. It must be performed on suitable candidates or it can produce irreversable hollowing of the cheeks.  When this procedure is carried out on the right patient it can produce signficant improvement in facial contour.  One must be evaluated to assess if they are a suitable candidate.  Other procedures that can enhance facial contour include chin implantation, botox to masseter muscle, and jaw angle surgery.

Philip Solomon, MD, FRCS
Toronto Facial Plastic Surgeon
4.3 out of 5 stars 74 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.