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,

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