Am I a good candidate for buccal fat removal?

Question

I have a lot of roundness on my lower face, particularly when smiling. I’m wondering if this is caused by buccal fat or if it would help to remove it?

John Mesa, MD · Answer

Buccal fat removal is the plastic surgery procedure that removes the fulness of the lower ANTERIOR cheek, or the fullness of the cheeks close to the corner of the mouth.
Patients seeing to decrease the fulness of the lower POSTERIOR cheek, or area of the cheek where the angle of the jaw  is located ( as marked in the posted picture), they are not candidates for buccal at removal by rather Botox treatment of the masseter muscle. Botox in the masseter makes the muscle to shrink ( decrease in volume) this making the lower face less wide and the posterior lower cheeks more slimmer.

Omar Lazos, MD · Answer

You are an eligible candidate for buccal fat pad removal. Buccal fat pad removal is a minimal invasive procedure that usually takes place in a doctor’s office (doesn´t take longer than 20 minutes). Removing this fat pad strategically gives a sharper, chiseled and more symmetric appearance. Good candidates are patients that despite losing weight or are in their normal weigh, the volume in their cheeks area is still prominent. Combining this with chin lipo has a very powerful result. This will improve your jawline making it look more chiseled. The procedure is highly bearable with local anesthesia which is injected inside the mouth at the level of the second upper molar. At this site a small puncture incision is made and it’s carefully dissected so that no neighboring structures (nerves or vessels) are damaged until the pad is found. Once the pad is found it is pulled to the oral cavity to remove it under direct vision, thus not harming any other structures. The incision heals by itself and closes by the 4-5 day, and no sutures are needed. Factors that influence results are: amount of buccal fat pad removed (average amount is 3 cc, the size of a chestnut), healing process, wound retraction, overall tissue (amount of facial muscle and skin). The results start to show after the swelling begins to fade away, usually at 1-month post op and the end results at 3 months postop. Search for a certified plastic surgeon to do this procedure that may seem not difficult but carries risks for complications. The most common complication although rare is hematoma that is related to efforts in the immediate 3 days postop. Hematoma is a self-limiting complication that besides the size of the swelling it always resolves (takes 1 week to get better). Other complications are: infection, facial nerve damage and salivary gland duct or Stenon duct.

Raffy Karamanoukian, MD, FACS · Answer

Treatment of ‘chubby cheeks’ cannot be achieved alone with buccal fat pad removal; a fact that I encounter time and time again when seeing patients in consultation for lower facial sculpting. My approach is to use a combined protocol that redefines aesthetic contours of the face. This includes the following: 
  
 
  
Buccal Fat Pad Removal 
  Non-surgical Muscle-Fascia Tightening
  Venus Legacy or Venus Viva
  Ultherapy
  Submental Liposuction or Coolsculpting
   
  
The combined approach is ideal. Buccal fat pad removal is a exceptional procedure that can remove excess fat from the cheek pads. Using an intraoral approach, a small incision is carried through the mucosa to remove a small fat pad within the cheek. Closure of the incisions is minimal with an absorbable suture and patients will experience some swelling post-operatively. We use SwellX tablets post treatment. Once healed, the contour of the cheek is improved and we begin Non-invasive tissue tightening to further enhance results. 
  
 
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Jonathan Kulbersh, MD · Answer

Buccal fat excision is an appropriate surgical procedure for patients that of overly full and wide cheek areas. In common terms, it is good for patients who have chipmunk cheeks. In reviewing your pictures, it is difficult to tell if you're a good candidate because your cheek area is slightly full but not overly full. You are a patient that would need an in person consultation for a complete evaluation and explanation of the positives and negatives of this procedure in your situation. I hope this helps.

Aditya Sood, MD, MBA, FACS · Answer

Thank you for your question! Based on the pictures you provided I think you would be an excellent candidate for buccal fat pad removal. It will help the areas you mentioned (the roundness of your lower face, just below the cheeks). Smiling causes it to become more pronounced due to the effect of your muscles on the fat pad. Looks like you have done your research and I wish you the best of luck!

Aydin Gozu, MD · Answer

Hi there,
Thank you for submitting your photographs.
Based on your photos, you may be a suitable candidate for a buccal fat removal procedure and having improvements regarding your issue. I would highly recommend you consult with a Board-certified plastic surgeon for best result.
Best Regards, 
Prof. Dr. Aydin Gozu

Lawrence Scott Ennis, MD, FACS · Answer

The buccal fat pads are an often-overlooked portion of the facial aging process.  The buccal fat pads naturally sit in the upper portion of the cheek and are designed to help us suckle as an infant.  As we get older, the buccal fat pad descends into the jowl, giving the face a tired look.  I often see patients from outside facilities who have had a facelift and they present stating “their jowls are back.”  Typically, in these patients, the jawline still looks nice, but they have the “chipmunk cheeks” or what appears to be a “walnut” in their jaw, which is this buccal fat pad. 
Removal in a young person can be done in the right person but in the wrong person can cause early hollowing of the cheeks.

This can be identified by pushing up on this small area just above the jawline and then releasing.  The skin will fall rapidly back into place, but you will typically see the fat pad descend back into the jowl slowly over 2- or 3-seconds as it refills this area.  This is indicative of a sliding buccal fat pad.
These are removed through a small incision inside the mouth.  Recovery is typically quick with minimal bruising.
Dr L Scott Ennis, Md FACS
Palm Beach, Boca Raton, Miami, Fl

Am I a good candidate for buccal fat removal?

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