Possible to Reverse Buccal Fat Removal?

Question

I had buccal fat removal and botox jawline reduction a month ago. Now my lower cheek looks really gaunt and my upper cheek looks really out of proportionly full. I wonder if there are any ways to reduce some fat from my upper cheek without surgery to even out the difference and also to add more fat in the lower cheek to balance everything. Thanks.

Richard H. Tholen, MD, FACS · Answer

Reducing facial volume is generally a bad thing, since this happens naturally as we age. The loss of facial volume is further worsened by the loss of collagen and elastic fibers in our skin, causing sagging, jowl formation, looseness in the neck area, and deepening of the nasolabial and subcommissural folds (marionette lines). You didn't state your age, but removing fat from your upper cheek only gives you more of the same problem you already have! (And, how do you do that without surgery, by the way?) Dr. Aldea is right, if you don't like how things look now, right after your ill-advised procedure, you will REALLY not like how things look as years go by and volume decreases more and skin sags more.

	You may need judicious and expert fat grafting to restore volume, and may also need facelift to tighten and lift the facial tissues to a more youthful position. Seek an experienced, board-certified plastic surgeon for more information; more than one consultation may be helpful in clarifying advice.

Caner Kacmaz, MD · Answer

The simple answer is no. Unlike other cosmetic procedures, buccal fat removal is permanent. Once the fat has been removed, it cannot be restored.

John Mesa, MD · Answer

Patients who underwent buccal fat removal and are displeased with the results, may benefit from other plastic surgery procedures. However without pictures of the face in question, it is impossible to asses the problem and recommend solutions. Consider updating your question by adding pictures of the face in several angles.

Benjamin Caughlin, MD, FACS · Answer

You have many options. It is all about fat (or volume) in the right places. In addition to facial cosmetic surgery I do feminization procedures in the transgender population and it applies to all sexes and orientations really. The key is Hot is HOT! One good option In your case is likely fat transfer to taper back in that lower 1/3rd of the face. The upper third volume is mostly muscle (temporalis) and bone (maxillary and zygomatic). So those are structures we need and cannot really be removed cosmetically. 
Hope this helps.
Best of luck.
DrC

Anil R. Shah, MD · Answer

Buccal fat can not be reversed but it can be improved.  Methods to improve the appearance of the overly gaunt face include:-Fat transfer to the area deficient-Facial fillers including Sculptra and HA fillersMost patients early on can not determine their real results so patience is always recommended.

John Diaz, MD · Answer

Altering the fatty compartments of the face can be done subcutaneously (below the skin) or submuscularly (below the muscles of the face).  The removal of the buccal fat pad consisted of removing the submuscular fat, with the goal of diminishing the volume in the midface (cheek) and highlighting the zygoma (cheek bones).  Non-surgical options do exist to add volume or augment the area, which is now “gaunt.”  These include fillers and fat grafting.A Board Certified plastic surgeon can evaluate you and determine the degree of deficiency in your lower cheek area.  Fillers can be used to temporarily improve the gaunt look. Fat is a more permanent option, but does require the use of incisions to harvest fat from another area of the body. Trying to reduce the fullness of the “upper cheek “ requires a different approach. Any attempt to reduce the fullness of the upper cheek is difficult. It may best to fill in the lower cheek and then re-evaluate your appearance. It is possible that simply restoring fullness to the lower cheek may correct your problem.

Sheila S. Nazarian, MD · Answer

I find that many patients fall into this trap of surgery after surgery after surgery... And eventually look far worse than what they initially looked like. I would recommend using temporary #Fillers with a surgeon to see if you like what the correction looks like before you commit to fat grafting.

Ali Sajjadian, MD, FACS · Answer

Hi 2574anon,

	 

	Thank you for sharing your concern.

	 

	In general, revisions tend to be complex and delicate.

	The quick answer to your question would be a "yes"; buccal fat pad removal can be reversed and good results will be obtained ONLY if done by an extensively experienced surgeon.

	 

	Time should be given for the healing process to take place. Only then, an examination will enable the surgeon to determine the best procedure that will fit the patient.

	 

	Usually, the long lasting approach is the one based on injecting autologous fat (harvested from the patient) into the depressed areas sculpting the buccal region and restoring the patient's natural features.


	Best of Luck.

	Dr. Sajjadian

Luis A. Vinas, MD · Answer

Reduction of facial fat is not recommended in most cases. If you were a good candidate for buccal fat removal and you do not like the results, it can be corrected with autologous fat injections.It is like sculpting your face by adding, not removing. When done properly, the results will be nice.

Toby Mayer, MD · Answer

Having performed facial plastic surgery for 35 years I have had the opportunity to follow my patients for that period of time. I do not like buccal fat removal for the reasons you stated. You need that fat when you are older.
Fat can be suctioned from another part of your body and injected into your face or done with fillers. Make sure you see an experienced surgeon to do this.

Possible to Reverse Buccal Fat Removal?

Answers (18)