Jowl Liposuction or Buccal Fat Removal to Reduce Cheek Fat?

Hi Doctors,

As I grew older and put on some weight, I noticed that my cheeks began to get bigger. I am considering some surgery but not sure if it buccal fat removal or jowl lipo.

I want a more tapered look and avoid looking like I have cotton in my mouth. Thanks.

Doctor Answers 19

Liposuction is probably a better answer.

Dear Chipmunk

Buccal fat remove can be helpful to some individuals. However the trend has been to preserve fat and the deep fat of the face may be very important to the long term volume of the face. On the other hand facial Liposuction can be done judiciously to sculpt the jaw line as well as reduce the lower cheek volume.

Bottom line: There is no substitute for a personal assessement with a straight forward cosmetic surgeon. Be careful what you look for because someone may offer it to you.

Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Is it Jowl Liposuction or Buccal Fat Pad Removal?

Hi Chipmunck cheeks,


Thank you for sharing your concern along with a photograph.


Jowl liposuction and Buccal fat pad removal are procedures of a delicate nature. So, it is highly recommended that you seek a consultation with an extensively experienced surgeon who can offer the best for you.


According to the photograph you have generously shared, it looks like you could use buccal fat pad removal to establish the Ogee curve through a conservative fat excision (removal).

Best Wishes.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 187 reviews

Buccal fat pad reduction for full lower cheeks

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.  You may be a candidate.  Please talk to an board certified surgeon experienced in buccal fat reduction to see if you are a candidate.

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 71 reviews

Buccal Fat Pad Removal Indicated Occasionally

The buccal fat pad can be removed to help define the cheekbones and decrease lower cheek volume in occasional patients.  I often like to see photographs of patients at their optimal weights to evaluate the actual shape of their lower faces.  In patients that have disproportionately full cheeks in younger photos are when thin, the removal of the buccal fat pad is a nice procedure to deliver more definition.  One has to be careful though, that facial fat is "expensive real estate" and very valuable as one ages.  A gaunt face ages a patient, and I have actually transferred fat in patients that have undergone inappropriate removal of the buccal fat pads.  Facial liposuction when done, should be sparingly performed with a very small cannula to avoid irregularities.

Buccal fat removal vs. cheek fat removal

The question would be which area of fat is contributing to the look you do not like-the buccal fat or the cheek fat. Your surgeon should be able to get an idea about that at the time of examination. Whichever procedure you have or if you have both the most important thing is to be conservative and not overly aggressive. As we get older we lose facial fat so if too much fat is removed now when you get older you will look a lot older and regret the earlier surgery.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Buccal fat pad or Jowl subcutaneous fat

From the picture it looks like buccal fat pad. This is a deeper fat that herniates to the jowl area. There is a simple test that you can do. Stand in front of a mirror. Using three fingers push the area of bulging in. Then let the pressure off. If it is buccal fat pad it will descend and recreate the bulging. if it is subcutaneous fat it will never disappear. One can't suction the buccal fat pad. It needs to be removed from inside your mouth. If it is the jowl fat it can be suctioned with a fine cannula and carefully. It may be hard for you to do the test yourself you may need an experienced plastic surgeon. Remember you are buying expertise, not an instrument.

Buccal fat pad removal

If you are a tooth grinder, I would recommend botox to the masseters first to see if that will slim your lower face. If you are not, then a buccal fat pad removal would help.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 44 reviews

Buccal fat pad removal or jowl liposuction

Buccal fat pad removal is the treatment of choice for those with fat pads that herniate outward and downward lateral to the oral commissures. Few people really need this.

Jowl liposuction is not a good procedure since it creates irregular results. When the jowls become herniated down over the jowl line, a face/neck lift is the best option for that.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Augment the cheeks to balance the face

Liposuction of the face or buccal fat pad excision needs to be performed with caution.  In your case it appears that your buccal fat pads are protruding but you may first consider evaluating your cheeks for augmentation.

Amir Moradi, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Treatment of cheek fat has several variables.

It does not look like you need any lifting procedures. Most patients like you see a surgeon who tells them what they want to hear. Buccal fat pad removal will not give you what you want. Also, liposuction(of whatever type) may give you irregularity and depressions. See an experienced facial surgeon who will give you an honest answer after examining your face.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 32 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.