Uneven cheeks after buccal fat removal: why did this happen? (Photo)

Question

I am 23 year old, always on the slimmer side. Last year I decided to get a buccal fat removal but I'm not happy with the results because my cheeks got asymmetrical. The right side looks fuller and feels thicker compared to the left side.I would like to know what caused this result and what are the possible solutions. (The surgeon told me that the affected side was more difficult to remove the bichat, so was a bit more aggressive. Also the extracted pieces had the same size)

John Mesa, MD · Answer

Buccal fat removal is a plastic surgery procedure that is not that easy as it seems. Buccal fat removal could be a very difficult procedure because some times it is nearly impossible to find the bucal fat pads (usually one side more than the other).
It is common that when patients develop asymmetric face after buccal fat removal, that is secondary to asymmetric buccal fat removal (eg. small amount of buccal fat pads or bight fat was removed from the difficult side comported with the other side the "easy side). 
In certain cases, facial asymmetry secondary from buccal fat removal could be resolved with asymmetric buccal fat removal (it means additional buccal fat is removed from the fullers side). This ideally should be done after the healing process from the initial procedure has happen ( aka 3 months post surgery)..See below the link of a patient with similar problem that was resolved with asymmetric buccal fat removal It is important to know that since a lot of post surgical scaring might be present in the fuller side, no surgeon can guarantee that all the buccal fat pad could be removed from that affected side.

Miguel Mascaro, MD · Answer

Thank you for your pictures, and I'm sorry to hear about your experience.  Often, when you need to be more aggressive on one side vs the other (for whatever reason), the muscle tends to swell and may develop an intramuscular scar.  Probably explains why it feels a little thicker on that side as well.  Since its been a year, I suggest going and discussing your case with the doc who performed this.  He has your before pictures and knows exactly what happened as they were trying to reach buccal space.  If it is scar tissue within the muscle, often massage and a cortisone shot may help but we would have to do a full exam to get a good idea.  I hope some of this helps. Best of luck.

Uneven cheeks after buccal fat removal: why did this happen? (Photo)

Answers (2)

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