Are plastic surgeons allowed to remove buccal fat during facelift surgery if that is not agreed separately?

My jaw looks very skinny and seems like my face has lost a lot of fat during facelift surgery. I wonder what happened since the doctor does not tell me. I did not want any fat to be taken out of my face because my face was very skinny to begin with.

Doctor Answers 7

Facelift & Bucal Fat Removal

Bucal fat removal is not standard part of a facelift and I can't imagine your surgeon performing the procedure without your prior consent. So, speak with your surgeon about what exactly was done. You can always order a copy of your operative report as well. Hope this helps.


Kouros Azar

Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Is buccal fat removal a standard part of facelift surgery?

To answer your question....buccal fat removal is not a standard part of facelift surgery and you should sign consent for this procedure in addition to your facelift consent. That is as much as I can say however, not knowing exactly what happened in your particular case. 

David Cangello, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Buccal fat pad resection isn't normally a part of a facelift

Sorry to hear of your concerns.  The buccal fat pad is one of the fat compartments of the face which notoriously disappears with age.  #Resection of the buccal fat pad used to be commonly done in the 80's and 90's when the female aesthetic ideal was "cocaine chic", however today's facial rejuvenation patients are more interested in a better supported, fuller face (as evidenced by the popularity of fillers).  The surgical approach to buccal fat resection is usually through a small incision in the upper jaw gum  line, so if you don't have sutures there, it's unlikely your PS removed it.  Verify with him/her, ask for a copy of the op report and communicate your concerns.  For most of my thin facelift patients, I discuss fat grafting options preop because it's relatively simple to transfer some fat from the abdomen or hip.  Most thin patients "love" the appearance of their face, 3-6 weeks postop, when there is still a lot of swelling.  If your face was thin from day 1, it may be related to the technique employed.  

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 56 reviews

Face lift - was buccal fat removed without my permission

Thank you for asking about your face lift.

  • Your face may look thinner because the face lift has tightened the loose tissues.
  • However, to know exactly what was done, ask for a copy of your surgeon's operative note for your records.
  • It would be quite unusual - and not acceptable - for a surgeon to do buccal fat resection without your prior approval.

Always see a Board Certified Plastic Surgeon. Best wishes, Elizabeth Morgan MD PHD

Facelift #faceliftrecovery #fatgrafting #beauty #tmbcosmeticsurgery #woundhealing

Dear Joshhhi

Thank you for your question!  A thinner appearing face can be the result of the deep layer reshaping - THE SMAS- which can appear like the  buccal fat has been removed.  Please speak with your surgeon about your results.

With Warm Regards

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 103 reviews

Facelift - What To Do To Give Volume To A Thin Face

When you say, "The doctor does not tell me," have you asked your surgeon? It is so very important for surgeons to have clear conversations with their patients before, and as importantly, after surgery. There are many questions posted on RealSelf that should be directed to one's plastic surgeon, and as a board certified plastic surgeon who understands that listening, and talking, to a patient is extremely important, it troubles me that so many patients post questions that their plastic surgeons should be helping them with! I suggest you make a follow-up appointment with your surgeon to discuss your expectations -- what was done during surgery, and how you now look. If your surgeon does not make time for you, I would seek another opinion, because it is our duty (and should be our pleasure) to help our patients through the postoperative period.

Are plastic surgeons allowed to remove buccal fat during facelift surgery if that is not agreed separately?

You certainly ask an interesting question.  Discussing goals and priorities is an important part of preparing the patient for surgery.  Not infrequently the buccal fat pad is seen to be protruding in the cheek during the facelift and part or all of it can be or at times should be removed.  This is to avoid a prominence in the cheek that could make you unhappy and probably amounts to a judgment call.  On the other hand, if you feel that your face was too slim to begin with, I think the doctor needs to explain to you why he made the decision. Not to say it was a wrong decision but you need to discuss the details with your surgeon.  Good luck,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 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.