Options To Permanently Reverse Buccal Fat Removal?

Question

I had buccal fat removal and was told my face would look slimmer but now i have uneven cheeks and it looks like i have 2 dents. I am looking for a permanent way of reversing it. I feel like my cheeks look droopy. This has really depressed me I just want my face to look normal again. Unfortunately my PS never told me that uneven cheeks could be a possibility if not I wouldnt have done it since I had to save money for the surgery. Please help.

John Mesa, MD · Answer

Patients with non-satisfactory buccal fat removal results, may need additional cosmetic treatment to correct the surgery and improve the face. 
In these spacial cases it is mandatory that the patient makes an in-person consultation with a surgeon specialized on the face. A physical exam of the face will help to determine the best next steps to achieve the patients goals.

Ali Sajjadian, MD, FACS · Answer

Hi RhinoNewbie,

	 

	I am sorry that you are going through a lot. The good news is that a relatively unsuccessful buccal fat pad removal could be revised through autologous fat injections.

	 

	The key is that you seek a consultation with an extensively experienced surgeon who could provide you with the appropriate guidance and the optimal results.

	 

	In general, buccal fat pad removal is delicate yet a good procedure for qualifying candidates.

	 

	Without photographs and physical examination it is hard to provide a definitive solution for your case.

	 

	Best of luck to you.

	Dr. Sajjadian

Raj S. Ambay, MD · Answer

Buccal fat pad reduction is a procedure that is not commonly performed but can make sense in the right patient.  It is important to understand the anatomy before undergoing the surgery so that you are well informed.  Normal aging reduces the buccal fat pad volume.  It is true that some people have more volume in their cheeks than others.  However, it is also universally true that that volume will decrease and descend over time.  Removing too much buccal fat can cause premature aging.  It is also important to remember that replacing fat that has been removed is extraordinarily difficult if not impossible.  The main reason is the location of the buccal fat pad.  It usually resides underneath a large muscle that is responsible for majority of the power motions of your chewing.  Once that fat is removed that space collapses.  Once collapsed it is very difficult to find the exact space and to reinsert a substance such as a filler or better yet fat.  One potential solution is to use something like Sculptra.  While I generally do not advocate buccal fat pad removal, I understand why somewhat would want procedures such as this.  I tried to choose my patients very carefully and I also tried to be conservative in the amount of fat that is removed.  Surgeons who trivialized this procedure simply don’t understand how difficult it is to correct deformities that may occur.  The cost of the procedure can run anywhere from $3000-$7000, depending upon your geographic locale.  Please visit with an experienced board certified plastic surgeon.  My best advice is to always be conservative with any buccal fat pad reduction.

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