How Can I Restore my Cheeks 10 Years After Buccal Fat Removal? (photo)

I had *bolsas de bichat* removed (I think that's Spanish for buccal fat pads) a decade ago. Now I look completely different. My face is flat and not as attractive. What can I do to look like before? What's the best option: implants, fillers, or any other ideas? If using Radiesse, how much would be necessary to look like before?

Doctor Answers 6

Restoring cheeks after fat removal.

Restoring cheeks after fat removal is a common question unfortunately. Your story is why I tell patients not to do this since they need the fat as they grow older to fill out the face. I would need to examine your face to tell if fillers would help and how much it would take to correct the problem. Fat grafting can be used but has its own problems in the face such as irregularities and lumps.

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews


To replace lost volume in your cheeks, I would recommend the use of a dermal filler.  For generalized volume, Sculptra is a great product.  If you have specific areas that need pin point treatment, then a product such as Juvederm will work well.


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Fillers of Volume Enhancers can Augment Cheeks

Removal of the buccal fat pads can cause some hollowing in the cheeks, which can be an issue for some patients.  I like to treat this area with fillers or volume enhancers. 

Fillers (Restylane, Juvederm, Perlane, Radiesse) show immediate results and last from 6 to 12 months depending on the filler.  Radiesse lasts the longest for most people with results fading at about a year.  The down side is that Radiesse is not easily reversible.  Most patients need one or two syringes to fill the cheeks.  Since the improvement is immediate we will often inject one syringe, give our patients a mirror, and make a determination if a second syringe is needed. 

Volume enhancement is performed with fat transfer or Sculptra.  We routinely use Sculptra.  Although it does not provide the instant gratification of immediate results, it does have better longevity, lasting a couple of years for most patients.

Hope that helps.

Jonathan Sonne, MD
Naples Facial Plastic Surgeon
4.0 out of 5 stars 4 reviews

Restoring Cheek Volume Following Buccal Fat Removal is Best Accomplishec with Dermal Fillers

Over zealous removal of the buccal fat pads may lead to the hollow cheeks or a gaunt look. I prefer the use of Sculptra for adding volume to this area. Dermal fillers, such as Juvederm Volume, Radiesse, and Perlane are also appropriate. I would recommend consulting with a Board Certified Plastic Surgeon.

Best of Luck.

Andrew T. Lyos, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 58 reviews

Restoring volume to cheeks

The options for filling the cheeks out include placing cheek implants into the malar or submalar space to give more volumetric augmentation to the cheeks.  This is a permanent solution.  Fillers are usually a temporary solution and will require repetitive injections.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Restoring Facial Fat Loss

Without an exam it is impossible to advise exactly. However, fat or filler injection can usually help significantly. Both would usually require several injections to get the contour just right. This is especially true of fat if you want it to be permanent. If not fat, I generally use Radiesse since it has a good longevity.


Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 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.