Revision Buccal Pad Removal, Is This A Normal Procedure?

About 2.5 months ago I had zygoma and jaw reduction in Korea. Part of the surgery was buccal fat removal. I asked the doctor to do it conservatively. Now my cheeks look puffy and I keep biting inside my cheek.Can the doctor control how much fat is removed? Are revisions normal?.I have a big event in a month, and a local doctor (to which I did not tell the Korea story) just looking at me the first thing he suggested is the buccal fat removal. I have scheduled the procedure 2 weeks b4 my event.

Doctor Answers 4

Tell your surgeon the full history

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Your surgeon needs to know that prior buccal fat was performed only 2.5mo prior. Buccal fat reoperation can be a hazardous task with your facial nerves at risk. 

At 2.5mo after cheek and jawline surgery, your face is still puffy. It takes closer to 9mo for the swelling to go out. You may have some buccal fat prolapse due to the jawline surgery which needs to be addressed, but withholding information from your surgeon is ultimately  putting yourself at risk for a disaster.

Beverly Hills Plastic Surgeon
4.5 out of 5 stars 79 reviews

Buccal Fat Removal

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Sorry to hear about your experience, but unfortunately you are not alone.  The first thing is to make sure you find a board certified specialist in the face who can help you.  After you have identified this person, it is important to give him/her full disclosure as to what surgery you have already had done.  In buccal fat removal, the amount of fat can removed can be somewhat controlled by the surgeon to ensure equal amounts are being removed.  I too am concerned that you are planning to do this only 2 weeks prior to an important event.  I would recommend that you perform this well in advance of your event to allow the maximum time for recovery.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Buccal Fat Removal: Reliability and Recovery

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When Buccal Fat Removal is performed by an experienced surgeon, the amount of excised fat can be satisfactorily controlled. This means that equal amounts of fat can be removed from each cheek, and the surgeon can limit the quantity of fat to an amount he believes suitable for the patient's wishes.

I'm concerned, however, about your expectations. You stated:

"I have a big event in a month, and a local doctor (to which I did not tell the Korea story) just looking at me the first thing he suggested is the buccal fat removal. I have scheduled the procedure 2 weeks b4 my event"

The amount of recovery time you're anticipating prior to your "event" is very short, in my opinion. At best, your cheeks will be sufficiently healed that you'll not have any discomfort or obvious signs of surgery. At worst, you may have both discomfort as well as excess swelling, discoloration and imbalanced appearance (if healing is unusually delayed since this is your second procedure).

More importantly, you should really inform your doctor of your prior surgery. This is important information, because your current puffiness may have little to do with excess buccal fat. At just 2 1/2 months after your jaw surgery, your puffy cheeks may very well be nothing more than swelling from your first procedure.

I would be much more comfortable if you had not only fully informed your new doctor but if you had also allowed 6 or more weeks for secondary surgical recovery. Proceeding, as scheduled, with your present plan may be a bad idea!

Charles Gruenwald, MD (retired)
Baton Rouge Plastic Surgeon

Recovery of Buccal Fat Pad Removal

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Hello 6729,


Thank you for sharing your story and we sympathize with you. Unfortunately, some complications and disappointments could happen after delicate surgeries as yours.


In general, 2.5 months is a relatively short period to establish an acceptable recovery before you can consider having a revision procedure. Without pictures and physical examination it is hard to assess how far of a recovery you have achieved.


I encourage you to share your experience with your surgeon in full because the last thing you want to do is to mask important facts from your surgeon.


Also, it is highly recommended that the patient invests enough time to become ready and then to recover from the surgery. Rushing the steps will jeopardize the commendable outcome of any surgery regardless of its magnitude.


Best of Luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 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.