Buccal Lipectomy (Cheek Reduction)
Are You Bothered by a Full Face?
Removal of the Buccal Fat Under Local Anesthesia
At Ideal Face and Body, there is no need to be put asleep or have a breathing tube for this procedure. This local anesthesia approach is especially true for cheek reduction or buccal fat removal. Once the cheeks are numb, small openings are created inside the mouth, one on each side. Careful dissection under direct visualization is performed and the perfect amount of buccal fat is removed from the cheek. To avoid over resection, only the offending cheek fat is removed by expressing it from the intraoral incision. Roughly two to three millimeters of fat are removed from each cheek. This fat volume is equivalent to removing two to three syringes of filler from each cheek. We like to say, “bye-bye buccal.” The procedure is completed by closing the incisions with absorbable sutures that will dissolve or fall out on their own.
To further slim the face, it is not unusual to combine buccal fat removal with other procedures such as PRECISION SCULPT® chin, neck, and jawline, and neurotoxin to the masseter muscles.
Recovery After Buccal Fat Removal
At the completion of the procedure, a custom facial garment is applied followed by ice packs to decrease swelling. To further decrease swelling, we recommend sleeping on the back with the head elevated on two pillows. The patient is allowed to shower the day after the procedure. The garment is worn most of the time while at home and at night for one week. The cheek swelling is similar to that of dental work such as wisdom tooth removal. Occasionally one cheek is more swollen than the other. Swelling typically peaks in two to three days and then gradually decreases. To decrease irritation and increase comfort, we recommend maintaining a diet of soft foods and non-acidic cold drinks for two to three days after the procedure. Water is always a good choice because it is hydrating, gentle, and keeps the area clean. Exercise can be resumed in one to two weeks.
Cosmetic Outcome After Buccal Fat Removal
The results of buccal fat pad removal begin to take shape after approximately two weeks of healing. Over the next couple of months, the cheeks become slimmer and more contoured as the swelling recedes and the scar tissue remodels. A smooth natural aesthetic transition, not an abrupt contour change, develops under the cheekbones and the desire for heavy facial contouring with makeup typically diminishes with time. The outcome is a beautifully refreshed upper cheek curve, not a gaunt or excessively aged appearance.
Determining If Buccal Lipectomy is the Correct Procedure for You
A patient may be a good candidate for buccal fat removal if they describe their face as chubby, full, round, plump, chipmunk, balloon-like, or oversized. Others may feel like they lack cheek hollows or contour. When the buccal fat pad is contributing to excessive facial fullness, there will be an outpouching or convexity of the cheeks in the area just below the cheekbones. Gently sucking in the cheeks can simulate the potential outcome of buccal fat removal. If this simulation is attractive then buccal fat removal may be the procedure for you.
Anatomy of the Cheeks and Buccal Fat Pad
Buccal is defined as pertaining to, adjacent to, or in the direction of the cheek. The buccal fat pad is a normal structure found in the cheek, varies in size between individuals, and lives in the deep space of the cheek. Buccal fat pads contribute to part of the upper cheek volume. Very chubby cheeks may have an abundance of buccal fat or may have a mild to a modest amount of buccal fat. The actual amount of buccal fat present is determined during the procedure when the fat pad is directly visualized. Other components of facial fullness in this region include the teeth, jaw, mucosa, muscles, connective tissue, vessels, nerves, glands, superficial fat, and skin.
Frequently Asked Questions and Answers Regarding Buccal Fat Removal
Am I a candidate for buccal fat removal?
If you have large upper cheeks then removal of the buccal fat may be the correct procedure for you. This is determined by a facial analysis during a consultation.
Do you remove all the buccal fat?
Although the buccal fat has extensions outside of the cheek, all of the cheek buccal fat is removed during the procedure.
Where are the incisions for buccal fat?
Buccal fat removal is essentially scarless because the incisions are inside of the mouth and disappear with time.
Are there any scars on my face?
There are no scars on the skin of the face. The only incisions are inside of the mouth.
How do you know how much fat to take?
How much fat do you take?
Approximately two to three syringes of filler equivalent are removed from the cheek.
Why do some doctors not recommend buccal fat removal?
This question has more than one answer. We find that the most common reason is that most surgeons have limited or no experience with the buccal fat and therefore do not offer the procedure. Lacking the surgical skill set and experience regarding the removal of the buccal fat is usually associated with not recommending the procedure. Another factor is the somewhat dogmatic opinion that cheek fat should never be removed from the face. The one-sided opinion is propagated as all-encompassing without distinguishing between thin faces and chubby faces. The reality is that some patients are great candidates and others are not. A thin contoured cheekbone hollow should not be further emptied because this will likely result in a gaunt appearance. On the other hand, a chubby full cheek will take on a more aesthetically pleasing appearance with a fat reduction. Lastly, there is an association with facial fat loss and aging. Therefore, some practitioners think that removal of cheek fat sets the stage for a larger cheek volume deficit in the older years. With proper patient selection the likelihood of this becoming a reality is minimized.
Will the buccal fat return with weight gain?
The buccal fat is removed forever and therefore will not return with an increase in weight.
Do I need the buccal fat?
It is thought that the buccal fat may assist in the gliding action of the muscle. Decades of experience have demonstrated no decrease in muscle function or any untoward functional effects with the removal of the buccal fat. The buccal fat appears to be only a cosmetic concern.
Do I need to go to a doctor who specializes in buccal fat removal?
Although buccal fat removal is a straight forward procedure, finding the fat pad during surgery is challenging for the novice or inexperienced surgeon. To increase the chances for the best outcome, it is to the patient’s advantage to seek a consultation with a plastic surgeon who has considerable experience with the removal of the buccal fat.
Is an antiseptic mouth wash needed after the procedure?
Although anti-septic mouthwashes may be used, we find that it is not necessary and does not enhance healing or recovery.
Is buccal fat removal painful?
The cheek is completely numb when the buccal fat is removed. The recovery is described as sore.
Can I have buccal fat removal if I have braces?
Yes, a patient with braces can undergo buccal fat removal.
Can I have buccal lipectomy and liposuction of the body?
Yes, it’s common to combine face and body procedures during the same operation.
Am I too young to get buccal fat?
Patients that are 18 years or older are candidates for buccal lipectomy evaluation.
Will buccal lipectomy decrease the volume around my mouth?
Fullness around the mouth is not due to the buccal fat so removing the buccal fat will not change the area around the mouth.
Does the jawline improve with the removal of buccal fat?
The buccal fat lives in the upper cheek and does not contribute to the jawline. Removal of the buccal fat does not change the jawline. The jawline is enhanced with PRECISION SCULPT®, fillers, and/or implants.
Does the buccal lipectomy address the jowls?
The buccal fat does not contribute to the jowls. Jowl fat is a different fat compartment and is addressed by PRECISION SCULPT®, Kybella, sutures, and/or a facelift.
Can I get the buccal lipectomy twice?
The buccal fat pad is completely removed during the initial procedure so returning a second time will not result in additional fat removal. In the situation where a patient thinks that only a partial or minimal buccal fat resection has occurred by another surgeon, a revision may be undertaken but it typically proves unsuccessful due to the lack of fat and scarred tissue space.
Will my dimples go away with buccal fat removal?
Cheek dimples are related to muscles, not fat. Removal of the buccal fat does not typically interfere with cheek dimples.
