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Three things to know about Buccal Fat removal

When we talk about facial structure, many would love to have a sculpted model look. A simple way to achieve this look is with makeup. But for people with a rounded face, makeup can only do so much. Buccal fat – that fat in your cheeks- may be more prominent and contribute to your overly round look. Reducing this fat pad will help narrow your cheeks and help accentuate your cheek bones. Christy Teigen, a famous model, is known to have gotten this surgery, is able to achieve a significant result. But you have to know that too much fat removal may create excessive gaunt look, almost like a skeleton. Furthermore, you might not see this result immediately, but this unfortunate result may be more noticeable as you age. So a potential unintended effect may be nice super sculpted look initially, but over time, one might look too gaunt. And to fix this won’t be easy. I tell my patients that the goal is to give a slight , almost subtle narrowing. Though you might not get the very noticeable high cheek bones look, the narrowing of the cheeks is enough that you will get a nice result with makeup. Men can get away with more aggressive removal of buccal fat, but we need to be conservative with women.

A second thing about buccal fat pad is it can improve a facelift’s results. More patients request facelifts in my practice than patients seeking just buccal fat. In patients who present with sagging face, jowls and loose neck skin, a lower facelift is the best option to rejuvenate their face and neck. Just doing a facelift will help tremendously. But some patients may also have cheek fullness. Buccal fat pad removal can enhance a facelift’s results. This procedure can be done at the same time as the facelift. Usually, those seeking just buccal fat pad removal are young patients.

The third thing to know is buccal fat pad removal is a fairly simple procedure to perform. It can easily be done in an office setting. One can either do this under no sedation, some sedation, or even under conscious sedation where essentially one is under general anesthesia. In majority of cases, this procedure is done through an intra oral approach, or through your mouth. The area is numbed with anesthesia. A precise cut is made in your mouth, near the back. Careful gentle dissection then proceeds to identify the buccal fat pad. Once identified, the buccal fat is carefully teased out and amount of fat desired to be removed is determined. Then the excess fat is carefully removed. Your surgeon will then make sure there is no bleeding. Many surgeons will put a few dissolvable sutures, but these aren’t necessary. If the incision is small, one can even leave the incision alone and it will heal well. It’s important not to close the incision too tight. Otherwise, fluid may build up and cause swelling. If there is tiny bits of bleeding, an overly tight closure may predispose to a hematoma. Another uncommon complication that might develop is infection. An infection is characterized by swelling, pain, fever, and purulent drainage. If you develop these symptoms, then you must contact your surgeon immediately to fix this. Another rare complication is facial nerve injury. This is pretty uncommon since the nerve is fairly far away, but may get injured if the surgeon is too aggressive during the dissection. While the intraoral approach is the most common way to remove or reduce your buccal fat, another way is to remove the fat from a lateral or side approach. The only time this approach is done is if you’re also getting a facelift. For some patients, during a facelift, the buccal fat is easily identified and can be carefully removed from the side approach. I think this approach has a very slightly higher risk of facial nerve injury because the nerve might be directly in your approach, lying right on top of the fat pad you want reduced. If I see the buccal fat pad easily during a facelift and identify the nerve well, then I will reduce the fat from this lateral exposure. If there’s any doubt in my mind, then I will complete the facelift, then go through the mouth to reduce the fat. Finally, another potential adverse side effect is removing too much buccal fat. This might result in an unattractive excessive gaunt look in the future.

If you are contemplating getting buccal fat pad removal, make sure you see a board- certified facial plastic surgeon or plastic surgeon. Ask questions and select the surgeon you trust most. When looking at pre and postoperative photos- especially on the internet- keep in mind to look at if the before and after photos are consistent. Make sure the angles are the same. Is the patient in a neutral pose (ie, no smiling) in both photos. Is the lighting consistent? Ask where the surgery will be performed and what sedation options are offered. If you just want the buccal fat removal under local anesthesia, then it should be safe to do the surgery in the surgeon’s office (assuming he or she is board certified). If you want any level of sedation, then I believe it’s very important that the procedure is done in an accredited facility. Even though the surgery is simple and safe, once you introduce sedation, you expose yourself to some degree of cardiac and airway complications. An accredited facility doesn’t guarantee no complications, but it does mean your risks are as low as possible and you can expect a safe surgery.

For more information about San Antonio buccal fat pad removal, please visit our interactive website at Dr. Kenneth Yu Facial Plastic and Reconstructive Surgery is a qualified team of experts serving the San Antonio, Texas area. To schedule a consultation, please contact our Concierge Patient Coordinator at (210) 876-6868 or