• Buccal fat removal is a procedure that involves removing certain fat pads in your cheeks.
  • This can make your face look narrower and your cheeks look less full.
  • But the look can also age you and give the appearance of cheeks that are too sunken in.

If you have very full cheeks and want to change your look, you might want to try a procedure called buccal fat removal. Buccal fat removal takes out small pads of fat from the lower part of your cheeks, making your face appear slimmer. 

But although this procedure has become popular in recent years, it's not a good option for everyone — removing too much fat can make your face look gaunt or make you look older.

Here's what you need to know about how buccal fat removal works and what the risks are.

What is buccal fat removal?

Your cheeks have several fat pads inside them, each creating volume in a different area of your face.

Your buccal fat pads sit in the lower cheek area, and "in some cases these grape-sized pads of fat can be oversized, resulting in a fuller looking face," says Dr. David Shafer, a double board-certified plastic surgeon at Shafer Clinic Fifth Avenue.

"When removing these pads of fat, you are creating a shadow underneath where they were, defining the cheek and jaw bones," Shafer says.

But buccal fat removal isn't a good option for everyone who wants to change their face shape, especially because the procedure is permanent. 

Why buccal fat removal isn't for everyone

"In approximately half of the patients I see for consultation for buccal fat removal, I strongly discourage them to undergo the procedure," says Dr. Edwin Kwon, a board certified plastic surgeon in private practice.

In some cases, removing your buccal fat can make your cheeks look too caved in or unnatural. You may want to avoid buccal fat removal for a few key reasons:

  • "If you are extremely thin, or already have pronounced cheekbones, I would recommend staying away from this procedure," Shafer says. The procedure may make you look even thinner, so your face might look skeletal.
  • If your weight fluctuates a lot, or you plan to lose a lot of weight, it's best to wait until your weight is stable, so you can see exactly how your face will look.
  • "I discourage older patients from undergoing buccal fat removal as this can have the effect of making them suddenly appear older," Kwon says. This is because you lose cheek volume as you grow older — so hollow cheeks can age your face.

 Instead, you may want to try other, more temporary options like cheek or jawline filler.

How the procedure works

"Buccal fat removal is a relatively quick and easy procedure with little to no downtime," Shafer says.

You can do the procedure in your doctor's office and you'll generally be awake, though you can take an oral medication like valium or an IV sedative to reduce nerves.

According to Kwon, the buccal fat removal procedure usually follows these steps:

1. You receive local anesthesia to numb the skin on your face.

2. The doctor makes a small incision in each of your cheeks, from the inside of your mouth. 

3. The doctor pushes on your cheek to expose the buccal fat pocket, and the buccal fat pads are carefully cut out and removed. 

4. The incisions are closed with sutures that dissolve on their own within a week. 

5. Afterward, "I recommend patients to be on a liquid diet for two days followed by a normal diet," Kwon says.

The procedure is relatively quick — it takes anywhere from 20 to 30 minutes on average.

Depending on where you get the procedure, you can expect to pay between $2,000 and $5,000 for buccal fat removal. 

The risks of buccal fat removal

Buccal fat removal is relatively low-risk, but any surgical procedure carries some risk of complications. These can include:

  • You will likely have bruising and swelling for a few days after the surgery.
  • The incision site may become infected.
  • In rare cases, your facial nerves can be damaged, resulting in pain or numbness. "There are nerves and blood vessels that are in the vicinity of the buccal fat pockets, but can all safely be avoided," Kwon says.
  • If you have an inexperienced surgeon, your results can look asymmetrical.

One perk of buccal fat removal is that you won't have any visible scars, because the incisions are made inside of your mouth, Shafer says.  

Insider's takeaway

If you're unhappy with the fullness of your cheeks, you might want to consider buccal fat removal. It's a low risk procedure, but it's permanent, so think carefully and discuss with your doctor before making any decisions.

For the best experience, follow these guidelines:

  • Make sure you go to a board certified plastic surgeon and a reputable clinic.
  • "Plan a consultation with your doctor and ask for before and after photos of previous patients or talk with a previous or current patient," Shafer says.
  • "I encourage patients to have a discussion with their plastic surgeon and ask for an honest opinion on whether this procedure will help them achieve their goals for their face," Kwon says.
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