Definition & Overview

A buccal fat removal is a plastic surgery procedure that removes excess fatty tissue in the cheeks to achieve a more proportional facial appearance and defined cheek contour. It is performed on an outpatient basis, can be completed in an hour, and can be combined with other facial plastic surgery procedures to achieve better outcomes.

Who Should Undergo and Expected Results

This elective plastic surgery procedure can be taken advantage of those who have excess buccal fats that create a disproportionate or excessively plump facial appearance. To qualify, patients must be physically fit, non-smokers, and at least 18 years of age.

Ideal candidates for the procedure undergo a thorough consultation process where the details of the operation are discussed and all their questions answered. The goal is to help patients develop realistic expectations and weigh the pros and cons of the procedure so they are able to make a well-informed decision.

Following a successful buccal fat removal, most patients report a greater feeling of confidence as well as a boost in their self-esteem. However, it may take up to four months after the surgery to fully appreciate the results, as it may take some time for the swelling to subside and the incisions to heal completely.

How is the Procedure Performed?

A buccal fat removal is performed on an outpatient basis under local or general anesthesia, or conscious sedation, depending on the patient's unique circumstances and surgeon's recommendation. During the procedure, the surgeon makes two incisions in the patient’s mouth; the first one near the second upper molar at the back of the buccal cavity and the second one through the buccinators muscle. The two incisions give the surgeon access to the buccal fat pads.

Once the fat pads are exposed, the surgeon applies manual pressure on the outside of the cheek, causing the buccal fat pads to protrude and allowing the surgeon’s forceps to grip them effectively. While held with the forceps, the fat pads are excised or cut away. The amount of tissue removed differs depending on the patient’s desired results. Any buccal fat tissue that remains is then returned to its original position before the incisions are sutured closed.

The whole procedure takes about an hour. However, if necessary or if the patient desires, the surgeon may also perform liposuction to remove fat deposits from the cheeks that can result in better outcomes.

It is normal for the patient to experience some pain, swelling, and difficulty chewing after the procedure and these usually last for a few days or even a week. Thus, most patients are advised to take an entire week off from work to facilitate a safe and uncomplicated recovery period.

Possible Risks and Complications

A buccal fat removal procedure is associated with a number of risks and possible complications, including:

  • Facial nerve injury, specifically to the buccal branch, which helps control facial functions. This injury can lead to a partial paralysis or numbness in some parts of the face as well as loss or reduction in the patient’s sense of taste
  • Parotid duct damage, which can affect salivation
  • Hematoma
  • Adverse reaction to the anesthetic
  • Infection
    Patients who choose to combine a buccal fat extraction with a liposuction also face an increased risk of scarring than those who have undergone buccal fat removal alone.

References:

  • Thomas MK., D’Silva JA., Borole AJ. (2012). “Facial sculpting: comprehensive approach for aesthetic correction of round face.” Indian J Plast Surg. 2012 Jan-Apr; 45(1):122-127. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3385376/

  • Surej K., Kurien N., Sakkir N. (2010). “Buccal fat pad reconstruction for oral submucous fibrosis.” Natl J Maxillofac Surg. 2010 Jul-Dec; 1(2): 164-167. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304196/

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