What Is Buccal Fat Removal? Here’s What to Expect From the Cosmetic Procedure

Buccal fat removal, clinically called a bichectomy or bichectomia, is a cosmetic procedure that removes fat in the cheek hollows to give the face a more sharply contoured appearance.

Read on to find out what else you need to know about buccal fat removal — including side effects, alternatives, and other information — to help you decide if it could be a good option for you.

“Patients seeking out this procedure are often looking for a slimmer jawline and reduced fullness in the cheeks,” says Mohiba Tareen, MD, medical director and founder of Tareen Dermatology in Roseville, Minnesota. “The benefits are a more contoured face.”

To perform the procedure, a plastic surgeon makes a small incision on the inside of the mouth on both sides of the face to access each side’s respective buccal fat pads. Then the surgeon presses on the pads to expose more of this fat tissue, making it easier to cut out and remove either all of the buccal fat pads or a portion of them.

Afterward, the surgeon places sutures to heal the incision, which may either be dissolvable or require a follow-up visit for removal.

Additionally, to achieve natural-looking results, having a rounder face rather than a long, thin face, may make you a better candidate for this procedure. That’s because removing fat on a face that’s naturally thin can lead to an unnaturally hollowed-out look, says Joshua Zeichner, MD, director of cosmetic and clinical research in the department of dermatology at Mount Sinai Hospital in New York City.

This cosmetic procedure is also a better option for younger adults than those of a more advanced age, Dr. Zeichner adds. That’s because middle-aged and older adults naturally lose fat in this part of the face and are less likely to achieve the chiseled results they seek by removing buccal fat.

“The procedure gives the face a more gaunt appearance, which many people prefer when they are in their twenties or thirties,” Zeichner says. “However, with age — in the forties, fifties, and above — the face naturally loses its fat. People who have had this procedure tend to develop a skeletonized appearance, much more so than people who left their buccal fat pads alone.”

In fact, many of the patients who undergo buccal fat removal come in later in life for injectable filler procedures to restore volume in the very area where they previously had buccal fat removed, Zeichner says. This happens in everyone, but may be most prominent in people who are thin to start.

As with any surgical procedure, buccal fat removal carries risks. Some such risks include:

• Infection at the incision site
• Injury to facial nerves or salivary duct injury
• Numbness or sensation changes
• Asymmetry

You should contact your healthcare provider if you experience excessive bleeding, a fever or any other signs of infection, any changes in your sense of taste, or any signs of asymmetry in your face that might mean you’re not healing properly.

While buccal fat removal is generally considered safe, rare serious complications can include shortness of breath, chest pain, or an abnormal heartbeat. If you notice any of these symptoms, immediately seek medical attention or call 911.

For people who want to achieve a more contoured face without cutting into their cheeks to remove buccal fat, there are some nonsurgical options. According to Dr. Tareen, these alternatives can help create a more defined jawline and slimmed-down cheeks.

Many of Tareen’s patients opt for facial injections containing onabotulinumtoxinA (Botox) or abobotulinumtoxinA (Dysport). When injected into the masseter muscles that run along the cheek and jaw on the sides of the face, this option can help create a more sculpted appearance, she says. Others opt for hyaluronic acid facial fillers to define the jaw line and lift the cheek to give an illusion of fullness in that area.

“There are very few risks involved in injectables versus surgery if performed by a board-certified dermatologist or plastic surgeon,” Tareen says.

To ensure that your surgeon is well-versed in the latest techniques to safely and effectively perform buccal fat removal, look for a board-certified plastic surgeon, Tareen advises.

• Buccal fat removal is a cosmetic surgical procedure that removes fat from the cheek hollows to help achieve a more chiseled look.
• Because buccal fat naturally decreases with age, doctors suggest that people who have naturally rounder, fuller cheeks are better candidates for the procedure than those who have naturally thinner faces.
• Less invasive alternatives for achieving a similar result include facial injections, like Botox and fillers.