Buccal fat removal is commonly sought after by patients who are aiming to create a slimmer or more sculpted appearance to their face—especially the lower cheeks. Celebrities are doing it, and the procedure is rocketing in popularity. Removing buccal fat can accentuate the cheekbones and jawline, or reduce the cheek fullness that bothers patients with naturally ‘chubby’ or ‘chipmunk’ cheeks. In essence, buccal fat removal is a facial slimming procedure to improve the contours of the face. It is quick and easy to perform with minimal downtime and risk, and it is generally done under local anesthesia in the office. Sounds great! When applied to the correct patient, the procedure results in a beautiful, natural enhancement without any scars or evidence to suggest surgery was done.
However, a quick internet search is sure to turn up a concern that frequently works its way into the conversation: Will buccal fat removal make me age prematurely? This concern is based on the idea that youthful cheeks are supposed to be plump and full and that reducing cheek volume with buccal fat removal is contrary to this tenet. As with anything else in plastic surgery, there is no simple ‘yes’ or ‘no’ answer to this question. The bottom line is that not everyone is an ideal candidate for the procedure.
There are various reasons why buccal fat removal may not be a good idea for everyone. Most commonly these reasons may have to do with inappropriate expectations with the procedure, patient age, or the relative size of the fat compartments in the face.
Some patients may expect a result that cannot be achieved with buccal fat removal. The word ‘cheek’ can refer to a pretty large territory of the face, so some confusion can arise—which part of the cheek are we talking about slimming? When we get into the specifics, it turns out that some patients that I see in consultation want to slim their lower face, but they are actually aiming to reduce the width of their jaw, and our conversation turns to reducing the masseter or jaw contouring. Buccal fat removal does not reshape the jawline.
Another situation where we need to be especially careful is with patients who are particularly young and the shape of their face is still maturing in early adulthood. (Buccal fat removal is permanent, and something that may look good at 18 years old, may not look good at 40 years old). Generally speaking, we need to be extra cautious not only with teenagers but patients in their 20s as well—this age group is the most likely to be advised to wait on undergoing the procedure to avoid looking volume-depleted when their facial structure is fully mature.
Lastly, I mentioned the relative size of the fat compartments. Buccal fat is a deep compartment that resides under the subcutaneous fat layer beneath the skin. Patients who carry a relatively high amount of subcutaneous fat with a high body weight may also not appreciate a significant difference with the removal of the deeper buccal fat compartment. Along this line, patients who are undergoing significant changes in weight are encouraged to stabilize their weight within their target range before undergoing procedures that remove, shift, or augment the fat compartments of the face. Finally, patients with deficient cheekbone projection need to be very careful with buccal fat removal—they are at higher risk for appearing gaunt or hollow if the procedure is misapplied.
Without a lot of practical experience in this subject, it may be hard for you to discern how any of these areas of caution apply to you. Moreover, there could be something better for you, so be wary of your preconceived notions. It is best to put your trust in the hands of a facial plastic surgeon or facial contouring expert with similar qualifications who can guide you to the best options for you to achieve your goals. If you are seeking buccal fat removal for the appropriate reasons, it is not likely to make you appear older or gaunt. However, the decision to undergo this procedure can be more nuanced than that which is why we can’t wait to meet you in person and discuss the cheeks you dream about.
