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Buccal Fat Removal: A Success Story of Facial Transformation

Updated: Jun 10

Dr Srinjoy Saha, Clinical Professor of Plastic Surgery and Consultant Plastic Surgeon, Apollo Hospitals Kolkata, India.

Modern Society's Quest for Sculpted Cheeks

Modern society places a lot of emphasis on facial aesthetics and beauty. Recently, it has become increasingly fixated on a singular facial feature: sculpted cheeks. Pursuing chiselled, defined cheekbones and sharper facial contours has become a global obsession. People of all ages and backgrounds are seeking to achieve this elusive look.  The pressure to conform to a perceived ideal has intensified from social media influencers to Hollywood celebrities.

Buccal fat removal before and after: oblique view - increasing facial attractiveness.
Before and after comparison of the patient's face in oblique view, illustrating the dramatic improvements in facial contours achieved through buccal fat removal surgery.

Here, we will discuss the benefits and problems of buccal fat pad removal surgery. It's based on a case study of a healthy woman in her mid-thirties. Like many others, she was facing career challenges due to her appearance.

A Celebrated Actor's Mid-Career Crisis

A 36-year-old television actor came to our plastic surgery clinic, distressed. She was going through an acute mid-career crisis. As she entered her mid-30s, the acting roles started drying up. No matter how many auditions she attended, she got the same feedback. They said, "You look too young and baby-faced for this role."

Hailing from Kolkata, she succeeded in the entertainment industry and settled in Mumbai. Her bright smile and bubbly personality made her a natural in front of the camera. 

At first, she tried to brush off these criticisms. Still, they silently began to weigh heavily on her self-confidence. She had inherited full, rounded cheeks from her family. Such traits made her look youthful and cute rather than mature and elegant. She worried whether her window for leading lady roles was closing rapidly. This emotional struggle was a significant factor in her decision to undergo the surgery.

After a particularly harsh audition, she was told she didn't have the right 'look'. That day, she was shattered and broke down in tears. It was a moment of reckoning, a turning point in her career. She knew something had to change to stay in the industry she loved. With a newfound determination, she set out to reinvent her appearance to better align with how she saw her true self.

Preoperative pictures of a patient before buccal fat pad removal: full cheeks appreciable.
Preoperative views of the patient's face showing the fullness of the cheeks due to the buccal fat pad. This image highlights the area of the face that will be targeted by a buccal fat removal procedure.

The Buccal Fat Removal Solution

She learned about buccal fat removal surgery after a thorough online search and speaking with friends. It's a plastic surgery that could sculpt a slimmer, more defined look to her cheeks. The procedure involves making small incisions inside the mouth, through which the buccal fat pads - rounded pockets of fat in the cheeks - are removed. Removing excess fat creates a more chiselled look.

She felt she needed this transformation to change how casting directors saw her. She had always been self-conscious about her full cheeks. But, she now embraced the idea of a more sculpted look. It could help her get taken more seriously for age-appropriate roles. She was interested mainly in 'leading lady roles'. It's a term used in the entertainment industry to refer to the main female character in a production.

To her, the surgery appeared intimidating. It involved cutting through the cheeks to extract the fat pads. Still, she was willing to go through the discomfort and downtime. She felt it provided just one chance to rejuvenate her stalled career. She carefully researched experienced plastic surgeons. While in Kolkata, she met another lady from her industry who underwent surgery. She took time to know about the details. She appreciated the results of slimming the cheeks.

Taking a break from work, she consulted our clinic in Kolkata while visiting her parents. The consultation involved a thorough examination of her facial structure and a discussion about her goals and expectations. We were careful to "not sell her any surgery". Instead, we focused more on the risks, making sure she knew what may lie ahead. After much deliberation, she decided to go ahead with a buccal lipectomy.

Buccal fat removal before and after: oblique view.
Before and after comparison of a previous patient's face in oblique view show the impressive slimming of the cheeks after buccal fat removal. This image illustrates the improvements in facial contours we can achieve through surgery.

The Results: Astonishing Facial Contours After The Surgery

The surgery went like a breeze. After the surgery, the face swelled up as predicted. It got worse initially in the next two days before getting better afterwards. The amount of swelling halved in about a week. Two weeks after the buccal fat pad removal surgery, facial swelling reduced a lot. 

Another section written below describes the details of this surgery. Remember, depending on the individual, the recovery process can take several weeks to a few months.

After a fortnight, her cheeks appeared noticeably slimmer and more contoured. The facial contours started improving with every passing week. In about a month, she could understand the impact of the surgery on her face. Finally, about three months after the surgery, she found her new face shape impressive. 

She was thrilled with the 3-monthly results. She sent us her new pictures with a 'thank you' note. She wrote, "I'm loving the results. Immensely grateful for your efforts."

Postoperative pictures after buccal fat pad removal: shows a nicely contoured face.
Postoperative views of the patient's face show a nicely contoured face and cheeks after a buccal fat removal procedure. This image highlights the significant facial contouring achievable within a few months of the surgery.

Her cheeks had a sleeker, more sculpted appearance without the former fullness. Her facial features looked more defined overall. She noticed that her facial contours improved gradually till six months after the surgery. The sculpted changes in her face were permanent.

A New Leading Lady

Her facial transformation paid off in a big way for her acting career. She started getting called in for leading lady roles again. Thanks to her more sculpted, mature appearance, she began drawing attention. Casting directors now saw her as a polished and sophisticated lady. They did not just see her as another cute young woman. Within six months, her career had an incredible resurgence. She had a packed schedule full of acting gigs. This significant career boost was a direct result of the surgery.

Buccal fat removal before and after comparison: frontal view.
Before and after comparison of the patient's face in frontal view, highlighting the significant changes in facial contouring brought about by a well-performed buccal fat pad removal procedure.

What are Buccal Fat Pads?

The buccal fat pads are small, naturally occurring pockets of fat in the cheek area. They aim to help ease chewing and smiling while using the cheek muscles. But, for some people, larger or more prominent buccal fat pads can make the cheeks look rounder. Overtly rounded cheeks can create a chipmunk-like appearance.  The face can achieve a more sculpted, defined look by removing these fat pads.

Anatomically, a buccal fat pad has three lobes - anterior, intermediate, and posterior. The posterior lobe, a.k.a. body, has four extensions - buccal, pterygoid, pterygopalatine, and temporal. The buccal extension is the most superficial of all. The body and buccal extension constitute about half of the total volume of the buccal fat pad. We remove only the buccal extension during our face contouring surgery.

Buccal fat pad specimen: removed excess fat while preserving the main body.
Left: Specimen of the removed buccal extension of the buccal fat pad from one side of the cheek. Right: The Arrow shows the preserved main body of the buccal fat pad, illustrating the conservative nature of buccal fat removal surgery.

How does Buccal Fat Pad Removal Sculpt The Face?

Removing some buccal fat pads slims the cheeks and enhances the cheekbones. Thereby, it creates a contoured, sculpted cheek appearance. It also makes the lower face more defined. People often call it the "inverted triangle of beauty."

Buccal Fat Pad Removal Surgery: Details Of The Procedure.

During the surgery, we anaesthetise our patients so they wouldn't feel any pain. We infiltrate local anaesthesia mixed with adrenaline to decrease bleeding on the face. After waiting a few minutes, we make small incisions about 1-2 cm long inside the mouth. We cut through the mucosa and submucosa between the parotid duct opening and the gingivobuccal sulcus. 

The cuts expose the cheek muscle fibres, which is called a buccinator. The muscle fibres are then retracted on two sides to expose the buccal fat pad. Gently grabbing an end of the freely floating buccal fat, the buccal extension is teased out through the incision and removed. After that, the main body comprising the posterior lobe of the buccal fat pad is seen and preserved completely.

Buccal fat removal surgical procedure: removing the fat through intraoral incisions.
Intraoral incisions made on both sides of the cheeks during the buccal fat pad removal procedure. This image illustrates the minimally invasive approach used to remove the excess buccal fat.

The incisions are then stitched up inside her mouth with dissolvable sutures. Since the incisions are internal, no external scars are left on the face. Typically, the entire procedure would take around 1-2 hours using general anaesthesia or IV sedation.

The patients are instructed to stick to a liquid diet for a few days afterwards. Restricting cheek movements allows the mouth to heal in a better way. After the wounds heal, patients are allowed to progress to semisolid foods and then a normal diet.

Benefits of Buccal Fat Pad Reduction.

Worldwide, buccal fat pad removal (a.k.a. buccal lipectomy) is becoming an increasingly popular procedure.  It's a wonderful tool for appropriately selected patients to enhance facial aesthetics. Combined with fat grafting, it highlights the cheekbones, known as zygomatic prominences. 

To get good results, patients need to understand the structure of their faces. Having realistic expectations is a must.  They should choose an experienced plastic surgeon for a good assessment and treatment.

Potential Risks and Complications of Buccal Fat Removal.

Like any surgery, buccal fat removal carries some risks, although significant complications are rare. Most common problems are fleeting and temporary. Patients can expect swelling, bruising, and discomfort during recovery for the first 1-2 weeks.

Potential issues can include:

  • Prolonged swelling or bruising.

  • Infection.

  • Asymmetry between sides.

  • Injury to salivary (parotid) ducts or facial nerves.

  • Excessive cheek hollowing.

  • Permanent numbness or nerve pain.

The risk of significant complications like nerve injuries is estimated to be less than 5% in experienced surgeons' hands. Minor complications like excessive swelling occur around 8-18% of the time.

Understanding The Limitations of a Buccal Fat Removal Surgery.

While buccal fat removal enhances cheek contours, we do not know how it may affect ageing. As plastic surgeons, we caution against removing too much buccal fat, as that could lead to premature ageing. It could permanently jeopardise the midface area in the future.

More research is needed on the procedure's impact on patients' faces decades after surgery. For this reason, many plastic surgeons are conservative in how much buccal fat they remove, especially in younger patients.

Buccal fat removal before and after: frontal view
Before and after comparison of a previous patient's face in frontal view shows the impressive slimming of the cheeks after buccal fat removal. This image highlights the dramatic improvement in facial contours achieved through our surgery.

Ensuring Patient Safety During Buccal Lipectomy.

During the patient's consultation, we would review the risks and benefits. We also take into account facial measurements, proportions, and patient goals. We would advise if buccal fat removal alone will achieve the treatment goals. Otherwise, we would check if more procedures, like cheek implants, fillers, or fat grafting, would be recommended.

Proper consultation and understanding are essential. Buccal fat removal can help some patients get a more ideal lower facial shape. However, patients always need to consider their surgery carefully. It may not be considered lightly to chase unrealistic beauty standards.

Importance of Facial Contouring In The Entertainment Industry.

The world of movies, television, and modelling is obsessed with looks. Subtle changes to one's appearance can open or close many doors in this industry. Buccal fat pad removal surgery is considered among the simpler of plastic surgeries. Still, it's ultimately able to turn how ordinary people perceive celebrities. It changes how the masses see their age, sophistication, and potential as leading ladies.

Many famous actors and models have performed this fat sculpting procedure in secret. Behind the scenes, they craft their face to a more chiselled, camera-ready look. It allows them to reshape their public persona and give their careers a reboot or pivot to a new role or image. A little facial slimming and re-contouring can reinvent celebrities' marketability.

How Transforming Faces Can Transform Many Careers.

Like the patient described here, some actors became typecast in younger, one-dimensional roles. For people like her, buccal fat removal offers an elegant way to look mature and ready for dramatic parts. The surgery has a subtle yet impactful result on the cheek contours. It may give their career a big new boost when needed the most.

Buccal fat pad removal remains a highly potent tool for facial transformation. Many entertainers, front-office workers, and public speakers are embracing buccal fat removal procedures. Buccal lipectomies help them defy age biases, shift out of typecasting, and rebrand their public image. Skilled plastic surgery for facial contouring plays a meaningful role in unlocking the next stage of their career.

Collage of pictures depicting different phases of buccal fat pad removal


This article and the information contained within it are for educational purposes only. It should not be construed or used as a medical opinion or advice. This article does NOT intend to supplement the advice of a trained, licensed medical professional in your area.


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