Buccal Fat Reduction
All cosmetic surgery involves risks and individual results vary. The outcomes shown in any images on this page are relevant only to the specific patient depicted and do not reflect the results that other patients may experience. Cosmetic surgery is a serious decision. Decisions about whether to proceed should be made after careful consideration and following at least two consultations with a qualified medical practitioner.
This page explains what buccal fat pad reduction involves, whom it suits, what it can and cannot achieve, and the risks to consider before deciding. Please read it carefully and raise any questions at your consultation. No question is too minor to ask, and it is important that you feel fully informed before proceeding.
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What is the Buccal Fat Pad?
The buccal fat pad is a deep pocket of fat that sits in the cheek, between the muscles used for chewing. It is separate from the fat that lies just beneath the skin. In some people these pads are naturally generous, giving the lower cheeks a full, rounded appearance.
What Does the Procedure Do?
Buccal fat pad reduction — also called buccal lipectomy or bichectomy — removes a measured portion of this fat to slim the lower cheek and to bring out greater definition beneath the cheekbone. The aim is a subtle, more sculpted contour rather than a dramatic change.
The procedure is permanent. The fat that is removed does not grow back, so the result is long-lasting. This is also why careful, conservative removal is important — it cannot easily be reversed.
Suitability
This procedure tends to be most appropriate for patients who:
- Have genuine fullness in the lower cheeks arising from the buccal fat pad specifically, rather than from overall facial fullness or a naturally wide bone structure
- Are at a stable, healthy weight
- Are in good general health and hold realistic expectations
It may not be appropriate if you have a naturally slim or narrow face, very little cheek fullness, or if your principal concern is jowls, a double chin, or loose skin. These are different problems that this operation does not treat.
What Are the Realistic Results?
The change is usually subtle and is best appreciated in profile and three-quarter views. Because of swelling, the true result will not be apparent for some time — early swelling may even make the cheeks appear fuller at first. The final contour typically settles over three to six months.
The Procedure
Risks and Possible Complications
All surgery carries risk. Buccal fat pad reduction is generally well tolerated, but it is important to understand what can go wrong. Because the result is permanent and over-correction is difficult to remedy, a deliberately conservative approach is taken.
Expected after surgery and settle with time. Significant swelling in the first weeks may temporarily make the cheeks appear fuller than before. Final results are not apparent for three to six months.
A collection of blood (haematoma) may develop inside the cheek and may require drainage. Avoiding aspirin, anti-inflammatory medications, and blood-thinning supplements before surgery reduces this risk.
Oral incisions are at risk of infection given proximity to bacteria in the mouth. Oral hygiene is important during recovery. Antibiotics are prescribed routinely.
Minor differences between the two sides are common after any facial procedure and often reflect pre-existing asymmetry rather than a surgical complication. Significant asymmetry may require further assessment.
Removing too much fat can produce a hollow, gaunt, or prematurely aged appearance — a risk that compounds as the face naturally loses volume with age. This is the most important reason for taking a conservative approach. Under-removal may leave a desire for further correction, which can be assessed at the twelve-month mark once healing is complete.
Temporary numbness in the cheek is common and usually resolves over weeks to months as sensation returns. Longer-lasting numbness is uncommon.
The facial nerve and its branches run in proximity to the buccal fat pad. Injury can cause temporary or, rarely, permanent weakness in part of the face. The parotid (Stensen’s) duct also lies nearby — injury can impair salivary flow. These complications are uncommon but serious, and are minimised by careful anatomical dissection.
The final result may not meet your expectations. Results depend on individual anatomy, the degree of swelling resolution, and how the soft tissues re-drape over the changed contour. Careful discussion of realistic expectations at consultation is essential.
Alternatives to Consider
- Taking no action — a valid choice, particularly given that the face naturally slims with age. Many patients find that reassessing in two to three years is worthwhile before committing to a permanent change.
- Non-surgical facial contouring — where appropriate for your anatomy and goals.
- Addressing related concerns by other means — concerns about jowls, a double chin, or skin laxity are different problems that this procedure does not address and may require separate assessment.
These options will be discussed at consultation.
Preparing for Surgery
- Please advise us of all medical conditions, allergies, and medications — including supplements
- You may be asked to stop blood-thinning medicines and certain supplements beforehand — specific instructions will be provided
- If you smoke, stopping well before and after surgery significantly improves healing
- You will need to fast as instructed and arrange for someone to drive you home and remain with you that night
- Please plan for a few quiet days afterwards — most patients take several days away from work
Fees and the Cooling-Off Period
A written quote will be provided before proceeding. The quoted surgical fee is the surgeon’s fee; depending on the procedure, there may be separate charges for the anaesthetist and the hospital or day surgery facility. We are happy to explain the total expected costs so the figures are clear.
Cosmetic procedures involve a cooling-off period following your consultation before surgery may be booked. This is intended to give you time — free of pressure — to be confident that the decision is right for you. This is not a formality. It exists to protect you, and it is taken seriously at this practice.
Questions
If any part of this information is unclear, or if questions arise after your consultation, please contact us. We would prefer that you ask.
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Dr Roth’s Clinical Perspective
Buccal fat pad reduction is a procedure I approach cautiously, and I think patients deserve to understand why. The result is permanent — the fat does not come back — and the face loses volume naturally as we age. A patient who has this done at twenty-five may look excellent at thirty but hollow and gaunt at forty-five. That is not a hypothetical concern; it is a pattern that is well recognised in the literature and that I have seen in consultation with patients seeking correction of over-reduced faces from procedures done elsewhere.
For the right patient — someone with genuine buccal fat excess, at a stable weight, with realistic expectations and a clear understanding that this is a subtle change rather than a dramatic one — the procedure is appropriate and the results are satisfying. My approach is conservative by design. I would rather remove slightly less and have a patient consider whether further correction is warranted at twelve months than remove too much and create a problem that is genuinely difficult to remedy.
I also want to be clear about what this procedure does not do. It does not address jowls, a double chin, skin laxity, or the jawline. Patients who present primarily concerned about these things are better served by a different assessment. The consultation is the right place to work out which concern is which and which treatment, if any, is appropriate.
— Dr Jason Roth, MBBS, FRACS (ORL-HNS), IBCFPRS
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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