Buccal fat is fat between your cheekbones and jaw bones in your face. These fat pads help make up the shape of your face. Buccal fat removal is a surgery to remove the fat in this area of your face.

Buccal fat removal can highlight the bone structure in your face, especially your cheekbones and the hollowed-out areas between your cheeks and jawline. The procedure is also sometimes called a cheek reduction.

Some people may feel the roundness in their cheeks creates a fullness to their face they don’t like. Having a cheek reduction can alleviate the sense of fullness or “chubbiness” of your cheeks.

You may consider having this procedure if you:

• Don’t like the appearance of fullness in your cheeks

• Are otherwise healthy and have a stable weight

You may not be a good candidate if your face is already narrow or thin, or if you are in your late thirties or older — buccal fat thins naturally with age, so removing more can accelerate a hollowed look. A surgeon who assesses your facial structure can tell you whether the fullness you are seeing is buccal fat at all.

Step 1 – Anesthesia  

You’ll receive a local anesthetic to numb the skin on your face so you won’t feel any pain. You’ll remain awake during the procedure. If you’re having more than one procedure done at the same time, you may receive general anesthesia.

Step 2 – The Incision  

Your surgeon will make a small incision on the inside of your mouth on both sides of your face to expose the buccal fat pads.

Step 3 – Removing the fat

Your provider will press gently on the fat pads to further expose them, then cut and remove the fat pads.

Step 4 – Closing the Incision 

Finally, your provider will close the incisions with sutures. Often, the sutures are dissolvable. Your provider will let you know if you need to come back for suture removal after your procedure.

Step 5 – See the Results 

After your procedure, your healthcare provider will explain how to care for your incisions. They may give you a special mouth rinse to help with healing and prevent infection. You’ll be on a liquid diet for a day or two while your incisions start to heal. Gradually, you can add soft foods to your diet as your provider says it’s OK.

Some things you can expect after surgery:

• Swelling

• Bruising

• Numbness at the incision sites

On its own, buccal fat removal takes about 45 minutes to an hour for both cheeks. Allow one to two hours when it is combined with another procedure, which is common.

Most patients are usually comfortable returning to their daily activities within 4 to 5 days after surgery.

There is some mild swelling after surgery that gradually resolves in the ensuing few days. As it does, the new, more defined, facial contours emerge. Gently applying cold compresses can help reduce swelling faster. Within 1 to 2 weeks, the swelling has sufficiently resolved to reveal the result. Cheek definition continues to improve over a 4 to 6-month period. It takes about 7 days for the sutures inside the mouth to completely dissolve and fall out.

The main restriction after surgery is avoiding strenuous physical activity and vigorous exercise. Avoiding acidic foods and liquids is also recommended because the small incisions inside the cheeks feel like small sores. Patients will need to rinse their mouths with saltwater to keep the small incisions inside the mouth clean during the healing process.

Cheek definition emerges as swelling settles over the first one to two weeks and continues to refine over about four to six months.

The result is permanent: the buccal fat pad does not grow back, and removing it cannot be reversed. If too much is taken, correcting it means adding volume back with fat grafting or filler, which is why experienced surgeons remove conservatively and assess each cheek separately.

Because it cannot be undone, some people start with injectable filler or another temporary option to try a change in facial contour before committing to surgery.

The cost of buccal fat removal procedure in Canada usually ranges from $2,750 to $6,750.

With any surgery, you must weigh the risks and the potential benefits of having the procedure. Your healthcare provider will discuss with you any risks so you can make an informed decision.

Some risks associated with buccal fat removal surgery are:

• Infection at the incision site

• Injury to facial nerves and/or salivary duct injury

• Numbness or sensation changes

• Facial asymmetry

• Removing too much fat, which can leave the mid-face looking hollow or gaunt. Buccal fat also thins naturally with age, so an over-resected result tends to become more noticeable over time rather than less. This is managed by removing conservatively — a smaller amount can be taken, and more removed later if needed, whereas fat that has been taken out cannot be put back the same way.

On the patient review site RealSelf, 367 of 404 people who reviewed buccal fat removal rated it “worth it” — about 91%. That is a self-selected group of reviewers rather than a clinical study, so treat it as a sense of general satisfaction, not a prediction of your own result.

Because the procedure cannot be reversed, the more useful question is whether the fullness you want to change is really buccal fat, and whether removing it will still suit your face in twenty years. A surgeon who says no to some patients is the one worth listening to.