They may have been cute back when Grandma pinched them, but many people are sometimes less satisfied with their chubby or ‘chipmunk’ cheeks as they get older. Rounded cheeks are caused by the fat pads, known as buccal fat, that are stored in the cheeks. The size of the buccal fat pads can be enlarged either as a result of genetics, increased weight, or both. For some, a rounded facial appearance can be very attractive. For others, particularly those with larger areas of buccal fat or with fat that extends to the lower cheek and jawline, a more contoured look may be desirable. When that is the case, buccal fat removal can provide the desired change.
Also called cheek reduction surgery or buccal fat extraction, buccal fat removal is a cosmetic surgery procedure used to remove a portion of the fat stored in pads in the cheek. The surgeon makes an incision inside the back part of the mouth between the cheek and gum. The pressure is then applied on the outside of the cheek to force the buccal fat into the incision. This allows the surgeon to remove the amount of fat necessary to achieve thinner, more sculpted facial features with the increased definition of the cheeks. Upon completion of the procedure, the incision is closed with stitches. A pressure dressing that goes around the top of the head and underneath the chin may also be applied.
Buccal fat removal is typically performed as an outpatient procedure in a physician’s office or surgery center in an hour or less. Anesthesia is generally a local anesthetic with light sleep sedation rendering the patient drowsy and insensitive to pain, but conscious. A local anesthetic, such as lidocaine, is injected into the area where the incision will be made. Generally, epinephrine will be used to constrict blood vessels in the area and reduce bleeding.
After the procedure
After the procedure, patients experience mild to moderate pain that can be controlled with oral pain medications. The swelling will occur within the first few days after the buccal fat reduction procedure and may be accompanied by some bruising. Some degree of swelling may last for a few weeks and tightness or tenderness may last for several weeks. Temporary loss of sensation in the area of the incision is common and rarely becomes permanent.
Most patients can return to work after one week but may have some restrictions for a few additional weeks to ensure proper healing. Although each patient must follow the instructions provided by their physician for their particular case during the recovery period, restrictions may include avoiding heavy lifting or other physically strenuous activities and temporary dietary restrictions due to the presence of stitches in the mouth. Special mouth rinses may be prescribed to reduce the potential for infection. Patients will generally be instructed to sleep with the head elevated for about a week.
Ideal candidates for buccal fat removal
Ideal candidates for buccal fat removal have a desire for more defined cheeks without extensive surgery and are generally healthy, of average weight, and past the age of 25 or perhaps older. Since facial fat increases naturally around the late twenties, prospective patients under the age of 25 may not be good candidates for the procedure. Often examining photographs of parents and other family members at younger ages and comparing them to their current appearance provides a clue as to whether buccal fat removal will be of benefit. Having the procedure prematurely risks a gaunt look after natural facial thinning occurs.
As with all cosmetic surgery procedures, consultation with an experienced, qualified physician is necessary to determine whether buccal fat removal is appropriate. The consultation also assures the patient understands the procedure itself, has realistic expectations, and is aware of the risks, benefits, and possible complications associated with the procedure