Buccal Fat Removal
Some faces look heavier through the lower cheeks even when the jawline is slim. Buccal fat removal (often called buccal refinement or bichectomy) selectively reduces the deep fat pad inside the cheek to reveal a cleaner transition from cheek to jaw.
My philosophy is conservative, anatomy-led: refine volume only where it truly blunts definition, and preserve soft-tissue support for ageing gracefully.
What it can—and cannot—do
Can help with:
- Fullness in the lower cheek that obscures cheek–jaw definition
- Faces that remain round despite normal weight and healthy lifestyle
- Improving midface–jaw harmony when combined with chin/jawline work
Cannot do:
- Replace weight optimisation for generalised facial fullness
- Tighten skin laxity (that’s a facelift/neck lift question)
Who is a good candidate?
- Stable weight, non-smoker (or willing to stop pre/post-op)
- Persistent lower-cheek fullness on photos (front & three-quarter) despite normal BMI
- Thicker soft-tissue envelope (not very thin or hollow-prone)
- Realistic goals: definition and contour—not drastic hollowing
If your fullness is mainly along the jaw angle or under the chin, jawline implants or submental contouring may be more effective; I’ll guide you.
Technique (how I perform it)
- Anaesthesia: local with or without light sedation; day procedure
- Approach: a small intraoral incision (inside the cheek—no external scar)
- Refinement: gentle exposure of the buccal fat pad and partial removal only; closure with dissolvable sutures
- Protection of structures: meticulous respect for the buccal branch of the facial nerve and Stensen’s duct (parotid)
Time in clinic: ~ gauntness 45 minutes for both sides.
Recovery & aftercare
- Day 0–2: head elevation, cold compresses; mild cheek pressure/fullness is common
- Diet: soft, lukewarm foods for 3–5 days; rinse with antiseptic mouthwash as directed
- Activity: gentle walking from day 1; avoid intense exercise/sauna for ~1 week
- Follow-up: sutures are absorbable; checks as scheduled
Downtime: many patients return to routine within 2–3 days; swelling settles over 2–6 weeks.
Result timeline: early contour at ~4–6 weeks; refined definition by 3 months as tissues adapt.
Results & longevity
Refinement is permanent in the area treated—the removed fat does not “grow back”. Ageing continues normally; by staying conservative we maintain softness while clarifying angles.
Risks (and how I minimise them)
Common, usually mild: swelling, bruising, temporary mouth-opening tightness, bite irritation at the incision line.
Less common: infection, haematoma, salivary duct irritation, prolonged numbness, asymmetry, or excess hollowing if over-resected. Risks are reduced by careful selection, partial removal only, and precise intraoral technique.
Combination planning (when it adds value)
to align the nose–lip–chin profile and enhance jawline
for angle definition when bone support is the limiting factor
if laxity—not fat—is the primary issue
support (skincare/SPF; selected energy-based treatments) to improve light reflection
FAQs
Will my face look too hollow later?
Not with conservative planning and the right candidate. I avoid over-resection and consider how your face will age.
Is there a scar?
The incision is inside the mouth; there is no visible external scar.
Can I combine this with other procedures?
Yes—commonly with chin/jawline enhancement or submental contouring for global harmony.
When will I see results?
You’ll notice steady improvement as swelling settles—most definition appears by 4–6 weeks, with final refinement by 3 months.
Does it help with jowls or loose skin?
No. Jowls/laxity respond better to facelift strategies; buccal refinement addresses deep cheek fullness.
