Buccal fat removal surgery: what it is, how it works, what are the benefits vs. risks, what it costs, before and afters, and more.

It seems like everyone and their mother wants thinner, more sculpted cheeks these days, hence the contouring craze and filters galore. But there’s another cheek-slimming method that’s gaining popularity, one that’s much more permanent. We’re talking about buccal fat removal, a surgery that removes the fat from inside your cheeks.

Plastic surgeons say the treatment is on the rise, and Chrissy Teigen recently made news when she shared her buccal fat removal results on social media. Still, it’s important to remember that, unlike your favorite Instagram filter or contouring trick, this is legit surgery and shouldn’t be taken lightly. Ahead, more on cheek buccal fat removal, what the procedure is like, who is a good candidate, and more.

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What exactly is buccal fat removal?

“Buccal fat, or more specifically the buccal fat pad, is a segment of fat that’s stored in the lower cheeks, part of the fat lining that stems from the temples to the jawline,” explains Raymond Douglas, MD, a board-certified oculoplastic and facial plastic surgeon in Beverly Hills. “It’s generally a round mass of fat that’s in the middle of the cheek, between facial muscles, in the hollow are beneath the cheekbone.” Buccal fat removal is simply the extraction of that specific fat from inside the cheeks, he says.

While this is a surgical procedure we’re talking about, Dr. Douglas says it’s relatively simple and minimally-invasive. It’s performed under local anesthesia only, AKA you won’t be put to sleep. The surgeon creates a small incision inside the cheek and essentially squeezes the fat pad out through this incision, removing the whole thing in one piece. The incision is closed with dissolvable stitches, and the entire procedure usually can be done in less than an hour, he says.

buccal fat removal

How does buccal fat removal change the look of your face?

“The buccal fat pad has a tremendous impact on the overall shape of the face,” explains Babak Azizzadeh, MD, a board-certified plastic surgeon in Beverly Hills. Buccal fat is more prominent when you’re young; it’s what’s responsible for that ‘baby face’ effect that most people lose by the time they hit their 30s, says Dr. Douglas. That being said, everyone’s buccal fat pad is a different size naturally, and some people may have larger ones, even as they get older. Removing it defines the cheekbones, thins out the cheeks, and highlights the jawline, he explains. “It creates more of a V-shaped face that’s currently in high-demand,” he adds.

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Who is a good candidate for buccal fat removal surgery?

Both doctors we spoke with underscore the fact that this isn’t a good option for anyone and everyone. Age is a big consideration. Even though it may be trending among younger patients — just search #buccalfat on TikTok and you’ll see what we mean — this generally isn’t a procedure for teens, who will continue to have natural changes to their face, notes Dr. Azizzadeh. Dr. Douglas agrees, noting that he typically wouldn’t perform this on patients in their 20s, since the fat may natural dissipate by the time they hit 30.

To that point, it’s also important to note that cheek fat removal may end up accelerating signs of aging down the road. Facial fat is generally a sign of youth. The fat pads deflate and descend as we age, so patients who remove their buccal fat pads can experience hollows that contribute to a more advanced aged appearance later, notes Dr. Douglas. Similarly, anyone who has a long and angular or leaner face to begin with isn’t a good candidate, since removing the buccal fat will only create more hollows, he adds.

So, who is a good candidate? Dr. Douglas says patients who have a round fullness to their cheeks and heavy volume under their cheekbone (even once they’re older) tend to have the best result. He adds that many patients who undergo this surgery also have thyroid issues, which can, for unknown reasons, lead to fat expansion that changes the shape of their face, making it fuller and rounder; in this case, buccal fat removal isn’t age-contingent, he says.

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Dr. Azizzadeh adds that he often performs it on older patients, for whom the buccal fat pad has moved or shifted. “As we age the buccal fat pad can ‘glide’ down near the jawline, widening the lower part of the face,” he explains. Rather than removing the fat pad entirely, he actually performs a unique type of surgery in which he moves it. “The purpose isn’t just to slim the face. It’s more about repositioning the fat pad, moving it to other areas that have lost volume over time. I’ve found this is an extremely effective way to perform the procedure on my patients who are looking for a more youthful appearance,” he says.

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How much does buccal fat removal cost?

This depends largely on where you live and the surgeon you see, but it isn’t cheap. After all, it’s a surgery. For context, Dr. Azizzadeh says the cost of buccal fat removal can run anywhere from $7,500 to $15,000.

What are the possible side effects of buccal fat removal?

It’s important to remember that the buccal fat pad actually has an anatomical purpose; it’s intertwined with both muscles and nerves in our mouth, as well as the salivary system. Point being, if done incorrectly, buccal fat removal can negatively impact all of these things, which is why it’s paramount to seek out an experienced, board-certified surgeon. Other potential side effects include possible infection, as well as numbness or weakness of the facial muscles.

However, when performed correctly, side effects are minimal. “Recovery from buccal fat removal is short. It only takes about a week or so for the incision to heal,” says Dr. Douglas. Expect some swelling, bruising, and discomfort for the first few days, but keep in mind that it can take up to three to six months for the swelling to fully resolve and for you to see the final results, notes Dr. Azizzadeh.

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Are there any alternatives to buccal fat removal?

In short, not really. “This isn’t a fat pad that can be liposuctioned because it’s too deep and intertwined with the facial nerve and salivary duct,” explains Dr. Azizzadeh. As far as non-surgical options, there really isn’t a good substitute, either. Dr. Douglas says Kybella (an injectable that dissolves fat) and radiofrequency microneedling are sometimes discussed as options, but, while they may offer some improvements in cheekbone contouring, the results are hardly equivalent.

At-home solutions — gua sha, jade rolling — can offer a temporary improvement by helping to flush out excess fluid and make the cheeks appear more lifted and sculpted, but these are exactly that, temporary. They’re not going to change the actual fullness of the cheeks, though they are good if you’re just after a fast fix before a big event, says Dr. Douglas.

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