Have You Heard Of Buccal Fat Pad Removal Surgery?

Basically, it’s the removal of the cheek pad (the word buccal comes from the Latin ‘bucca’ meaning cheek) – and young men and women, in particular, are increasingly turning to it as a shortcut to remove face fat or achieve a more sculpted or chiselled face.

Although buccal fat removal surgery isn’t new, interest in it has significantly increased among the younger population. This is largely from the influence of the ‘snatched’ look of social influencers and celebrities they follow. Chrissy Teigen, a Hollywood actress and model, has publicly shared that she’s had the surgery.

Buccal fat removal surgery is designed to ‘thin’ the cheeks for those who don’t like their cheeks being ‘fat’ – which is weird, seeing as the rest of the older population is trying to plump theirs up! And this is one of the issues with this surgery, as we’ll find out later.

We asked Dr Ivan Puah, an aesthetics and liposuction doctor at Amaris B. Clinic in Singapore – and someone with over 17 years of facial and body sculpting experience – for a more medical view of the trend.

The importance of the buccal fat pad

Dr Puah describes the buccal fat pad as a unique and essential piece of facial structure. “It fills the deep tissue spaces and acts as a gliding pad when the masticatory and mimetic muscles (for chewing and showing expression, respectively) contract.”

And it profoundly impacts the look and shape of the face. The buccal fat pad develops significantly between the ages of 10 and 20 before gradually shrinking in size over the following 30 years.

Unsuitable candidates

The ideal candidate has prominent cheekbones that are obscured by very full cheeks. Buccal fat pad removal reduces cheek fullness and, in turn, highlights the cheekbones. However, Dr Puah says that it’s not suitable for all patients.

“If you have malar hypoplasia (underdevelopment of the cheekbones) or an already gaunt face, it will just result in a hollowed appearance, making you look much older than your peers. For others, they must consider how this area naturally diminishes over time anyway, and how that will also impact the look.”

Potential complications of buccal fat removal surgery

The buccal fat pad is removed permanently during the surgery, and the effect is irreversible. Over-resection may occur when the plastic surgeon is overzealous or is not skilled. A study has also concluded that there is a 26.3% chance of injury to the buccal branch. This nerve allows you to move your nose, blink, and raise your upper lip and corners of your mouth to make a smile.

“I’ve seen patients who had this form of facial plastic surgery done by other doctors and regretted it as they’ve grown older,” says Dr Puah. “They come to me for treatments to replace the facial volume loss. Their objective has now shifted from looking chiselled and modelesque to desperately wanting to ‘reverse’ the effects of the worn-out look. In such cases, dermal fillers or facial fat grafting may help to restore facial volume loss to the cheeks area.”

Can buccal fat pad removal surgery give you a sculpted jawline and cheek definition?

If you want to slim down a bulky jawline (which could be due to an overactive masseter muscle), injectable neurotoxins can easily rectify this, says Dr Puah. “I would perform facial liposuction for patients with excessive fullness in the lower face and cheeks. This not only addresses the issue of excess facial fat, but it also can effectively sculpt the jawline and lift and tighten saggy skin. Facial liposuction targets localised superficial fat while leaving the buccal fat pad – a critical support structure for the face – untouched.

The difference between buccal fat removal and cheek liposuction

Dr Puah explains that facial liposuction delivers different results and is done for different indications compared to buccal fat removal . “It can eliminate excess fat from the cheeks, jowls, , chin and upper neck,,” he says. “It also allows a skilled doctor to sculpt and recreate a more defined jawline and chin. Best of all, facial liposuction, if done in a specific way, helps to lift and tighten facial skin.”

Facial liposuction is, therefore, suitable for patients who wish to look slimmer and achieve facial skin tightening and a more defined jawline without affecting the buccal fat pad.

Final word

“Facial fat volume and distribution are essential in sustaining facial contours and youthfulness,” says Dr Puah. “Losing and removing too much facial fat will do the opposite and lead to facial hollowing that will only worsen with age.

“Once the buccal fat pad is removed, it’s permanent. It’s therefore critical to do as much research and understand the results that different surgical techniques and modalities can achieve before committing to permanent cosmetic surgery – as the effect is irreversible.”