Buccal fat removal is a cosmetic surgical procedure for cheek contouring and midface tapering. Other names for the procedure are cheek reduction, buccal fat excision, bichectomy, or buccal lipectomy.
People with excessive buccal fat may present a child-like or overweight appearance despite appropriate weight for height. Surgical excision of buccal fat through intraoral incisions may result in zygomatic (cheekbone) prominence and inverted triangular beauty. Moreover, the patient's age and sex do not affect the procedure's outcomes.
Regarding the anesthesia regimen, the procedure is carried out under local anesthesia or conscious sedation. General anesthesia is required for extensive surgery when procedures like rhinoplasty or submental liposuction are performed simultaneously. Buccal fat removal is considered a simple and safe procedure that is routinely performed. However, there is scarce knowledge regarding the procedure's long-term effects and role in facial aging.
Rare complications are facial asymmetry, hemorrhage, hematoma, facial nerve impairment, mandible dislocation, pain when chewing, trismus (spasm of jaw muscles), or infection. The procedure is not suitable for patients with hemifacial atrophy (progressive deterioration of the skin and soft tissues on one side of the face) or hypoplastic malar bones (underdeveloped cheekbone).
Steps of the procedure
Buccal fat removal involves the following steps:
Anesthesia
The patient is placed supine with 30° head-of-bed elevation, and anesthetic medicines are administered to comfort them during the procedure. Usually, the procedure is performed under local anesthesia or intravenous sedation. However, the surgeon may recommend general anesthesia, depending on the patient's specific condition.
The incisions
A buccal fat removal procedure requires intraoral incisions (incisions inside the mouth). Sometimes, buccal fat removal is performed during facelift surgery. It rules out the use of incisions for removing cheek fat.
Closing the incisions
Incisions inside the mouth are closed using sutures. Usually, the sutures are absorbable, but each surgeon adopts a unique approach to performing the procedure. Be sure not to play with the sutures with your tongue until they are entirely absorbed or cleared by your surgeon.
Postoperative care
There is standard postoperative care for patients getting buccal fat removal through any procedure:
Patients should take a clear liquid diet and use antiseptic mouthwash four times daily. They should use cold compression pads five times a day for 10 minutes. This protocol should be carried out for the first three postoperative days, and neck and chin elastic compression garments should be worn 12 hours a day for seven days.