Cheek reduction surgery: procedure and risks explained

Cosmetic Procedures

What is a cheek reduction surgery?

Cheek reduction surgery is also called the buccal fat pad reduction or Bichat’s fat pad surgery (buccal refers to the Latin word Bucca which means cheek). And it is just that. In this procedure the surgeon will reduce your buccal fat pad which looks like a golf ball sized mass position on either sides of your face just below the cheekbones, and between the nostril and corner of the mouth. They are there to give you a more round and plump look. But at time they can look a bit like chubby cheeks, great for babies. Not great for adults. The reduction of the buccal fat pad will give your face a more contoured, lean, higher cheek bones look and chiseled appearance.

There is a difference between removing and reduction of the fat pads. It is not advisable to completely remove them. Later on this difference will be discussed.

Who should have it done?

This procedure of removing the buccal fat pads are for people that have excessively chubby and puffy cheeks. These are normally people that have them due to hereditary reasons.

What is the procedure?

Normally you would be advised not to eat 8 hours prior to your surgery. The surgery will be conducted on an outpatient bases. It is also a good idea to get someone drive you home after the procedure.

The doctor will give you anesthesia with sedation to reduce the feeling of pain and make the surgery more bearable.
The actual procedure might involve different facial plastic surgery procedures, like lip augmentation, an eye lift or a nose job. These will all be discussed with your doctor and what you individual needs might be.

Although you occasionally hear about liposuction of the buccal fat pads, I don’t ever do this for several reasons. Number one, these pads have heavy fibrous capsules that do not lend themselves to common liposuction. More importantly, facial nerve branches, the anterior facial vein and parotid duct are frequently in close approximation to these fat pads and could be injured producing facial paralysis or severe bleeding. For this reason, I always perform a magnification assisted precision surgical reduction of the fat pads. It is not an area for imprecise technique and it is important for patients to select a surgeon with lots of experience and expertise in facial surgery.

The fat is located by making several small incisions on the inside of the cheek. The surgeon then locates the buccal extension of the fat pad which is generally very plentiful and protrudes into the mouth. The amount of fat to be removed is determined and the fat pad is removed using a laser or radio wave device. This is important as it seals the blood vessels and prevents bleeding which can be problematic in that area. After the fat is removed the small incisions are closed with dissolving sutures.

The procedure takes about 20 minutes per side and is performed with IV anesthesia. This procedure may be performed with other cosmetic facial procedures such as facial implants, liposuction, or face lift surgery.

Cosmetic Procedures

Before and after cheek reduction surgery

What are the possible complications?

After the surgery your cheeks will be swollen. This will go away within a few days.

You will be unable to eat like normal. Instead your will be instructed to follow a liquid and soft diet.

It is not advisable to remove all the fat, as years later as you age you can start to look very skinny and unhealthy appearance. An appearance that is normally associated with starvation, drug miss use and illness.

Injury to the buccal branch of the facial nerve is a risk; the buccal branch nerves that might be affected control facial functions, therefore, such damage might result in partial facial paralysis, regional facial numbness, loss of taste, et cetera. Likewise, damage to the parotid duct also might occur in men and women whose parotid ducts run deep to the buccal fat pad, which can lead to hematoma, and might affect salivation.

Buccal fat pad removal is performed through a small incision inside the mouth. This is typically performed under local anesthesia with oral medications to reduce anxiety and pain. The buccal fat is about the size of a deflated golf ball or ping-pong ball. Buccal fat removal is often done with a face lift or chin implant to further enhance the facial contour. The location of buccal fat deep within the face prevents its removal with liposuction.