All About Buccal Fat Removal (cheek reduction surgery)
Originally published June 26, 2014. Updated June 17,2025 with additional information.
Discussion of aesthetic procedures for the cheeks tends to focus on adding volume. However, there are a number of people who through weight gain or other genetic factors have issues stemming from overly large cheeks.
Buccal fat removal has become an increasingly popular procedure for those seeking a slimmer, more sculpted facial appearance. Celebrities and influencers have brought this procedure into the spotlight, but there is still a lot of confusion around what it is, how it works, and who it is right for. If you are considering buccal fat reduction or simply want to understand the ins and outs, this comprehensive guide breaks down everything you need to know.
What is Buccal Fat Removal (or Buccal Fat Reduction)?
Buccal fat removal is a cosmetic surgical procedure designed to thin the cheeks by removing the buccal fat pads—small, naturally occurring pockets of fat located deep within the lower part of the cheeks. These fat pads sit between the facial muscles and contribute to the fullness of the face, especially around the mid-cheek area.
The goal of the procedure is to contour the face, resulting in a more defined jawline and cheekbone structure. It is often sought after by individuals who feel their face appears too round, chubby, or “baby-faced,” regardless of their overall body weight.
How Does Buccal Fat Removal Differ from Cheek Liposuction?
While both procedures aim to slim the face, they differ significantly in technique, target area, and results.
- Target area: Buccal fat removal specifically targets the buccal fat pads located deep in the lower cheeks. Cheek liposuction, on the other hand, addresses superficial fat closer to the skin’s surface and can be performed on the upper cheek and jowl areas.
- Technique: Buccal fat removal is a more delicate, intraoral procedure (performed inside the mouth), whereas cheek liposuction involves small incisions typically made near the ear or jawline to insert a cannula and suction out fat.
- Results: Buccal fat removal creates a hollowed-out appearance beneath the cheekbones, enhancing facial angularity. Liposuction provides more general volume reduction and can be used to treat multiple facial areas in one session.
What Results Does Buccal Fat Removal Provide?
The procedure enhances facial definition by creating a more sculpted and angular look. Patients typically notice:
- More prominent cheekbones
- A sharper jawline
- Reduced cheek roundness or fullness
- A leaner, more mature facial appearance
However, results can vary depending on a person’s natural anatomy and the size of their buccal fat pads. It is also important to note that results become more apparent as post-surgical swelling subsides—usually around 3–6 months post-op.
Are Results Permanent?
Yes, the results of buccal fat removal are generally permanent. Once the fat pads are removed, they do not regenerate. However, weight fluctuations, aging, and other facial changes over time can impact overall appearance.
Because the face naturally loses fat with age, excessive removal at a younger age may lead to a gaunt or hollowed look later in life. This is why many surgeons advise caution when performing this procedure on younger patients.
Does Buccal Fat Removal Correct Smile Lines?
No—buccal fat removal does not correct smile lines (also known as nasolabial folds). These lines extend from the nose to the corners of the mouth and are caused by factors like aging, volume loss, and skin laxity—not buccal fat.
In fact, excessive removal of buccal fat can exaggerate smile lines by creating a stark contrast between the mid-cheek area and surrounding tissues. For those concerned about nasolabial folds, dermal fillers or a midface lift may be more appropriate solutions.
Who Is a Good Candidate for Buccal Fat Removal?
The ideal candidate for buccal fat removal is:
- In good physical health
- At or near their ideal body weight
- Bothered by full or chubby cheeks
- Seeking a more contoured facial appearance
- Not a smoker (or willing to quit temporarily)
- Realistic about their expectations
Patients with naturally thin faces may not be good candidates, as the procedure could leave them looking overly hollow or aged. A thorough consultation with a board-certified plastic surgeon is essential to determine if this is the right approach.
How to Prepare for Buccal Fat Removal
Preparation typically involves:
- Medical evaluation: Your surgeon will take a full medical history and perform a physical exam to assess your candidacy.
- Medication adjustments: You may need to stop taking blood-thinning medications like aspirin, ibuprofen, or certain supplements a week or two before surgery.
- Smoking cessation: Smoking can impair healing, so it should be stopped at least 2 weeks prior.
- Dietary guidelines: You may be advised to fast before the procedure if general anesthesia or sedation will be used.
- Arrange post-op care: Plan for someone to drive you home and assist during the initial recovery period.
How is the Procedure Performed?
The first step of treatment is proper diagnosis. A surgeon must first assess if the cause of excess cheek volume stems from a genetic influence or from aging, which tend to affect the jowels. In the latter case a facelift procedure would be more appropriate. However if the patient is younger and doesn’t exhibit other signs of significant aging, the cause of overly large cheeks is likely excess fat under the skin or overly large buccal fat pads (or a combination of both issues).
There are two distinct issues that result in overly chubby cheeks: the lower submalar (which is subcutaneous fat) and the upper submalar (where the buccal fat pad resides).
Correcting Lower Submalar Issues
Liposuction performed with a very small cannula from the corners of the mouth can correct lower submalar issues. Similar to traditional liposuction, a skilled physician can suction out targeted excess fat to provide the desired look.
Correcting Upper Submalar Issues
Buccal fat removal is the most effective way to address upper submalar issues. The proceudre is typically performed under local anesthesia with or without sedation, and occasionally under general anesthesia, depending on patient preference and surgical complexity.
The procedure includes:
- Sterilizing the inside of the mouth to prevent infection.
- A small incision (1–1.5 cm) is made inside each cheek, typically near the upper molars.
- The surgeon carefully teases out the buccal fat pad, controlling bleeding and minimizing trauma to nearby structures.
- Excess fat is removed, and the incision is closed with dissolvable sutures.
Since the incision is inside the mouth, there are no visible scars.
Removing the Appropriate Quantity of Fat
A natural component of facial aging is the reduction of cheek volume in both upper and lower submalar areas. Individuals age at their own rate dependent on genetics, heredity, and external factors like smoking, excessive UV exposure, and alcohol consumption. It is important to have a solid understanding of this aging process, as removing too much fatty tissue can result in premature aging. Additionally, uneven removal can affect facial symmetry which is a crucial factor in the overall aesthetic of the face.
How Long Does the Procedure Take?
The surgery is relatively quick, lasting about 30 to 60 minutes on average. It is often performed as an outpatient procedure, meaning you can go home the same day.
What to Expect After Buccal Fat Removal (Recovery Process)
Initial recovery timeline:
- Days 1–3: Swelling and mild discomfort are common; ice packs and over-the-counter pain meds are often sufficient.
- Days 3–7: Most patients return to light activity or work. Soft food and gentle mouth care are recommended.
- Weeks 2–4: Swelling begins to subside significantly, but subtle puffiness may persist.
- Months 1–3: Final contours gradually emerge as all swelling resolves.
Post-operative care tips include:
- Rinsing with antiseptic mouthwash to reduce infection risk
- Sleeping with your head elevated
- Avoiding strenuous activity for at least a week
- Sticking to a soft-food diet for several days
Is There Scarring?
No visible scarring occurs because the incisions are made inside the mouth. Internal stitches are typically dissolvable and do not require removal.
Are There Any Side Effects?
As with any surgical procedure, buccal fat removal comes with risks. Common side effects include:
- Swelling and bruising
- Mild pain or tenderness
- Temporary numbness in the cheeks
Less common but serious complications may include:
- Infection
- Injury to nearby facial nerves or salivary ducts
- Asymmetry
- Over-removal leading to a sunken or aged appearance
According to a 2021 review published in the Aesthetic Surgery Journal, buccal fat removal has a low complication rate when performed by experienced surgeons.
Are There Non-Surgical Alternatives to Buccal Fat Removal?
Yes, for those hesitant to go under the knife, there are a few non-surgical options that can provide subtle facial slimming:
- Injectable Neurotoxins (e.g., Botox): When injected into the masseter muscles (jaw muscles), they can slim the lower face—a technique known as “masseter slimming.”
- Kybella (deoxycholic acid): FDA-approved for submental fat (under the chin), Kybella has been used off-label to reduce small fat pockets in the face, though it is not a direct substitute for buccal fat removal.
- RF Microneedling or Ultrasound-Based Devices (e.g., Morpheus8, Ultherapy): These can tighten and contour facial skin, improving definition without removing fat.
While these options are less invasive, they typically offer subtler results and may require multiple sessions.
Buccal fat removal is a highly effective procedure for achieving a slimmer, more sculpted facial profile—but it is not for everyone. Understanding the nuances, benefits, and potential drawbacks is crucial for making an informed decision. If you are considering this surgery, consult with a board-certified facial plastic surgeon or cosmetic surgeon who has extensive experience in facial contouring procedures.
A well-executed buccal fat removal can enhance your natural bone structure and boost your confidence—but as with any cosmetic treatment, the key to success lies in individualized planning and skilled execution.
Cameron Craven MD, FACS is board certified by the American Board of Plastic Surgery. Dr. Craven specializes in the full spectrum of cosmetic surgery including breast augmentation, liposuction and body contouring, facial rejuvenation, laser surgery, eyelid surgery, and rhinoplasty, as well as reconstructive surgery for skin cancers.
Disclaimer: The contents of the Westlake Dermatology website, including text, graphics, and images, are for informational purposes only and are not intended to substitute for direct medical advice from your physician or other qualified professional.
Is liposuction of the cheeks possible?
Hi Janet, Thanks for reading our blog and submitting your question. Liposuction is a great treatment for the cheek area, especially if the patient is looking to remove a relatively small amount of fat. The best treatment will depend on the characteristics of the patient and their desired goal.
Please let us know if you have any additional questions or if you would like a free consultation!
Thanks,
WD Staff
I’m very VERY interested in buccal fat removal surgery but I have really low tolerance for pain and local anesthesia usually doesn’t do anything for me. Is it possible to be completely put to sleep for this process?
Hi Tatiana, thanks for submitting your question!
The concern over pain/anesthesia is quite common of perspective patients. While it may be possible the procedure to be done under general anesthesia (with you “completely under”), we would probably encourage you to think about Twilight Anesthesia instead (read more on that here: https://www.westlakedermatology.com/blog/twilight-anesthesia/).
We feel that twilight anesthesia (combined with local anesthetic) is just as effective in terms of blocking pain while being a safer option.
Please contact our office today at 512.328.3376 for more information!
Thanks again,
WD Staff
I’ve never heard about this type of procedure before. Is it the same think as liposuction? It sounds like it could be a good option for people wanting to get rid of some of the fat from their face to get them the look they want, like you said. I’m sure my wife will want to learn more about this. She’s been looking into different types of cosmetic procedures.
Hi Gary, thanks for reading our post and for submitting your question. In some cases the excess fat can be removed by liposuction. However, if the issue is an abundance of under-the-muscle tissue it may require surgical excision.
Please let you wife know that she can give us a call to setup a free consultation!
Thanks,
WD Staff
Hello! I’m in my mid 40s and am not overweight but have naturally chubby cheeks unless I loose an excess amount of weight, which I’m not necessarily interested in. I am starting to have some sagging but am not sure if I should entertain fillers. So yes, I have chubby cheeks, not much definition, and am beginning to have some sagging. Thoughts or recommendations?
Hi Elle
Thanks for sharing that great comment! As always, the best way to determine the best course of treatment would be to have you come in for an in-person assessment. It’s really the only way to come up with a proper treatment plan.
With that caveat, it sounds like fillers may be a good option for the issues you stated. In cases with minor sagging, filler can be used to add definition.
But again, an in-person consultation would be needed to make sure its the right route.
We hope that helps!
Thanks,
WD Staff