Many patients who desire slimmer cheeks and a more sculpted facial appearance, opt for buccal fat removal surgery. This face contouring procedure, also known as bichectomy, buccal lipectomy, or cheek reduction, is a simple and very safe 1-hour intraoral surgery, indicated for patients with a rounded and wide face. The goal of buccal fat removal surgery is to thin the cheeks, specifically in the area of the cheek hollows, resulting in a harmonious middle and lower third of face (1). This procedure can be safely performed in-office, under local anesthesia with sedation. Downtime is typically 24-48 hours, which make this facial plastic surgery very convenient to my patients. Furthermore, buccal fat removal may be combined with other aesthetic procedures, such as facelift, brow lift or eyelid surgery, in which case the treatment time will be longer, depending on each patient’s particular needs and cosmetic goals.
The buccal fat removal procedure involves making 1 centimeter long incisions inside the patient’s mouth, located opposite your second upper molar. The surgeon removes fat from the cheeks through these incisions before closing them often with absorbable sutures. Swelling, bruising, and some discomfort are temporary side effects after cheek reduction. However, your surgeon may prescribe analgesics (painkillers) to help to control pain and discomfort. Any swelling should have subsided significantly after the first week of your buccal fat extraction recovery. Patients will need to follow a soft foods diet for 3 to 5 days after surgery, and will be instructed to sleep with their heads elevated, for healing purposes. I usually recommend my patients combining buccal fat removal surgery with neurotoxin injections (Botox, Dysport or Xeomin) to masseter muscle to achieve slimmer, more contoured cheeks plus a chiseled jaw line. Injecting botulinum toxin into the masseter muscle is an excellent and safe nonsurgical option to reduce the size of the muscle, resulting in a desirable oval face (2). Have in mind that only a highly trained, and experienced plastic surgeon can help you achieve optimal results, while significantly minimizing post-operative risks.
(1) Guedes, Ruy. “Bichectomy: A Simple Intraoral Surgical Procedure with Great Facial Results”. OMICS International. https://www.omicsonline.org/proceedings/bichectomy-a-simple-intraoral-surgical-procedure-with-great-facial-results-65860.html
(2) Sharad, Jaishree. “Contouring of lower face with injection of botulinum toxin into the masseter muscle”. Journal of Applied Aesthetics Cosmetic Medicine. http://www.cosmeticmedicine-online.com/reviews/contouring-of-lower-face-with-injection-of-botulinum-toxin-into-the-masseter-muscle/