Hollow cheeks: A focus on buccal fat removal

When considering recent plastic surgery trends, a lesser-known procedure might come to mind – buccal fat removal. This decades-old procedure that involves reshaping the face through the removal of fat found in the cheeks has recently seen a boom in demand.

Now touted as the "holy grail" of facial contouring procedures among many younger patients, buccal fat removal has seen a significant increase in popularity and prevalence during the last five years.

To gather further insight into the world of buccal fat removal and the trends behind the popularity of this procedure, we spoke with ASPS Member Surgeon Omar Hussain, MD. Discover what he had to say about buccal fat removal and the future of this procedure.

The ins and outs of buccal fat removal

Buccal fat removal may have been around for decades, but we've seen a recent explosion in popularity thanks to the prevalence of social media and the work-from-home "Zoom boom" during the pandemic.

"Staring at your own face during hours of a video conference can make one more critical," said Hussain. "Buccal fat removal can provide more contour to your cheek and reduce the appearance of fullness."

We all may be familiar with the results of buccal fat removal, but we might not be as closely acquainted with how the procedure is performed. Incisions and scars from the procedure can be easily concealed and paired with other procedures with no negative effects.

"The technique of removal can be hidden on the inside of the mouth, which is the most common approach," said Hussain. "Buccal fat can also be addressed at the same time as a facelift from the outside. Both of these approaches are safe in experienced hands."

A shift toward younger patients

Patients of all ages seek out buccal fat removal, but there has been a notable shift in the demographics within the past several years.

"The majority of patients seeing me for buccal fat removal are in their 20s and 30s, have noticed the genetic predisposition in their parents and want to address their lack of cheek definition," said Hussain. "They are all well-educated on the issue and have done extensive research on the topic. My consults go smoothly because I'm just confirming whether their expectations are in line with what can actually be achieved with the surgery."

Many patients may be tempted to take the plunge on buccal fat removal to achieve chiseled cheeks, but this type of procedure is often better suited for a particular patient group.

"The surgery works best in patients with palpable buccal fat in the area of concern with good skin elasticity," said Hussain. "In older patients or those who have less elasticity, combining the removal with a facelift is required to address the skin laxity."

Tips to maximize your results

As with any surgical procedure, there are a few key methods to maximize your recovery and results from buccal fat removal.

Use a board-certified plastic surgeon

Since this type of procedure has very little downtime, many patients are tempted to opt for the quickest route to get it done rather than take their time to find a board-certified plastic surgeon. Yet, it is critical you identify the right surgeon to achieve your desired results.

"Make sure you see a board-certified plastic surgeon who specializes in facial procedures," said Hussain. "The anatomy is straightforward if it's an area that the surgeon operates on routinely."

Be cautious around this type of procedure

You may be tempted to jump right into a buccal fat removal procedure to achieve the hollow cheeks of your dreams, but be mindful that the results may not be what you want in the long run.

"I advise caution when considering any fat removal or grafting into the face," said Hussain. "Fullness in the face is associated with youth, and hollowing is associated with aging. If you trade a full cheek with a mid-cheek furrow, you've advanced your perceived age by a decade or more. These patients should consider an additional lifting procedure to be performed at the same time."

Set yourself up for success

In addition to finding the right surgeon, prepare yourself ahead of time for your recovery process.

"Make sure you buy Peroxyl mouthwash for home," said Hussain. "You will use it after every meal and at night for the first two weeks afterward to heal the incisions on the inside of your mouth."

In addition to purchasing mouthwash, prepare to alter your diet for a few weeks following your surgery.

"Plan on a liquid diet for a couple of days after surgery, followed by a soft diet," said Hussain. "You won't be chewing anything solid for a few days while you heal."

Take the time to rest and recover

Since this procedure feels minimally invasive, you may be tempted to jump right back into work or your everyday life. However, make sure that you take the proper amount of time to allow your body to recover before you do.

"Give yourself five days off after surgery so you can heal without worrying about work while you're swollen," said Hussain. "You'll be icing your cheeks a lot and resting during that time."

Maintain a stable weight

Last, but certainly not least, is to prepare ahead of time by maintaining a stable weight.

"When considering buccal fat removal, make sure your weight is stable for at least six months prior to considering surgery," said Hussain. "Weight fluctuations take time to balance out across your body."

More than just a trend?

No one is sure if buccal fat removal is more than just a passing trend or if it will become a plastic surgery mainstay. It may continue to see growth along with other facial procedures in this increasingly digital age, with people spending more time than ever staring at their faces on screen.

Regardless of its popularity, if buccal fat removal is right for you, by preparing ahead of time and working with a board-certified plastic surgeon, you can set yourself up for success and to achieve the perfect chiseled cheeks that you've been dreaming of.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.