The cheek contouring craze: Expert insights on check reduction

There's a good chance you're familiar with procedures that add volume to the face, such as implants and/or fillers. Yet, patients may not be as acquainted with procedures that remove volume from the face, and when it comes to removing facial volume, the cheeks get a lot of attention.

Cheek reduction is having its moment in the spotlight right now, and the most common of these procedures is buccal fat removal. A wave of speculation has hit the media about whether certain celebrities have had buccal fat removal in the last few years, with some – such as Chrissy Teigen – admitting to the procedure.

This procedure involves extracting the fat pad inside the cheek. It is often sought out by patients who have larger cheeks or a cheek size that is disproportionate to the rest of their face. Cheek reduction has started to grow in popularity given the sudden buzz with celebrities and the dramatic results it provides.

But what exactly goes into a cheek reduction procedure and what is the recovery like? What kind of results can be expected from a successful cheek reduction? To answer these questions and gather more insights into cheek reduction, we reached out to ASPS Member Surgeons Darrick Antell, MD, and Johnny Franco, MD.

The growing popularity of cheek reduction

Cheek reduction aims to create more facial harmony and a better balance of facial features. Many attribute the recent boom in popularity to social media and general public awareness of buccal fat removal, although this may just be one piece of the puzzle.

"A lot of people are aware of implants and fillers are used to add volume, especially to the face," said Dr. Antell. "But fewer people are familiar with reduction and what that can offer in terms of facial harmony. At our office, we do see lots of people for cheek reduction, most commonly buccal fat removal, which is located in the central mid-cheek. It's one of my favorite operations."

Buccal fat removal can be a transformative procedure with natural results and little downtime when done correctly.

"There was once the thought that if you had buccal fat removal, you'd look aged, but it's just not true," said Dr. Franco. "There's been a movement away from overfilling the face and towards something a little more natural. This procedure has been so popular because it can be done in the office under local anesthesia, and it makes a big change while being a little more budget-friendly."

While buccal fat removal may be the best-known form of cheek reduction, there are other procedures that can address the appearance of the cheek.

"A little bit less common in this country is reduction of the cheekbone itself," said Dr. Antell. "I have done the procedure before and there are ways that you could go in and cut some of the bone, you can push in the Zygomatic arch, which is the part that goes horizontally in front of the ear to change the shape of the face. However, this procedure is not as common as the buccal fat procedure."

The basics of cheek reduction

While many plastic surgery procedures are very intense, requiring an extensive recovery period, the beauty of buccal fat removal is that it is a very straightforward outpatient procedure.

"You make an incision up near the second molar tooth," said Dr. Antell. "The incision is no more than a centimeter. If you make it in the correct spot, and that's very important, the fat spills out like popping a pimple. If you're off even by a few millimeters, you could be there all afternoon looking for it."

Following buccal fat removal, there is very little downtime and a quick recovery, but expect some swelling.

"There aren't any scars that you can see," said Dr. Franco. "Sometimes you can feel the sutures in the mouth, but after a couple of weeks, you won't even be able to find the incision. We do tell people to be mindful that they can have enlarged cheeks a few weeks following before they get better."

Downtime is minimal, but there are still a few steps you'll need to take to ensure a smooth recovery.

"There's no bandage for buccal fat removal," said Dr. Antell. "Patients are instructed to put some ice on their cheeks for the next day or two. They're able to eat right away, but it's imperative that they rinse their mouth after every meal for approximately a week. I also recommend that they rinse with hydrogen peroxide daily for about a week because the bacteria in your mouth really don't like hydrogen peroxide."

The results of cheek reduction

As with any aesthetic procedure, the results that can be expected from a successful cheek reduction do vary from patient to patient and surgeon to surgeon, depending on their goals and the techniques used. However, one commonality among these procedures is that they have an incredibly high level of patient satisfaction.

"Overall, buccal fat removal is an operation that I have never had anyone complain about – never," said Dr. Antell. "That's a big thing to be able to say. They're very happy with it. Even taking a little bit out makes a big difference."

Cheek reduction results are understated yet can completely transform the appearance of the face, providing further facial balance and harmony.

"This is a subtle yet very powerful procedure," said Dr. Franco. "It's an underutilized procedure because it makes such a big difference. People will know that you look better, but they can't pinpoint where it is."

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.