Many people start to lose their facial fat in their 20’s but some have genetic predisposition to have heavy, fuller cheeks with an overly round face and a cherubic appearance even much beyond that. This puffiness in the cheek area can mask the contours of a beautiful upper cheekbone and lower jawbone and can give a bottom-heavy, plump look (sometimes referred to as chipmunk cheeks). Excess fat in this area can also give the illusion of being overweight even if you’re otherwise not in the obese category, and usually doesn’t respond to weight loss in these cases.
This cheek fat pad removal produces a chiseled contour, slightly hollowed look creating an ‘Ogee or S curve’ for the cheek, considered a sign of beauty. The cheekbones become more distinct and this helps in providing more definition to the midface area. It also helps in achieving a slimmer and more symmetrical facial appearance.
Q: Who are the ideal candidates for this surgery?
A: The ideal candidates for this surgery would be adults who are otherwise physically fit, non-smokers with realistic expectations from the surgery. Buccal fat extraction is typically performed on those in their mid-20s to 40s, who are distraught because of cherubic, puffy and round appearance and have not experienced any age-related fat loss in this area after their 20’s. People past their 40’s should not consider undergoing this surgery as by this time our face naturally loses fat and begins to slim down. People younger than 20 should also not consider this surgery as they may end up with a gaunt or scrawny appearance (a face that looks too thin) when their natural fat loss begins in the early twenties. Note that buccal fat is contained within membranes and cannot be replaced once it is taken out. The right case selection is therefore of paramount importance.
Q: How is Buccal Fat Extraction surgery performed?
A: Buccal Fat is the fat pad that is found in the cheek area and gives the cheek its fullness. It resides in a deep space between the lining of the mouth and its accompanying muscle (the buccinator muscle), and the overlying muscles of facial expression. This is a space with very little blood supply and the fat can, therefore, be safely and easily extracted with surgery. The deep location of the buccal fat prevents its removal with liposuction.
Buccal fat removal is performed through a very small incision (2-3 cm) on the inside of the mouth on each side, just above the upper molars. Using blunt dissection, the fascia and fibers of the buccinator muscle are exposed and the buccal fat is made to protrude through the incision using thumb pressure on the outside of the cheek right under the cheekbone. This protruded fat is then teased out slowly, with forceps. This process is repeated on the other side and the incision is then closed using a non-dissolvable type of suture. The amount of fat removed depends on the desired level of effect, and can be up to the size of a golf ball. Since the incision is within the mouth, there will be no visible scarring. The surgery takes less than 1 hour to complete.
Q: What other procedures can be combined with a Buccal fat extraction surgery?
A: Buccal fat removal can be done in conjunction with other procedures like rhinoplasty, facelift, cheek augmentation, and chin augmentation, but is usually done as a stand-alone treatment.
Q: What type of anaesthesia is used in Buccal Fat Extraction?
A: The reduction of buccal fat pads usually is performed under Local anesthesia with sedation (meaning thereby that the patient will be awake but drowsy and insensitive to pain) or under general anesthesia. It is a day care procedure and there is usually no need for hospital admission unless other procedures are also done in the same sitting.
Q: How much time does the Buccal Fat Extraction surgery take?
A: The surgery as a stand-alone procedure, generally takes less than an hour.
Q: What are the risks or complications from this surgery?
A: Every surgery entails some kind of risk. Since Buccal fat extraction is a relatively less invasive procedure, the risks some swelling are usually minimal and include mild bruising, hematoma (blood collection), seroma (fluid collection), mild discomfort, infection (prevented with peri-operative antibiotics) and numbness. Numbness may be noticed around the incision lines, on the central cheeks, or the jawline after the surgery and usually subsides with decrease in swelling in the area, which may take 1-2 weeks. Very rarely this numbness may be permanent, indicating nerve damage. In some cases, results could be asymmetrical which can be corrected with a revision surgery. It is therefore of paramount importance that you choose a surgeon who has enough experience.
Q: What is the recovery profile and postoperative care needed after Buccal Fat Extraction surgery?
A: The recovery process is relatively quick and painless and the patient can go home after a few hours. The patients are usually able to resume routine office work the next day but strenuous activity must be avoided for 2-3 weeks.
Following buccal fat extraction, most patients will experience a sore, swollen and tender lower face and mouth. There is usually some mild discomfort, which can be controlled by pain medication. To decrease the swelling, it is best to sleep with head raised using an extra pillow. Since the incision is inside the mouth, it is advisable to take a liquid diet on the first day, followed by a soft diet for the next 4-5 days. Acidic foods like citrus fruits must be avoided during this time to prevent the irritation of oral mucosa. The doctor will usually advise you to rinse your mouth with an antiseptic mouthwash several times each day to prevent any infection. The swelling usually dissipates completely in 3-4 weeks. There is, however, no need to miss work. There is no need to remove sutures as absorbable sutures are used.
Q. When can one expect to see the results?
A: It takes approximately one month for swelling to completely resolve completely and up to three months for the final result. Preliminary results are however visible within a week or two and keep improving as the swelling subsides.
Q. How long do the effects last?
A: The results of buccal fat extraction are usually permanent. However, if there is a significant gain in weight in the future, the cheeks may again become fuller.
Q: Can the Buccal Fat be removed with liposuction instead?
A: The location of buccal fat deep within the layers of muscles of the face, prevents its removal with liposuction. Liposuction will only remove superficial fat, which may cause rippling and is therefore not preferred.