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Face Contouring with Buccal Fat Removal

Buccal fat pad removal, also known as bichectomy or check reduction, is a cosmetic procedure that removes excessive fat pads from the cheeks to create a more contoured and sculpted facial appearance. It is generally used to reduce chubby cheeks (“chipmunk cheeks”) that can be due to genetics or weight gain. The goal of buccal fat removal is to thin the cheeks, specifically in the area of the cheek hollows. Although a face that is naturally soft and filled out is considered youthful, some people find that their face feels too full, even chubby. According to the American Society of Plastic Surgeons (ASPS), a patient may be good a buccal fat removal candidate if he or she is physically healthy and at a stable weight, has realistic expectations, is a nonsmoker, and is bothered by the appearance of his/her chubby cheeks (1).

Buccal fat removal combined with neurotoxin injections to masseter muscle performed by Dr. De La Cruz.

Cheek reduction surgery helps a patient improve not only the appearance of the cheeks but brings harmony to the overall facial shape. For patients with overly full, round or chubby cheeks, removing the buccal fat pads results in a more sculpted and symmetrical facial appearance. The procedure is performed from inside of the mouth and does not result in visible scars on the face. Plastic surgeons will strategically remove the correct amount of the buccal fat pad to enhance the patient’s youthful contours and overall facial shape. Among the numerous benefits that buccal fat removal surgery offers are the following: more defined cheeks, improved facial contours, rejuvenated facial shape, enhanced facial appearance, and increased self-confidence.

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 most patients. Furthermore, buccal fat removal may be combined with other aesthetic procedures, such as facelift, FaceTite, NeckTite, Fractora, fat transfer to the face, chin augmentation, brow lift or eyelid surgery, in which case the treatment time will be longer, depending on each patient’s particular needs and cosmetic goals. It’s also recommended 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.

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. Your plastic surgeon will give you specific instructions on how to care for yourself after Bichectomy. Following his/her pre and post-operative instructions is key to the success of your cosmetic surgery. It is essential that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing.


(1) “Buccal Fat Removal”. American Society of Plastic Surgeons.

(2) Sharad, Jaishree. “Contouring of lower face with injection of botulinum toxin into the masseter muscle”. Journal of Applied Aesthetics Cosmetic Medicine.

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