Buccal fat removal takes out part of the buccal fat pads, the fatty tissue lying between the masseter and the buccinator. In adults they serve no significant function; removing them slims the middle third of the face and brings out the cheekbones.
It is a day case, under local anaesthetic, taking about 50 minutes. The incision is inside the mouth, a few millimetres long, at the level of the second molar, closed with dissolvable stitches: it leaves no visible scar.
The profile that benefits: a round face or prominent cheeks, good skin elasticity and localised fullness without general excess weight. Over the age of 50 it is only indicated where there is good muscle tone, skin elasticity and good facial structure.
Normal life resumes the next day. The effects begin to show from the third week and the final result should not be judged before six months.
The result is permanent — the fat removed does not grow back — but it depends on keeping your weight stable. The risks are uncommon: internal bruising, local infection, injury to the parotid duct or to nearby nerves, and asymmetry if unequal amounts are removed.
Buccal fat removal is a minimally invasive operation that defines the contour of the face by taking out the buccal fat pads. At the Instituto de Cirugía Plástica del Mediterráneo, in Valencia, we carry out this procedure for aesthetic purposes, particularly in patients with rounded or prominent cheeks.
Throughout this article we explain, with medical rigour, what the surgery involves, in which cases it is indicated, how it is carried out, what recovery is like, what results can be expected and what guarantees a specialist centre such as ours offers.
Would you like to book a consultation to have your case assessed?
Buccal fat removal is a surgical technique that consists of taking out part of the fatty tissue in the cheeks, known as the buccal fat pads or pads of Bichat. These structures lie between the masseter and the buccinator muscles, within the thickness of the cheek, and can give the face a fuller or rounder shape.
Although the buccal fat pads have a function in infancy related to sucking and to lubricating the chewing muscles, in adults they serve no significant purpose. Removing them can slim the face, bringing out the cheekbones and refining the middle third.
This operation is not aimed only at improving physical appearance: it also has a positive influence on how patients perceive their own image. A more defined jaw and a face with harmonious proportions can improve self-esteem and help project a more confident, professional image.
The whole decision between buccal fat removal and facial liposuction fits into one anatomical question: which plane the surplus fat is in. The buccal fat pad is deep fat, lying between the masseter and the buccinator, neither visible nor palpable from outside; it is removed from inside the mouth, through the lining of the cheek, and that is why it leaves no scar on the skin. Subcutaneous fat lies just beneath the skin, gives the contour its roundness and forms the double chin; it is treated from outside, with a cannula, through a minimal incision hidden in a natural crease — near the tragus, behind the ear or under the chin. They are not interchangeable: removing the wrong structure does not correct the problem and can leave an unnatural result, so the first thing decided at the consultation is the plane, not the technique. Original diagram by the Instituto de Cirugía Plástica del Mediterráneo, simplified for general readers.
Who can benefit from buccal fat removal?
The profile of the ideal patient for buccal fat removal includes the following:
People with a round face or prominent cheeks who want to define their facial contour.
Young or adult patients with good skin elasticity, which helps the skin retract naturally after surgery.
People who are not generally overweight but do have localised fullness in the cheeks.
Patients with slight facial asymmetry or cheeks that have dropped through premature ageing.
In every case a medical assessment beforehand is needed, including examination of the face, analysis of proportions and bone structure, a review of the medical history and a detailed conversation about expectations and goals. At the Instituto de Cirugía Plástica del Mediterráneo we carry out this study at the first consultation, tailoring our recommendations to each case.
Buccal fat removal is carried out as a day case under local anaesthetic. It needs no hospital stay and takes approximately 50 minutes. The procedure is as follows:
Marking and preparation: a small internal mark is made to locate the point of entry. There are no external incisions.
Local anaesthetic: anaesthetic is applied inside the mouth to avoid discomfort throughout the operation. Where the patient prefers, it can be done under sedation.
Intraoral incision: the surgeon makes an incision a few millimetres long inside the mouth at the level of the cheek, by the second molar.
Partial removal: the buccal fat pad is carefully reached and removed with care, to avoid damaging other structures.
Dissolvable stitches: the incision is closed with stitches that dissolve on their own, with no need to remove them later.
The whole procedure is carried out with precision surgical instruments and under direct vision, ensuring safety and keeping trauma to the surrounding tissues to a minimum.
What aftercare is needed following the operation?
Recovery is quick and straightforward. In general the patient can resume normal life the next day, following some basic advice:
Applying cold locally, on and off, during the first 24-48 hours to reduce swelling.
Sleeping with the head slightly raised during the first few days.
Avoiding very hot, hard or irritant foods during the first week.
Keeping the mouth scrupulously clean with antiseptic mouthwash and gentle brushing.
Avoiding strenuous physical activity for 7 days.
Not smoking or drinking alcohol while healing.
Slight swelling or internal bruising can appear in some cases, although most often the swelling is minor and allows an immediate return to work. Pain is usually minimal and controlled with ordinary painkillers if needed.
When are the results noticeable?
The first effects of buccal fat removal begin to be noticeable from the third week, but the final result should not be judged before six months. This is because of the natural process by which the skin retracts and the tissue adapts.
The result is gradual, natural and permanent. It is important, however, to keep your weight stable and your habits healthy, since significant changes in weight can affect the balance achieved by the operation.
What risks are there and how are they kept to a minimum?
Like any operation, buccal fat removal carries certain risks, although they are very uncommon when the procedure is carried out by experienced professionals in a proper clinical setting. The possible complications include:
Internal bruising.
Local infection.
Injury to the parotid duct or to nearby nerves.
Facial asymmetry if unequal amounts are removed.
To keep any risk to a minimum, at the Instituto de Cirugía Plástica del Mediterráneo we follow strict protocols of asepsis, surgical precision and postoperative follow-up. The plastic surgeon who performs this operation specialises in facial surgery and has extensive experience in advanced surgical anatomy.
What has been measured and what has not, yet
Buccal fat removal has become popular faster than it has been studied, so it is worth separating clearly what the literature has measured from what it has not.
What has been measured comes from a systematic review of four studies and 134 procedures:
The volume removed is small and fairly consistent: 2.74 mL on average, with a range of 1.8 to 4.9. That is a little over half a teaspoon per side.
Short-term satisfaction is high: 84.6% described their facial contour as “much better” and the remaining 15.4% as “better”.
Seven complications were recorded across 134 operations, all minor, with no injury to the parotid duct or the facial nerve.
What has not been measured is stated plainly by the other systematic review available: no study has assessed facial ageing or long-term effects. It is not that harm has been demonstrated; it is that it has not been studied, and that distinction matters.
From that asymmetry comes our criterion, which is the one we would apply to any young technique: remove exactly the right amount and choose the patient carefully. A face that already has little fullness in the cheek does not gain definition by having more taken away, and time subtracts volume of its own accord. In a full face, by contrast, the effect is exactly what is wanted and the volume removed is so modest that it is hard to overdo. That is why this operation is decided on examination, not from a photograph.
Buccal fat removal is a technique that requires a deep knowledge of facial anatomy. It is not a minor operation or a superficial aesthetic treatment. Performing it without proper analysis can compromise the aesthetic result or cause complications in the medium term.
Choosing a clinic with experience in facial plastic surgery, such as the Instituto de Cirugía Plástica del Mediterráneo, ensures the procedure is carried out to the highest standards of safety, precision and support. Every patient also receives an individual plan, both for the assessment and for the follow-up.
We have advanced technology for facial planning, protocols for quick recovery and an accessible medical team that responds promptly to any question or need during the process.
Detailed guides on buccal fat removal
These guides expand on what is summarised on this page:
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions about buccal fat removal
Does buccal fat removal leave scars? No. The incision is internal, on the inner surface of the cheek, so there are no visible marks.
Can I go back to work the next day? Yes, in most cases no time off is needed, provided the aftercare is followed.
Can the operation be repeated? It is not usually necessary. The removal is permanent and the fat taken out does not grow back.
Is it indicated over the age of 50? Only where there is good muscle tone and skin elasticity and a very good facial structure. In other cases it can be combined with a facelift or rejuvenation techniques.
What results can I expect? A slimmer face, with greater projection of the cheekbone and a more defined jawline.
Buccal fat removal is an effective and safe solution for anyone wanting to improve the proportions of their face by reducing the prominence of the cheeks, with no visible scars. It is a straightforward procedure, with quick recovery and lasting results.
At the Instituto de Cirugía Plástica del Mediterráneo in Valencia we offer you a team of specialists in facial aesthetic surgery with extensive experience. If you want to know whether you are a candidate for buccal fat removal, or you need more information, you can request a first assessment consultation with no obligation. We will be glad to help you look your best.
Traboulsi-Garet B, Camps-Font O, Traboulsi-Garet M, Gay-Escoda C.Buccal fat pad excision for cheek refinement: A systematic review. Med Oral Patol Oral Cir Bucal. 2021;26(4):e474-e481. PMID 34023838 — 134 procedures: a mean volume removed of 2.74 mL, 84.6% reporting a “much better” contour and seven minor complications.
Moura LB, Spin JR, Spin-Neto R, Pereira-Filho VA.Buccal fat pad removal to improve facial aesthetics: an established technique? Med Oral Patol Oral Cir Bucal. 2018;23(4):e478-e484. PMID 29924767 — a systematic review: no study assessed facial ageing or long-term results.
To provide the best experiences, we use technologies like cookies to store and/or access device information. Consenting to these technologies will allow us to process data such as browsing behaviour or unique IDs on this site. Not consenting or withdrawing consent may adversely affect certain features and functions.
Functional
Always active
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
Preferences
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
Statistics
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
Marketing
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
