The underlying difference is which plane the fat is in: buccal fat removal takes out deep fat — the buccal fat pads, between the masseter and the buccinator, neither visible nor palpable from outside; facial liposuction aspirates the subcutaneous fat, the layer just beneath the skin that forms the double chin.
Each therefore treats a different area: buccal fat removal slims the middle part of the cheek and brings out the cheekbones; liposuction defines the double chin, the jaw angle and the line of the neck.
The technique differs too: buccal fat removal is done through an incision inside the mouth, under local anaesthetic, in 30-60 minutes; liposuction with cannulas, through a minimal incision behind the ear or under the chin, under local anaesthetic or sedation, in 45-90 minutes. Both are day cases, but liposuction swells more at first.
The candidates do not coincide: buccal fat removal calls for a round face with no lax skin, a stable weight and an age band of 18 to 40; liposuction allows a wider range — 25 to 60 — and some associated laxity.
They are not mutually exclusive: where the excess is in both planes they are combined for a complete contour. In both the result is gradual — buccal fat removal is apparent at three weeks and final at six months; liposuction between two and three weeks, improving thereafter.
When a more defined face is the aim, with less volume in the lower part and greater harmony in its proportions, there are two operations that tend to be compared: buccal fat removal and facial liposuction. Although both set out to improve the facial contour and remove localised fat, they are different techniques, indicated for different cases and with results that answer to specific anatomical criteria.
At the Instituto de Cirugía Plástica del Mediterráneo, in Valencia, we carry out both operations with an individual approach. It is not a matter of choosing one or the other without a diagnosis, but of assessing which is the more suitable according to the distribution of the fat, the bone structure, the skin type and each patient’s aesthetic goals.
In this article we explain clearly and professionally the key differences between buccal fat removal and facial liposuction, their indications, the results to be expected and the criteria for choosing the more appropriate technique.
If what you are looking for is to slim the middle third of the face, the guide to buccal fat removal describes that route in detail.
Would you like to book a consultation to have your case assessed?
Buccal fat removal is a facial aesthetic operation consisting of the partial removal of the buccal fat pads. These pads are collections of deep fat in the middle part of the cheeks, between the masseter and buccinator muscles. Although they serve no vital function in adults, they can give the face excessive volume, particularly in people with a round facial structure.
Main aim: to reduce the volume of the cheeks from inside the mouth, producing a slimmer outline and bringing out the cheekbones.
Indicated in:
Round faces with prominent cheeks.
Younger people with good skin tone.
Patients who are not generally overweight.
What is facial liposuction?
Facial liposuction is a surgical technique that removes superficial subcutaneous fat built up in various areas of the face. Through fine cannulas, the surgeon aspirates the fatty tissue from areas such as the chin, the double chin, the lower cheeks or the jaw.
Main aim: to sculpt the facial contour by removing localised fat in the subcutaneous layer, improving the definition of the lower third of the face.
Indicated in:
Patients with visible subcutaneous fat.
People with a double chin, heavy cheeks or loss of jaw definition, but without excessive skin laxity.
Patients with a stable weight but with localised collections of fat.
Anatomical differences: deep fat vs subcutaneous fat
One of the most relevant points in understanding the difference between the two procedures is the anatomical plane worked on:
Buccal fat removal: acts on the deep fat of the cheek (the buccal fat pads), neither visible nor palpable from outside. It lies between the chewing muscles.
Facial liposuction: removes subcutaneous fat, that is, the fatty tissue immediately beneath the skin. It is the fat that creates a double chin or superficial bulges.
The choice therefore depends on where the excess volume lies: if it is in the deep layer, buccal fat removal is indicated; if it is at the surface, liposuction is the option.
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.
Differences in the surgical technique
Buccal fat removal:
An incision inside the mouth (not visible).
No cannulas or suction needed.
Carried out under local anaesthetic.
Duration: 30 to 60 minutes.
Quick recovery, in 1 to 2 days.
Facial liposuction:
A minimal incision behind the ear or under the chin.
Uses cannulas to aspirate fat.
May require local anaesthetic or sedation.
Duration: 45 to 90 minutes.
May produce bruising or swelling for longer.
Both techniques are day cases, but liposuction can produce more swelling at first because of the disturbance to the subcutaneous tissue.
Differences in the results
Buccal fat removal:
Slims the middle part of the face.
Brings out the cheekbones and refines the oval of the face.
Subtle, gradual results: visible at 3 weeks and final at 6 months.
Ideal for achieving a “V”-shaped face.
Facial liposuction:
Reduces the double chin and volume in the lower third of the face.
Defines the jaw angle and the line of the neck.
Subtle results, visible after 2 to 3 weeks, improving gradually.
Ideal for redefining the neck and the outline of the jaw.
It is worth stressing that they are not mutually exclusive procedures. In many cases they can be combined to achieve a complete, harmonious contour.
How much volume each one actually moves
The comparison between the two is usually made in the abstract — “deep” against “superficial” — and it becomes a good deal clearer once a figure is put on the table.
With buccal fat removal, what is taken out has been measured: 2.74 mL on average, with a range of 1.8 to 4.9, in the systematic review that brought together 134 procedures. A little over half a teaspoon per side. And it is not an amount decided as you go along: it is the accessible portion of a specific anatomical structure, the buccal fat pad, which is where it is and is the size it is.
That is the underlying difference from facial liposuction, which works on subcutaneous fat: a continuous layer, with no anatomical boundaries of its own, whose quantity depends on each face and on how much is aspirated. One acts on a defined piece; the other on a sheet.
That distinction has three very practical consequences:
The ceiling of the result. Buccal fat removal gives what it gives. You cannot press on for more definition, because there is no more piece to remove.
Where it shows. Being deep, it slims the middle third without acting on the surface of the skin; liposuction, being superficial, also depends on how that skin redistributes and adapts.
Restraint. Neither is reversible, so with both, moderation is worth more than ambition. With one addition for buccal fat removal: no study has yet assessed how an operated face ages in the long term, so removing just enough is not timidity, it is judgement.
Differences in the ideal candidates
The patient profile for buccal fat removal:
Aged between 18 and 40.
No lax skin.
Round cheeks with no excess superficial fat.
A stable body weight.
The patient profile for facial liposuction:
A collection of fat in the double chin or the jaw.
Skin with some elasticity, although it can also be combined with skin tightening.
There may be slight associated laxity.
A wider age range, between 25 and 60.
In every case a medical assessment is essential in determining the origin of the facial volume and its distribution.
Differences in the risks and the recovery
Buccal fat removal: generally low risk, with no visible scars and no significant discomfort. There may be slight swelling, which settles within a few days.
Facial liposuction: also carries certain risks, but requires closer postoperative monitoring. There may be bruising, seromas or temporary changes in sensation.
Both procedures should be carried out by surgeons specialising in facial aesthetics, with a command of the anatomy and of the surgical planes, to avoid complications.
There is no technique that is better in absolute terms. It all depends on the type of face, the aesthetic goal and the distribution of facial fat.
If the problem is in the middle of the cheeks, with internal volume and no laxity: buccal fat removal.
If the excess fat is in the double chin, the jawline or under the chin: facial liposuction.
If complete definition of the face is wanted: a combination of both techniques, adapted to the clinical diagnosis.
At the Instituto de Cirugía Plástica del Mediterráneo we assess each case individually. We use medical photography, analysis of proportions and digital planning tools to design the best surgical strategy for your face.
Buccal fat removal and facial liposuction are different but complementary procedures that slim the face and improve its harmony. While the first acts in the deep plane, removing fat from the cheeks, the second shapes the superficial areas of the neck and jaw.
With the right diagnosis and a specialist medical team, both procedures give safe, lasting and natural results, with no need for fillers or continuing treatments.
If you want to improve the appearance of your face, bring out your cheekbones or define your jaw, we invite you to request a consultation at our clinic in Valencia. We will be glad to help you choose the option that suits you best, backed by surgery that is ethical, precise and tailored to your face.
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What is the underlying difference between the two?
The plane the fat is in. Buccal fat removal takes out deep fat — the buccal fat pads, between the masseter and the buccinator, neither visible nor palpable from outside; facial liposuction aspirates the subcutaneous fat, the layer just beneath the skin that forms the double chin.
Which area does each one slim?
Buccal fat removal slims the middle of the cheek and enhances the cheekbones, towards a V-shaped face. Liposuction defines the double chin, the jaw angle and the neckline, that is, the lower third of the face.
How is each one done?
Buccal fat removal, through an incision inside the mouth — not visible, with no scar on the skin — under local anaesthetic and in 30 to 60 minutes. Liposuction, with cannulas through a minimal incision hidden behind the ear or under the chin, under local anaesthetic or sedation and in 45 to 90 minutes. Both are day cases, although liposuction swells more at first.
How much fat is removed in a buccal fat removal?
It has been measured: 2.74 mL on average, ranging from 1.8 to 4.9, according to the systematic review that gathered 134 procedures. A little over half a teaspoon per side. And it is not an amount decided on the spot: it is the accessible portion of a specific anatomical structure that is where it is and measures what it measures.
Can I ask for more to be removed so it shows more?
No. Buccal fat removal gives what it gives: you cannot press for more definition because there is no more to remove. Liposuction, by contrast, works on a continuous layer with no anatomical limits of its own, whose amount depends on each face and on how much is aspirated. One acts on a defined piece; the other on a blanket.
Are they reversible?
Neither of them. That is why in both restraint is worth more than ambition. With one addition for buccal fat removal: no study has yet assessed how the operated face ages in the long term, so removing just enough is not timidity, it is judgement.
Who is a candidate for each?
For buccal fat removal: a round face with prominent cheeks, no slack skin, stable body weight and an age range of 18 to 40. For facial liposuction: a build-up of fat under the chin or jaw, skin with some elasticity — it tolerates a degree of laxity — and a wider age range, 25 to 60.
Can they be combined?
Yes. They are not mutually exclusive: when the excess is in both planes they are combined to achieve a complete, harmonious contour.
When is the result visible?
In both it is progressive. Buccal fat removal shows at 3 weeks and is definitive at 6 months. Liposuction, between 2 and 3 weeks, with continued improvement.
What are the risks of each?
Buccal fat removal carries a low risk generally, with no visible scars and mild swelling that settles within a few days. Liposuction needs closer post-operative monitoring: there can be bruising, seromas or temporary changes in sensation.
So which is better?
There is no better in absolute terms. If the volume is in the mid-cheeks, internal and with no slackness: buccal fat removal. If the excess is under the chin, along the jaw or below the chin: facial liposuction. The first thing decided at the consultation is the plane, not the technique: removing the wrong structure does not correct the problem.
Sources
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 — a mean volume removed of 2.74 ± 0.69 mL (range 1.8-4.9) across 134 procedures.
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 — no study has assessed facial ageing or long-term effects.
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