Buccal Fat Removal for Jowls: Is it a Good Idea?

by: Linda Robison / Facial Fitness Specialist @ ABZ

Can Buccal fat excision (cheek reduction) really fix sagging jowls? Could it age your face? Is it right for you? 

Buccal fat removal for jowls: While this surgery is not primarily intended to address sagging jowls, it can help achieve a more contoured and sculpted appearance in the cheek area. 

In this article, we'll cover:

  • what is buccal fat
  • how this cheek reduction surgery works
  • how it affects the jowls
  • safety and side effects
  • who isn't a good candidate for this surgery
chrissy Teigen Buccal Fat Pad RemovalBuccal fat removal surgery has become a "trendy" cosmetic procedure among celebrities like Chrissy Teigen

What and where are buccal fat pads

where is your buccal fat

Buccal fat is a small-rounded fat pad located on each side of your lower cheeks. It's found deep beneath the skin, close to your mouth.

These fat pads give your cheeks a full, rounded and sometimes a youthful appearance.

The amount of buccal fat can vary from person to person and can affect the shape of your face.

Some people may have more buccal fat, resulting in fuller, rounded, or puffier, (think chipmunk cheeks). While others may have less, leading to a slimmer looking face.

What is Bichectomy: Buccal fat removal surgery

buccal fat surgeryBuccal fat diagram.

The proper term for buccal fat excision or cheek reduction is called Bichectomy. It's a cosmetic procedure that removes the small fat pads located in the lower cheeks, between the cheekbones and jawline. 

How is it done:

A surgeon makes tiny incisions inside the cheek and carefully cuts out a portion of the buccal fat pads from each cheek.

The patient is given local anesthesia and is usually awake during the procedure. However, it can be uncomfortable because the anesthesia does not fully number the inside of the cheek.

What Does It Do?

Lea Michele speculation of buccal fat removal??Some speculate that celebrity Lea Michele had cheek reduction surgery based on the hollows under her cheek bones that weren't there before. However, this has not been confirmed.

The original purpose was to help reduce excess fullness, puffy or "chipmunk" cheeks. Creating a more contoured, slimmer appearance in the mid-face area. And for some face shapes, it can highlight cheekbones and jawlines. 

It works best on those with excessively chubby or rounded cheeks who desire a more defined cheekbones and jawline.

If done on the wrong person or the surgeon is too aggressive and removed too much fat, it can cause a gaunt, aging appearance.

However, it's become a trendy cosmetic procedure amongst celebrities (who may not have issues with puffy cheeks) seeking to achieve a more chiseled and sculpted look.

Does buccal fat grow back

No, buccal fat does not grow back once it's been surgically removed. That's why it's important to carefully weigh the pros and cons of this procedure.

Facial fat changes naturally as we age, and fluctuations in weight can also impact how your face will appear in the future.

Is buccal fat removal for jowls?

Not really.

Some people mistakenly believe that treating chubby cheeks can also fix sagging jowls because both issues affect the lower part of the face.

However, excess buccal fat and the development of jowls are two diffe things.

Difference between excess buccal fat and saggy jowls

Excessively chubby cheeks: 

  • Are primarily caused by larger buccal fat pads. The fullness is located in the upper-mid face area near the cheeks, giving the face a rounded or "baby-face" look.
  • Best treatment for this issue is to remove excess buccal fat.

Sagging jowls:

  • Are due to sagging skin, not too much fat. As people age, skin loses its elasticity, and natural facial fat pads start to shrink. This leads to sagging, drooping and fullness at the bottom of the face along the jawline and under the chin. This can cause the face to look tired or older.
  • Best treatment for jowls include procedures to lift and tighten like facelifts, thread lifts, dermal fillers. Jowl exercises can help prevent and fix age related dropping, to a degree. Face exercises can help create a youthful, slimmer lower face. 

Is the problem due too much fat or loose skin

It's easy to see why these two facial issues can cause confusion. Both cause excessive facial fullness. However, large fat pads in the cheeks creates fullness in the mid-face area. 

On the other hand, jowls (due to loose, sagging skin) cause fullness in the lower face area, around the jawline, chin, and neck.

Buccal fat and aging

There is some controversy over this very popular cheek reduction surgery. Some plastic surgeons feel that since these fat pads have no impact on the support of the overall face, it should not cause an aged look.

And, some even feel that leaving the fat pads in place will, over time, pull down the mid-face area, leading to signs of aging.

Other surgeons disagree.

According to an article in Plasticsurgery.org, facial fat is precious, and it's what gives the face a youthful appearance.

Buccal fat remains relatively stable throughout life. But facial fat atrophies with age. So removing buccal fat may look good when you're 20 and have plenty of facial fat.

But, when you're older (40s, 50s, and 60s) and your normal facial fat pads begin to shrink, you may look gaunt or prematurely aged.

Side-effects of buccal fat removal: Bichectomy Surgery

Bichectomy Gone Wrong?

According to Dr. Gary Linkov, a NYC double board-certified facial plastic surgeon, the buccal fat pad is connected to very important parts of your face and mouth, such as:

  • the parotid duct which carries saliva to your mouth, helps you swallow your food easily
  • the facial nerve, controlling facial muscles
  • the maxillary artery. This is a major blood vessel that supplies blood to parts of your face like muscles, skin, and teeth.

Side effects include:

  • infection
  • scarring
  • bruising
  • swelling
  • asymmetry

Buccal fat pad removal: Cost

The cost of buccal fat pad removal can vary based on several factors, including:

  • the location of doctor
  • the experience of the doctor
  • where the procedure is done, in a hospital or your doctor's office
  • additional fees, like anesthesia

The average cost of buccal fat pad removal can range from $2,000 to $5,000 or more.

Who is not a good candidate

For obvious reasons, people with narrow or very thin faces are not candidates for this surgery.

Also, most older people are not considered good candidates for several reasons:

1. Loss of Facial Fat Pads: As people age, facial fat naturally shrinks and shifts. So the area around the upper face and cheeks thins out or become hollowed. Removing buccal fat pads will only result in a more gaunt or hollowed-out appearance.

2. Skin Elasticity: With age, skin becomes less firm and looses elasticity. Removing facial fat will likely make the skin sag even more, making one look older.

Final Point: The face keeps changing as we grow older. So removing fat may seem like a good idea when we're young. But it's important to remember that facial fat is your friend and can help prevent you from looking saggy and gaunt.

That's why I'm a huge advocate of facial exercises, which can help keep those precious fat pads in place! 😊 See my before and after pictures here.



FAQ: Buccal fat removal for jowls

Q: Does buccal fat grow back

A: No, it does not grow back. So it's important that it's right for your face shape and the surgeon is not too aggressive and remove too much fat.

Q: What surgery removes sagging jowls?

A: A facelift is the best surgical choice to improve the visible signs of aging in the lower face and neck, including sagging jowls

Q: How can you reverse sagging jowls?

A: Surgical procedures like neck or lower face lifts can tighten the skin and reduce sagging.

Non-surgical options, such as thermage, lasers, and peels, can help tighten the skin a bit. 

You could also try jowl exercises as part of a face exercise workout. 

Q: Which celebrities had buccal fat removal?

A: The only celebrity that's admitted to having bichectomy surgery is Chrissy Teigen. However, it's speculated that Lea Michele, Bella Hadid, Zoë Kravitz, Anya Taylor-Joy and Eiza Gonzalez all had this done too.

Q: Why would I regret getting my buccal fat removed?

A: Aside from possible side-effects, it could make you look older. Maybe not when you're young, but later when your natural fat pads thin out.

If you don't have excess buccal fat, removing it could cause you to look older faster. It's best to consult with a plastic surgeon.

Q: What's the price for buccal fat pad removal surgery?

A: The cost of bichectomy surgery typically ranges from $2,000 to $6,000, with some cases possibly being more expensive. Keep in mind that prices can vary depending on your location.



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chrissy teign buccal fat