New York Center for Facial Plastic Surgery
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When most people think of plastic surgery, the first things that come to mind are the most popular procedures of today: the rhinoplasty, the blepharoplasty (eyelid surgery), the lip lift, and, of course, the facelift>. This shouldn’t come as a surprise considering that, for decades, celebrities have undergone and passionately endorsed these tried-and-true nip-and-tucks.
Recently, though, lesser-known cosmetic procedures have gained their due traction. One of these is buccal fat reduction, which removes, and sometimes repositions, pads of fatty tissue around the cheekbones. It’s no secret that the cheeks are an exceedingly popular plastic surgery target—normally, they are amplified with hyaluronic acid-based dermal fillers—but rather than increasing their plumpness, buccal fat surgery reduces their volume and creates a more defined facial contour.
“For the uninitiated, buccal fat is part of a deep anatomical pocket that stretches from the temple to the cheek and has a massive impact on the face’s shape,” says Dr. Jacono. “Unfortunately, as we age, the buccal fat pads droop and make the lower part of the face appear wider. The goal of buccal fat surgery, then, is to trim and in some cases reposition the buccal fat to leave patients looking more chiseled. Of course, the procedure isn’t as simple as it sounds; buccal fat can’t be accessed with liposuction because it lies under the facial muscles and nerves, which can easily be damaged.”
Despite its dramatic effects, buccal fat surgery is a fast and minimally invasive procedure.
“The entire process takes about thirty minutes,” says Dr. Jacono. “It can be done under twilight or local anesthesia, and recovery doesn’t require an overnight stay in the hospital. The surgery can even be performed in a licensed ambulatory setting, or in an in-office operating room. I think that this lack of hassle is part of the reason why buccal fat reduction has become so popular.”
The procedural techniques are as follows: an incision is made within the mouth so that there are no visible scars, and through this opening, the surgeon enters the buccal space. Some doctors prefer to remove the entire fat pad, while others, including Dr. Jacono, choose to reposition it.
“To make a face look as natural as possible, it’s important to reduce and contour the buccal fat instead of completely excising it,” explains Dr. Jacono. “If the whole fat pad is removed, the face can look too hollow and ‘sucked-in.’”
Another option is to suspend the buccal fat in areas of the face that lack aesthetic volume; the nasolabial folds, for example, can be nicely filled. Because there is no need to process the fat as one would need to during a typical fat transfer procedure, this repositioning technique is quite effective.
Once the buccal fat has been adequately reshaped, incisions are closed with absorbable sutures.
Much like the procedure itself, buccal fat surgery’s recovery time is short.
“Most of my patients only take three days off from work,” says Dr. Jacono. “They’ll come in on a Friday and go back to work on Monday. Some of them experience a week or two of swelling and mild bruising, but this can be addressed with ice packs.”
Dr. Jacono also recommends an oral rinse to prevent infection at the site of surgery, as well as a primarily liquid diet that progresses to soft foods as soreness dissipates. Generally speaking, initial swelling will conceal results, but patients can expect to see a difference in a few weeks.
The best candidate for buccal fat surgery is a person who has a natural excessive fullness within their cheeks—in other words, someone who is dissatisfied with the roundness of their face. Taking this into account, not everyone qualifies for this procedure.
“Sometimes, prospective patients in their twenties ask me for a buccal fat reduction, even though they don’t have particularly round cheeks. I tell them that it’s not a good idea to go through with the surgery, as they might be sorry in a decade when their facial fat naturally begins to recede and causes them to look prematurely older.”
So, rather than rushing into surgery, Dr. Jacono recommends that all patients weigh the pros and cons of buccal fat removal—before scheduling an intake.
New York Center for Facial Plastic Surgery
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