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If you inherited a round, chubby, or childish facial structure, your look can be enhanced with a customized facial procedure called buccal fat removal. A rounded facial structure — a “baby face” or “chipmunk cheeks” — can make you look heavier, even if you are slim and in good physical condition.

What is a buccal fat pad?

The buccal fat pad is a separate pad of facial fat that has a significant impact on your facial appearance. When this fat pad is overly large, it creates a round, flat, or chubby facial appearance. Removing this fat pad can create a more elegant, chiseled look.

What is buccal fat pad removal?

Buccal fat removal is a minimally invasive procedure that creates a more sculpted facial profile. Dr. Mesa performs this procedure with local anesthesia, with the incisions placed within the mouth. The fat pad is surgically removed to create a more structured, V-shaped facial appearance. The V-shape is universally recognized as a factor in human attraction, and can be yours with this minor surgery.

How do I prepare for a buccal fat excision surgery?

Once the buccal fat removal surgery has been scheduled, Dr. Mesa’s staff will give you a complete set of written aftercare instructions; follow them closely for proper healing. In general, these are the main points a patient should remember to ensure a smooth procedure and recovery process:

  • Avoid any medications and oral supplements thin the blood and therefore increase the risk of bruising (e.g., aspirin, ibuprofen, Motrin, Advil, fish oil, omega oils, multivitamins, etc.)
  • Fill prescriptions for antibiotics before the day of your surgery.
  • Fill out your medical-grade oral mouthwash and use it after every meal for one week to avoid food to be trapped close to the incision and decrease the risk of infection.
  • Drink one bottle of Gatorade the night before the surgery and a second one the morning before the procedure to make sure you are hydrated, so the buccal fat removal is easier).
  • Avoid eating any hard food like chips, Doritos, crackers, etc., since they could pull the dissolvable stitches inside the mouth.
  • Schedule your two follow-up appointments with Mesa and add these on your calendar so you don’t miss your visits.

How is the buccal fat removal surgery performed?

Dr. Mesa routinely performs the buccal fat removal procedure at his office-based operating room. It is performed with local anesthesia without any type of sedation (neither oral nor IV sedation), and is an outpatient procedure.

If you are very nervous, Dr. Mesa can perform the procedure under general anesthesia or IV sedation, but this is not needed to stay comfortable. The procedure takes less than one hour from start to finish.

The process is as follows:

  • Dr. Mesa will place a mouth retractor similar to the one used at the dentist. 
  • A small incision is made between inside the mouth near the second molar tooth. 
  • The incision is gently opened. This allows the buccal fat to present itself between the masticatory muscle called masseter and the soft tissue of the cheek.
  • Through this incision, Dr. Mesa will gently tease the buccal fat pad out, as it flows freely out of the incision as yolk from an egg.
  • The right amount of buccal fat is removed, sculpting the cheek to a slender, pleasing contour.

Once the buccal fat has been excised, the small incision is closed dissolvable sutures. These absorbable sutures allow for proper healing of the incision. The oral incisions heal quickly. Any resulting scars are hidden on the inside of the mouth, completely hidden from view.

Who is a good candidate for buccal fat removal?

The ideal candidates for buccal fat excision surgery are both men and women with excessive fullness in the lower cheek area, round face, chubby cheeks, or chipmunk cheeks who would like to have a more sculpted, refined, chiseled facial structure. This video will help you understand who could be a good candidate for buccal fat removal:

Why is a “V-shaped” face a universal standard of attraction?

Human attraction has been the subject of many scientific studies. Across all cultures, a V-shaped face is considered the ideal — however, not everyone is lucky enough to be born with this trait. Many ethnicities have a rounder facial look. A V-shape, or V-line facial structure, is a slim, oval face shape that narrows to the chin, along with a defined jawline. The human eye recognizes this facial shape as being attractive both in men and women. If you inherited a rounded face and want to achieve a more structured, chiseled look, buccal fat pad removal may be the ideal procedure for you. The procedure, when performed by Dr. Mesa, is fast and painless. These images will provide you with an idea of what to expect:

How large is the buccal fat pad?

The size of the buccal fat pad varies from patient to patient. Buccal fat pads are typically half the size of a ping-pong ball or the size of a teaspoon. This amount of fat pad may not seem like much excess, but in the face, it is enough to remove the fullness of the lower cheeks and contour the overall face.

Why choose Dr. Mesa for buccal fat removal?

Dr. Mesa is a leading cosmetic plastic surgeon practicing in NYC, with offices in New Jersey and Miami. His experience and surgical techniques have led to a reputation as being the top practitioner for buccal fat pad removal. When you’re under the care of Dr. Mesa, you can expect a different kind of experience: pleasant, warm, and completely dedicated to helping you look and feel your best. Patients trust him to achieve exceptional results, and for the strong doctor-patient bond created. As a Harvard-educated medical professional with hundreds of excellent reviews, Dr. Mesa is considered to be among the most accomplished plastic surgeons practicing in NYC and beyond.

What are the benefits of removing the buccal fat pad?

Your facial structure is one of the most significant aspects of the first impression you make on other people — whether socially, in business, or when seeking a relationship. If you have a round face, you may feel less confident or be treated differently due to others seeing you as young or inexperienced. The benefits of buccal fat pad removal surgery include:

  • Creates a more defined, sculpted facial structure
  • Creates a slimmer facial appearance
  • Subtly thins the cheeks
  • Enhances the contour of the cheekbones
  • Makes you appear thinner
  • Increases your self-confidence 
  • Changes how others see you
  • Creates a more sculpted elegant facial profile
  • Ideal for both men and women with round faces
  • Creates a more V-shaped facial structure

How long does the buccal fat excision take?

Buccal fat removal is a relatively short procedure and performed in-office. The entire process can take as little as 30 minutes to complete, and recovery time is minimal. Different from other surgeons, Dr. Mesa performs the procedure under pure local anesthetic without sedation to ensure patients can commute to the office, driving themselves, or using public transportation without the need of a companion to maintain the privacy of the procedure.

What is the recovery after buccal fat removal surgery?

There is minimal downtime after a buccal fat excision surgery for 90% of the patients. It is normal to experience some minimal swelling for a few days. The cheeks could appear fuller than before, but this subsides as the swelling goes away.

Bruising may occur but is extremely rare. The recovery is virtually pain-free. Most patients can return to work or school the next day. You should begin to see thinning in your cheeks within four weeks after your buccal fat removal surgery. In 10% of the patients, the swelling is significant, and it could last up to one week. In those cases, Dr. Mesa recommends continuing to ice the cheeks until the swelling subsides. Dr. Mesa will request that you avoid vigorous exercise or activities for one to two weeks after the procedure.

Dr. Mesa

Should stitches from buccal fat removal be removed?

No, stitches don’t need to be removed. Dr. Mesa places dissolvable stitches to close the small incisions made inside the mouth to remove the buccal fat pads. The stitches self-dissolve in about two weeks.

Dr. Mesa

How long will the results of buccal fat removal last?

Buccal fat removal lasts a lifetime. Once the buccal fat is removed, it never comes back. 

FAQ

What are the causes of a full, round face?

In most cases, a rounder facial look is inherited through your family line. This trait is typically impossible to change with diet or exercise.

Can I improve my “chipmunk cheeks” (chubby cheeks) with another procedure other than buccal fat excision, such as liposuction?

Buccal fat (Bichat’s fat or buccal fat pad) is a distinct encased fat pad within each the cheeks, located underneath the deep tissues that can’t be accessed easily with a liposuction cannula. Liposuction and skin tightening techniques don’t work as they do on other parts of the body.

At what age can a buccal fat excision be performed?

Candidates for buccal fat removal are patients of all ages. Patients from their 20’s to their 60’s can benefit from this facial sculpting procedure.

Does the buccal fat removal procedure hurt?

This procedure does not hurt. When performed by Dr. Mesa under local anesthesia you will feel a pulling sensation, but no pain or discomfort.

Can I add other procedures to my buccal fat removal?

When you’re under the care of Dr. Mesa, he performs a thorough evaluation of your facial structure, and may recommend added procedures to help you achieve your aesthetic goals. However, he will never pressure you to undergo a surgery or procedure you don’t need, which often occurs in other surgical practices. You may choose to undergo additional treatments during your buccal fat removal, including enhancing your cheekbone size with dermal fillers or implants or surgically crafting a more defined jawline.

How much bruising occurs after buccal fat pad removal?

Since the incision is inside the mouth, bruising is minimal and not visible to others.

How soon can I go back to work or school after buccal fat excision surgery?

Most of the patients undergoing buccal fat removal surgery with Dr. Mesa typically feel fine after the procedure and return to work or school as early as the following day.

Do I need to stay in the hospital for buccal fat removal surgery?

No, you don’t. Buccal fat removal surgery with Dr. Mesa is an outpatient procedure. Therefore, you will be able to go home the same day, just right after the operation. Dr. Mesa performs the procedure with pure local anesthesia without oral or IV sedation. You can drive yourself safely to our office, and keep your procedure 100 percent confidential!

What are the potential risks of buccal fat removal surgery?

Buccal fat removal (cheek reduction surgery) is extremely safe. Dr. Mesa, a Harvard trained triple-fellowship-trained, board-certified plastic surgeon, performs hundreds of these procedures a year, so he is very skilled, further decreasing the risks of any complications. Some of the common risks of the procedure include swelling of the cheeks from one few days to a week. Bruising also may occur, especially if patients taking medications or oral supplements that thin the blood. Some of the rare complications include bleeding, poor healing, scarring, prolonged swelling, and asymmetry.

How much does buccal fat removal surgery cost?

The exact cost depends on several factors like location and type of anesthesia. The cost of the procedure varies if performed in New York City (Manhattan) or New Jersey. Also, the price varies if you would like it to be performed with local anesthesia or IV sedation. Please call our office to get an estimated quote based on your needs.

When will I see the results of buccal fat excision surgery?

Results start to appear at about the three-week mark following your procedure. The final results will become noticeable generally after six weeks when the swelling disappears. Your full results could take up to three or more months to fully settle in.

How soon can I schedule my buccal fat removal surgery?

To schedule your procedure, you need an initial consultation with Dr. Mesa to determine if you are a candidate for buccal fat removal surgery. If Dr. Mesa considers you a candidate, your procedure will be scheduled the next day. Since the surgery is relatively short (under an hour), Dr. Mesa may be able to perform it almost immediately.

Will buccal fat removal surgery affect the parotid gland salivary tube or muscles inside the cheeks, such as the masseter muscle or pterygoid muscles or other structures?

Dr. Mesa is a very skilled board-certified plastic surgeon that performs hundreds of buccal fat removal surgeries. During the procedure, Dr. Mesa avoids damage to the parotid gland salivary tube or those muscles.

Can anything be done to help prevent or decrease the swelling after buccal fat removal surgery?

Swelling after buccal fat removal surgery will occur, but it is minimal. Following Dr. Mesa’s post-procedure instructions will further reduce the swelling. Sleeping with your head elevated and wearing the compression bandage around the cheeks until the next day is the most critical measure to decrease the swelling.

Can buccal fat removal surgery be performed at the same time as other cosmetic procedures?

Buccal fat pad removal can be combined with various other cosmetic procedures. Dr. Mesa usually performs cheek augmentation with soft tissue fillers (like Voluma) to enhance the results of the buccal fat removal surgery. Other cosmetic plastic surgery procedures such as neck liposuction, eyelid lift (blepharoplasty), Fractora facial skin tightening, or other treatments can be performed at the same time.

What will friends and family notice after I get buccal fat removal surgery?

People would likely notice that your face looks noticeably thinner and more chiseled. They may wonder if you’ve lost weight recently due to diet or exercise.

Will medical insurance pay for buccal fat removal?

No. This is a cosmetic procedure, and insurance does not cover it. Our office offers financing options, and we are happy to provide you the information in our business office.

Do you finance buccal fat removal surgery?

Yes, Dr. Mesa offers financing options. Buccal fat removal surgery can be paid with cash, all credit cards, and cashiers checks. Dr. Mesa offers medical financing for buccal fat removal surgery through two companies: CareCredit and Alphaeon Credit

I have been told that buccal fat removal will make me look older. Is that right?

Doctors who try to criticize buccal fat reduction are not familiar with the procedure or not trained in how to perform buccal fat removal. They will state that as you age, “you need that fat” because “old people all have sunken faces.”

Buccal fat removal will not make you old if you have good cheekbones. Cheekbones are the support of the mid and lower face. If the cheekbones are prominent, the face will not look aged after buccal fat removal. However, if the cheekbones are weak and buccal fat removal is performed, it could make you look older.

Dr. Mesa always evaluates the cheekbones on patients interested in buccal fat removal. If the cheekbones are weak, he recommends enhancing them with either soft tissue fillers or cheek implants. If the cheekbones are very weak, Dr. Mesa will not perform the buccal fat removal unless the cheekbones are enhanced, to prevent an older appearance after the procedure.

Are there any diet restrictions after buccal fat removal?

Technically there are no diet restrictions after buccal fat removal. Right after surgery, Dr. Mesa recommends not to eat or drink any food hot in temperature like hot tea, hot coffee, hot soups, etc. for four hours after surgery. As the mouth is numbed due to local anesthesia (for approximately four hours), the patient may burn themselves while eating or drinking hot food while the effect of the local anesthetic is active. Afterward, you can eat any foods, except those with hard edges like Doritos, crackers, etc. that could “cut” the stitches inside the mouth and therefore cause the surgical wounds to open up. Dr. Mesa does not recommend a liquid diet after buccal fat removal surgery since it is unnecessary.

Dr. Mesa

Will buccal fat removal make me look old?

Are there any diet restrictions after buccal fat removal?

Is Dr. Mesa trained to perform buccal fat removal?

Dr. Mesa’s credentials confirm that he is trained to perform buccal fat removal. Dr. Mesa is a Harvard-trained board-certified plastic surgeon. In addition to his plastic surgery residency training, Dr. Mesa pursued a fellowship sub-specialization in craniofacial surgery (reconstruction of the pediatric and adult face) at the prestigious University of Michigan in Ann Arbor, Michigan. Then he pursued a second fellowship sub-specialization in aesthetic surgery (cosmetic surgery of the face and body) at the University of Alabama in Birmingham, Alabama. Therefore he is more than qualified to perform buccal fat removal. Additionally, his extensive experience in buccal fat removal in New York City and New Jersey makes him a buccal fat removal specialist.

Dr. Mesa

Why not go to dentists, obstetricians, internists, primary care physicians, or “cosmetologists” for buccal fat pad removal?

Practitioners like dentists and other doctors who are not formally residency-trained and board-certified to perform buccal fat pad removal have a higher rate of complications. The procedure is a side interest, not a treatment they’re certified to do all day long.

The most common complaints are a minimal improvement, asymmetries, “operated look,” etc.

Only a licensed professional with the knowledge, training, and skills required to achieve optimum results should perform buccal fat pad removal. Look for a plastic surgeon who is board-certified by the American Board of Plastic Surgery and who has completed training at the top residency and fellowship institutions. If you’re tired of your chubby cheeks and want to achieve a slimmer face, please call Dr. John Mesa’s office today to schedule your consultation.

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