Buccal fat removal surgery helps an individual not only the appearance of the cheeks but brings more harmony to the overall facial shape. For patients with an overly full, round or chubby face, removing the buccal fat pads results in a more sculpted, slim and symmetrical facial appearance.
Buccal fat removal or buccal fat pad extraction is an aesthetic facial surgery procedure for reducing prominent cheeks by the proportional removal of the buccal fat pad tissue. It is helpful to maintain permanent contour to v shape of the face. This surgery for cheeks needs strategic removal of the correct amount of buccal fat from the lower part of the cheeks to define more facial angles.
Buccal fat removal surgery is performed from the inside of the mouth. Therefore, it does not result in visible scars from the outside. Although the surgery is easy and quick, the success of the results depends on appropriate indications for the procedure. Therefore, not all patients are eligible for this surgery.
Table of Contents
What is buccal fat?
Buccal fat can cause a person to have chubby or chipmunk cheeks. There are several reasons for this condition.
• Overweight
• Genetic predisposition
• Poor diet
• Lack of exercise
• Lack of sleep
• Overall bone structure and muscles in the face
During the buccal fat removal surgery, a trigone-shaped, encapsulated fat mass is removed from your cheeks. This fat mass is called buccal fat pad or Bichat’s pad. These tissues are deeply located on either side of the face between facial muscles.
The buccal fat pad is 6 mm in thickness and usually 3.9 g in weight. It is composed of a lobulated body and four processes. It has a rich blood supply from branches of the maxillary artery, facial artery, and transverse facial artery. Additionally, it is associated with the structures such as the buccal branch of the facial nerve and parotid duct.
The primary functions of this buccal fat are
• To protect sensitive structures such as facial vessels and nerves.
• Fill the deep tissue spaces.
• Acts as gliding pads during the contractions of masticatory muscles.
Who are the candidates?
• A younger patient with good health
• A person with Overly full round chubby cheeks
• A non-smoking person with good physical health
• A person with a healthy weight
• A person who is bothered by the appearance of their round cheeks
• A person who is realistic about the goals of the surgery
• A person with a positive attitude about the procedure and the results.
A person who meets the above qualifications can achieve the desired results from this surgery.
Buccal fat removal surgery procedure
Buccal fat removal surgery or bichectomy is an aesthetic surgical procedure that removes fat pads in your cheeks. It is also known as buccal lipectomy. It is a relatively safe and less complicated surgery if performed by trained and experienced professionals. Before removing the buccal fat, the surgeon should fully explain the different issues regarding the surgery to the patient.
• Results that can and cannot be obtained through the surgery
• Inherent risks
• Cost for the surgery
• Possible infections and bleeding that can happen after surgery
After completing necessary oral clinical assessments, the patient is evaluated for laboratory tests such as complete blood count, fasting blood glucose test and coagulation test.
The surgery is performed using either local anesthesia or intravenous sedation. Additionally, it should be performed with careful attention to anatomical structures. The main reference point for surgical access is the location of the parotid duct.
• An intraoral incision about 1.5 cm long is made in the oral mucosa. It should be immediately under and slightly behind the parotid duct.
• The anatomic planes are carefully dissected with forceps without damaging the sensitive structures such as the facial artery branches, parotid duct and facial nerve.
• The surrounding capsule is delicately incised to remove the fat pad.
• The removal of the fat pad is limited to 2/3 of its total volume.
• Incision is closed using sutures.
• This surgery typically takes 30 minutes to complete.
• Photographs are taken before and after the surgery at 3, 6 and 12 months to evaluate the results.
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Recovery after buccal fat removal
Recovery from buccal fat removal surgery is relatively short, and the incision is dissolved in 10 days. You can expect considerable swelling for a week after surgery. There is no harm in doing your day to day activities as usual, but taking some social downtime is advisable until the swelling goes down. Applying ice packs to your cheeks for the first three days and drinking ice water is also helpful.
Whistle recovering from the surgery, do not eat solid and acidic foods. Instead, drink more liquids such as water. Also, you should not return to your usual diet suddenly. First, take some soft foods and then gradually progress to solid foods. It can take up to three weeks for you to fully recover. During this time, you should follow the instructions properly that was given by your doctor. If you experience some unbearable pain, you should immediately inform your doctor.
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Complications of fat pad removal
The buccal fat pad is surrounded by several important anatomical structures such as,
• The parotid gland duct
• Facial nerve branches
• Blood vessels
• Muscles
The complications of the buccal fat removal from a bichectomy are not frequent, but sometimes hematoma, infections, facial nerve and facial vessel injuries may occur.
Therefore, precise knowledge of this region is necessary to avoid possible complications such as,
• Parotid duct injury – swollen face due to salivary fluid retention, excessive pain
• Facial artery injury – abnormal degree of bleeding and bruises
• Uneven removal of the fat pads – facial asymmetry
• Facial nerve damage – numbness, changes in sensation and rarely facial muscle paralysis.
• Trauma to mastication muscles – limited movements of jaws.
• Negative reactions to anaesthesia
• Salivary gland damages
Removing too much fat cause your face to look gaunt. Therefore, it is advisable to choose a certified and experienced plastic surgeon who knows how to keep away from these risks.
Achieving thinner cheeks by buccal fat removal surgery is aesthetically successful, but this face region loses its fat masses naturally with age. Hence removal of those fat pads can cause someone to look more aged in their later life. The condition is worse if both fat pads are completely removed.
Benefits of buccal fat removal surgery
• The results are permanent even if you gain weight
• It takes a maximum of 30 minutes to complete
• The surgery is performed using only a small incision inside of the mouth. Therefore, do not leave any visible scars.
• Simple and easy surgery
• Low frequency of downtime
• Fast recovery; patients usually return to work three days after surgery
• Can be combined with other facial plastic surgery procedures
When done correctly, buccal fat removal gives a more mature, slim and V-shaped face.
Buccal fat removal cost
Usually Buccal fat removal costs about $2000 to $5000. But the price will depend on,
• Your location
• Surgeon’s level of experience
• Medications and follow-up needs
• Type of anaesthesia used
Since this is cosmetic surgery, it is not covered by your health insurance.
How to lose buccal fat naturally?
• Maintain your body weight by consuming a balanced diet and doing exercises
• Stay hydrated throughout the day. Drink 2 – 3 liters of water every day
• Face massages and exercises can be beneficial
• Reduce your alcohol intake. alcohol is full of calorie-rich carbs
• Get enough sleep every day to maintain good mental and physical health.
References and citations –
• Aesthetic Facial Surgery – By Juarez M. Avelar
• Integrated Procedures in Facial Cosmetic Surgery- By Seied Omid Keyhan
• Internet Guide to Cosmetic Surgery for Women – By M. Sandra Wood
• : http://www.rbcp.org.br/details/2208/bichectomy-and-its-contribution-to-facial-harmony
• : http://dx.doi.org/10.1590/1981-8637201800030000143488
• : https://www.webmd.com/beauty/what-to-know-buccal-fat-removal
• : https://juniperpublishers-dentistroralhealth.blogspot.com/2018/11/bichectomy- orbichatectomy-small-and.html
• : https://www.healthline.com/health/all-about-buccal-fat-removal-for-thinner-cheeks
