The sharp-cheeked look has taken over social media feeds and celebrity red carpets alike. But behind the sculpted selfies lies a procedure that’s far more nuanced than a simple fix. Here, top plastic surgeons weigh in on what buccal fat pad removal really involves—and whether it’s right for you.
What is buccal fat pad removal?
Buccal fat pad removal is a facial plastic surgery procedure that sculpts and slims the lower cheeks by removing fat pads from the inside of the mouth. The treatment promises a more contoured appearance, often enhancing the cheekbone-to-jawline definition that’s become synonymous with faces like Bella Hadid, Zoë Kravitz, and Chrissy Teigen, who publicly shared her own experience with the surgery in 2021.
“Patients might complain of excessive fullness or roundness of the face,” says Dr. Lara Devgan, a board-certified plastic surgeon based in New York City. “A beautiful face has natural topography—highlights at the cheekbones and jawline, and lowlights in the mid-cheek and neck.” Buccal fat removal, she explains, subtly enhances that contrast without dramatic downtime.
What happens during the procedure?
Performed under local anesthesia in most cases, the surgery is relatively quick and minimally invasive. A small incision—usually around 5mm—is made inside the cheek, allowing the surgeon to access and remove the buccal fat. The cut is closed with dissolvable stitches, and since it’s entirely internal, there are no visible scars.
“It’s a popular procedure because it has very little-to-no downtime,” says Dr. Kimberly Lee, a board-certified facial plastic surgeon based in Los Angeles. “You might experience a week of swelling or bruising, but it’s discreet and low-maintenance.” Importantly, most surgeons don’t remove the entire fat pad. “I always leave some behind to avoid an overly hollowed look. Everyone’s anatomy is different, and moderation is key,” she adds.
Who is the ideal candidate?
While buccal fat removal is considered safe, it’s not for everyone. Dr. Ben Talei, double board-certified plastic surgeon and founder of the Beverly Hills Center for Plastic Surgery, emphasizes the importance of careful screening. “On the wrong patient, buccal fat removal can age them ten to twenty years,” he warns. That’s because buccal fat provides foundational support to the face—and removing too much can lead to premature sagging, hollowness, and deepened folds.
Genetics plays a major role in determining who qualifies. According to Dr. Jason Roostaeian, a board-certified plastic surgeon and UCLA Associate Professor, people with dense, slowly rebounding buccal fat are the best candidates. “For these patients, removal can actually help delay the appearance of jowls as collagen decreases with age.”
For others, buccal fat reduction is used as a complementary procedure, paired with treatments like rhinoplasty, submental liposuction, or jawline fillers to create a more defined lower face. Devgan notes that at her practice, it’s often combined with cheek and chin augmentation for a complete facial harmonization.
What are the risks?
While complications are rare when the procedure is performed by an experienced surgeon, they can happen. “The main concern is over-resection—removing too much fat,” says Talei. “This can cause shadowing and hollowing in the cheeks that’s difficult to reverse.” Other potential, though uncommon, risks include injury to the facial nerve, salivary glands, or parotid duct.
Age is another key factor. “I’ve had older patients who had the procedure done in their twenties and later regretted it,” Roostaeian says. That’s because facial fat naturally diminishes over time, and removing it too early can lead to an aged appearance well before its time.
For those experiencing regret, the options are limited. Fat grafting—transplanting fat from another part of the body—is one possibility, though it’s technically challenging in this area. Some doctors also turn to bio-stimulatory fillers like Sculptra or low molecular weight dermal fillers to restore lost volume.
What does it cost?
The price of buccal fat removal can vary widely based on location, surgeon experience, and whether the procedure is combined with other treatments. In the U.S., it typically ranges from $2,000 to $15,000.
Because results are permanent, a thorough consultation is essential. Seek out a board-certified facial plastic surgeon whose aesthetic philosophy aligns with yours. Review their before-and-after gallery, and don’t hesitate to ask about long-term effects. While buccal fat removal may seem like a quick fix, its impact lasts for decades.
Are there alternatives?
For those wary of surgery, there are a few non-invasive ways to mimic the slimming effect. “While there’s no direct alternative to removing buccal fat, certain treatments can help contour the lower face,” says Lee. These include masseter Botox, which slims the jawline by reducing the size of the chewing muscles, and chin fillers that create the illusion of a more V-shaped face.
Other supportive treatments include radiofrequency microneedling (like Profound RF) to tighten sagging skin, and strategic facial contouring with hyaluronic acid fillers. Talei, however, advises against procedures like Kybella or facial liposuction in this area, citing risks of asymmetry and contour irregularities.
Ultimately, buccal fat removal is best suited for those with a specific genetic predisposition to cheek fullness and a stable facial structure. As Dr. Theda Kontis, president of the American Academy of Facial Plastic and Reconstructive Surgery, points out: “Intuitively, removing fat from the face is a bad idea because as we age, we lose facial volume. I spend a lot of time restoring that volume with fillers—especially in patients over 50.”
The final word
Buccal fat removal may be trending, but it’s not a decision to take lightly. While it can dramatically enhance facial definition for the right candidate, it also carries long-term implications. As with all cosmetic procedures, natural anatomy, age, and long-term goals must be considered—not just the current viral aesthetic. Before you take the plunge, consult with a board-certified surgeon, think carefully about how your face may change over time, and weigh your options. In beauty, as in life, sometimes less (intervention) really is more.
