In this post:

While buccal fat removal offers a contoured look, it carries significant risks, including facial asymmetry, nerve damage, and premature ageing.
Buccal fat removal gained popularity through social media, celebrity influence, and the shift toward hollow-cheek aesthetics. However, aesthetic trends change, and permanent procedures like this may leave patients regretting their decision in the long run.
Instead of surgery, non-invasive options like facial fillers, Botox for masseter reduction, thread lifts, and radiofrequency treatments provide temporary yet effective results.
Responsible practitioners should prioritise long-term patient well-being over fleeting beauty trends. At Smileworks Aesthetic Training HUB, we emphasise evidence-based, non-surgical alternatives and advanced training.

From lip filler to BBLs and even hip dip filler, we’ve seen time and time again how aesthetic treatment trends come and go. When one starts to drop in popularity, another treatment swoops into take its place. It’s an endless cycle. In early 2023, the aesthetic treatment of the moment was buccal fat removal.

While the trend has (for the most part) died down, you’ll still see the occasional post or TikTok scrutinising celebrity buccal fat removal before and after photos. However, behind this trend lies a more complex reality that every aesthetic medicine professional should understand.

As aesthetic practitioners, we have a responsibility to provide our patients with treatments that enhance their appearance while prioritising their long-term well-being. Does buccal fat removal do this properly? We’re about to find out.

At the Smileworks Aesthetic Training HUB, we believe in evidence-based practice and responsible aesthetic medicine. This is why in this blog post we’re taking a closer look at buccal fat removal – a procedure that, while seemingly simple, carries long-term consequences that patients should carefully consider.

What is Buccal Fat?

Buccal fat is a fat pad located in the lower cheek area, between the facial muscles. These fat pads serve several important anatomical functions:

They provide structural support for facial muscles
They assist with everyday facial movements including chewing, smiling, and speaking
They contribute to the youthful fullness of the face
They maintain facial volume as we age

Unlike subcutaneous fat that responds to diet and exercise, buccal fat is determined primarily by genetics. The size and shape of buccal fat pads vary significantly between individuals, contributing to each person’s unique facial structure.

It’s worth noting that buccal fat is one of the few facial fat pads that doesn’t degrade as quickly with age–a crucial consideration when evaluating candidates for removal.

What is Buccal Fat Removal?

Buccal fat removal, also known as buccal lipectomy, is a surgical procedure designed to reduce the fullness of the lower cheeks by partially or completely removing the buccal fat pads. This procedure typically involves:

Creating an incision inside the mouth (typically near the second upper molar)
Identifying and carefully accessing the buccal fat pad
Removing a portion of or all of the fat pad
Closing the incision with dissolvable sutures

The procedure is relatively quick, usually taking no more than 30 minutes, and can be performed under local anaesthesia with or without sedation. Recovery typically involves a few days of swelling and mild discomfort, with final results becoming visible as swelling subsides.

Key Considerations

When removing buccal fat, we need to remember that while the procedure itself may seem straightforward, several critical factors determine both immediate results and long-term patient satisfaction. No patient wants a case of buccal fat removal gone wrong.

These factors are:

Symmetry: Ensuring even removal from both sides
Preservation: Deciding how much fat to remove versus retain
Patient anatomy: Understanding individual facial structure and fat distribution
Aftercare: proper management of swelling and potential complications (more on that later!)

The Trend of Buccal Fat Removal

Like many of its preceding facial aesthetic trends, buccal fat removal seemingly appeared out of nowhere. A treatment most of us had never heard of before was leading many women to consider whether they needed buccal fat removal.

The rise in awareness of buccal fat pads was akin to hip dips in 2020. An area that no one used to fixate on is now being fixated on by thousands.

The popularity of buccal fat removal can be traced to several cultural shifts in aesthetics:

The Rise of Facial Contouring

The 2010s saw an explosion in contouring makeup techniques that created the illusion of more defined facial features. Soon enough, contour sticks and powder were no longer enough, and many turned to dermal fillers to give them a semi-permanent lift to their face.

For some, even fillers weren’t enough. Buccal fat removal could achieve the equivalent of that perfectly placed contour, but this time the results are permanent. If buccal fat removal goes wrong, there is little that can be done to fix it.

Celebrity Influence

No doubt one of the biggest reasons for buccal fat’s rise in the cultural zeitgeist is due to the rise of celebrities and influencers allegedly getting the procedure. Though few have openly discussed getting their buccal fat pads removed, several high-profile figures have been speculated to have undergone the procedure.

In late 2022, Chrissy Teigen became one of the few celebrities to publicly acknowledge having the surgery, and this is arguably what brought it into mainstream conversation. Suddenly, people were comparing old and new photos of their favourite celebrities, wondering if they too have had the procedure.

Social Media Aesthetics

The prevalence of photo filters and carefully posed selfies has created a distorted perception of what people actually look like. The ‘Instagram face–characterised by high cheekbones, hollow cheeks, and a defined jawline–has become the look everyone strives for. Those interested turn to procedures that can deliver this look, buccal fat removal being one of them.

Trend vs. Timelessness

It’s crucial to recognise that facial aesthetic trends change rapidly. What is desirable today may not remain so in five or ten years. We’ve seen this most recently with the hourglass, BBL body type. While it was all anyone wanted in the late 2010s, we’ve seen a shift towards a slimmer figure in the 2020s, hence the rise in interest in the gaunt, slim look buccal fat removal can provide the face.

While the Kardashians might be able to afford to get their BBLs removed at a moment’s notice, most people don’t have millions of pounds at their disposal to reverse treatments they’ll later regret. Someone may have saved for years to get a BBL, only for it to go out of style the year after.

In the case of buccal fat removal, it is permanent and irreversible. When the trends inevitably shift, you cannot simply add the fat pads back in or fill in your face with dermal fillers to get your old face back. Once the buccal fat is gone, it’s gone.

Buccal Fat Removal Risks

As with any surgical procedure, buccal fat removal carries both immediate and long-term risks that should be thoroughly discussed with patients. Many of these complications can be mitigated when the surgery is performed by a medical doctor with years of training and experience under their belt. If you’re considering this procedure, always do your research.

Immediate Surgical Risks

Nerve damage: The buccal nerve runs through this area and if damaged can cause numbness, tingling, or even motor dysfunction in parts of the face
Infection: Though rare, infections can occur at the surgical site
Asymmetry: Uneven removal can result in facial imbalance
Bleeding and bruising: Common but typically minor complications

Long-term Aesthetic Risks

Accelerated facial ageing: Removing structural fat can lead to premature sagging and hollowing
Irreversibility: Unlike fillers, removed fat pads cannot be replaced
Changing facial dynamics: The procedure may alter how the face moves during expression.
‘Trend Regret’: As aesthetic ideals inevitably shift, patients may regret permanent changes

Considering the Ageing Face

Perhaps the most significant risk is how buccal fat removal affects the natural ageing process. When done on the wrong patient, it can make them go from looking 25 to 45.

As we age our faces naturally lose volume, including fat, muscle, and bone density. Removing buccal fat in one’s twenties or thirties can accelerate this process potentially resulting in:

Premature facial hollowing
More pronounced nasolabial folds
Increased jowling and sagging
An overall gaunt appearance

This is why many aesthetic doctors advise against the procedure, especially for younger patients or those with naturally thin faces.

Why You Shouldn’t Get Buccal Fat Removal

While there are specific cases where buccal fat removal may be appropriate, we generally caution against the procedure for several reasons:

The Permanence Factor

Unlike injectable treatments that can be dissolved or will naturally metabolise, buccal fat removal is permanent. Once the fat is removed, it will never regenerate. This leaves patients with no good options of restoring their natural facial structure if they end up being unhappy with the results.

Ageing Considerations

As we’ve previously discussed, our buccal fat pads provide crucial volume that helps maintain a youthful appearance as we age. Removing this support structure often necessitated ongoing filler treatments later in life to compensate for this lost volume. This creates a life-long dependency on cosmetic procedures to correct an iatrogenic condition.

Patient Selection is Critical

The procedure is potentially suitable for a very small demographic–typically individuals with genuinely excessive buccal fat that causes significant, noticeable facial roundness. For those with average or thin faves, the procedure risks creating an unnaturally gaunt appearance, one that will get worse with age.

The Financial Long Game

While the initial procedure may seem relatively affordable, usually starting at £2200 in the UK, patients should be counseled about the potential long-term financial implications. Many who undergo buccal fat removal find themselves spending significantly more on fillers and other volumising treatments in later years.

Buccal Fat Removal Alternatives

For aesthetic practitioners committed to helping their patients achieve their aesthetic goals without resorting to permanent surgical solutions, several alternatives exist:

Temporary Aesthetic Solutions

Facial contouring makeup: Professional makeup techniques can create the illusion of more defined cheekbones
Masseter Botox: Reducing the size of the masseter muscle can slim the lower face without removing fat. Lasts up to 3-4 months.
Dermal fillers: Strategic placement of fillers can enhance cheekbones and improve facial proportions. Lasts up to 2 years.
Thread lifts: Can provide subtle lifting and contouring effects. Lasts up to 3 years.

Radiofrequency treatment (e.g. Morpheus8): Can tighten skin and improve facial contours. Lasts up to 3 years.

Lifestyle Approaches

Weight management: Weight loss may reduce facial fullness for some patients who have weight to lose.
Reducing salt intake: Can minimise facial bloating that contributes to fuller cheeks
Facial massages/exercises: May help tone facial muscles, improve definition, and reduce fluid retention

Final Thoughts

As aesthetic practitioners, our goal should be to enhance our patients’ natural beauty while protecting their long-term well-being. Well buccal fat removal may deliver ideal results for patients with fuller faces, the potential for regret and complications warrants a conservative approach.

Keep in mind the most successful practitioners aren’t those who simply follow trends, but those who understand facial anatomy, ageing processes, and the principles of timeless beauty. There’s no better place to learn this treatment process than at the Smileworks Aesthetic Training HUB.

Learn From The UK’s Best Injectors

Discover the HUB – an esteemed aesthetic training centre based in the UK. We pride ourselves on our wide range of online and hands-on courses tailored for every skill level.

If you want to train in non-surgical buccal fat removal alternatives, the best starting point is our Botox & Lip Filler course. This course is best for beginners just starting out in the industry. You’ll learn all of the basics to start a flourishing aesthetics practice. All of our courses are designed specifically with medical professionals like doctors, dentists, and nurses in mind. You’ll walk away with the skills and knowledge necessary to start practicing on real patients right away.

Already have some injecting experience under your belt? Look no further that our Foundation Facial Ultrasound Course and our Advanced Facial Ultrasound Course, two musts for injectors who care about patient safety. Ultrasound is the single most important too for ensuring safe and effective treatments every time.

For those looking for more in-depth training, we recommend booking a one-to-one mentoring session with Dr MJ. These sessions at 100% customisable, and you’ll receive personalised instruction based on your skill level and goals.

It’s time to embrace the prospering world of aesthetic medicine. The HUB provides you with all the right training and guidance you need to succeed. Take control of your professional journey and step into a future filled with endless potential and opportunities.

Join us at the HUB. Let’s shape the future of aesthetic medicine together and ensure safe, effective, and transformative results for every patient.

Want to try out our courses before committing? Take advantage of our free trial for a taste of what learning at the HUB is like.

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