Buccal Fat Removal
Also known as cheek fat removal, bichectomy
Hollows the lower cheek. Quick and popular, and the procedure most likely to be regretted in twenty years.
US $2,000–6,000.
How it works
The buccal fat pad, a discrete pocket of fat in the mid-cheek, is partially removed through a small incision inside the mouth, creating a shadow beneath the cheekbone.
How it's used
Be very conservative and be honest about your age and face shape. Faces lose volume naturally with age, so removing fat at 22 can produce a gaunt, prematurely aged appearance at 40. Genuinely good candidates have full lower cheeks with defined bone structure underneath. If your fullness is subcutaneous rather than buccal, this will not help.
Trade-offs
In favour
- Simple, quick procedure under local anaesthetic
- No external scar
- Permanent definition beneath the cheekbone
- Fast recovery
Against
- Irreversible — the fat pad does not come back
- Substantial risk of looking gaunt with age
- Frequently performed on poor candidates
- Effect is subtle in people who wanted it dramatic
Risks and side effects
- Over-resection producing permanent hollowing and premature ageing
- Facial nerve branch injury (buccal branch)
- Parotid duct injury
- Asymmetry
- Infection from the intraoral incision
- Regret — this is among the most commonly regretted facial procedures
Recovery
Week 1: swelling, soft diet, salt-water mouth rinses. Week 2: back to normal activity, swelling declining. Weeks 3–12: contour gradually emerges as swelling resolves.
How good is the evidence?
Technically straightforward with reliable short-term results, but limited long-term outcome data and well-documented clinical concern about ageing.
Sources
Sources point to guideline bodies and literature searches rather than single papers, so they stay accurate as the evidence moves.