Cheek Reduction

Buccal fat removal, also referred to as a cheek reduction, bichectomy, or buccal lipectomy, aims to thin the cheeks, particularly in the area of the cheek hollows, to give patients a more contoured facial appearance. Although a face that is naturally soft and filled out is considered youthful, some people feel their face is too full. In addition, the area can be highly resistant to any sort of exercise and diet, so even though you may be thin everywhere else, your face can still appear chubby. If you’re unhappy with the appearance of your cheeks, buccal fat removal at our clinic may help restore your confidence and boost your self-esteem.

Buccal fat removal (or cheek reduction) involves removing the buccal fat pad, a naturally-occurring pad of fat found in your cheek hollow area. The size of the buccal fat pad varies with each individual patient and can even differ in each cheek. For that reason, Dr. Zelken uses his technical expertise to assess each new case individually — one size never fits all.

BUCCAL FAT REMOVAL AT THE JONATHAN ZELKEN, MD

As a board-certified plastic surgeon, Dr. Zelken and his team have successfully performed many cheek reduction surgeries to improve facial contouring and profiles. However, the procedure is typically not performed in people with thin, narrow faces, as removal of the fat may cause the face to look excessively thin and haggard over time.

HOW IT WORKS

In this video, Dr. Zelken demonstrates his technique for a buccal fat removal procedure. Warning graphic content.

IDEAL CANDIDATES FOR BUCCAL FAT REMOVAL

If you are bothered by your chubby cheeks, have a fairly stable weight and are physically healthy, you may be a good fit for buccal fat removal. It’s also mandatory that you are a nonsmoker without any life-threatening illness or medical condition that may impair healing. It’s important that you have realistic goals in mind for the surgery, as well.

If you’re considering buccal fat removal, spend some time reviewing our before-and-after photos and find out what to expect during recovery. Every surgery at Jonathan Zelken, MD of Aesthetic Medicine, including cheek reduction surgery, is highly individualized, and we encourage you to only undergo the procedure for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

HOW TO MAKE YOUR OWN BUCC-O-METER IN 10 EASY STEPS:

Supplies needed: cardboard or construction paper, scissors or x-acto knife, marker, ruler, post-it-note.

To conform to the LEFT cheek (for right, flip it over)

• Mark and cut out a 9 cm (3.5 in) square.
• On the bottom edge, mark 2 cm from the left.
• On the right edge mark 3 cm up from the bottom.
• Connect the dots and cut out 2 triangles.
• Cut out the center leaving about 2 cm of borders.
• On the bottom write “mandible” (jaw)
• On the top write “malar” (cheek)
• On the left write “mouth” (deep nasolabial fat compartment)
• On the right write “masseter” (jaw muscle)
• Then place a piece of leftover material inside and move it to line up with the front edge of your masseter muscle. (Optional: take a post it note and line the adhesive up with the front edge of the masseter)
• To find your masseter, clench your jaw and look for an angled shadow from your cheek to the angle of your jaw OR feel for it with your thumb.
• The remaining space is where the buccal fat can herniate.

WHAT TO EXPECT PRIOR TO BUCCAL FAT REMOVAL SURGERY

Prior to any surgery at the Jonathan Zelken, MD of Aesthetic Medicine, you will have a consultation with Dr. Zelken. We will examine your cheeks and facial profile in detail, discuss your goals, past medical procedures and may take photographs for your medical record. When we ask questions pertaining to your health, desires and lifestyle, the success and safety of your procedure depends on your complete candidness. During this consultation, you will be presented with a course of action based on Dr. Zelken’s extensive experience with cheek reduction procedures.

Though you will have access to Dr. Zelken and his staff throughout the process, this is a great time for you to ask any questions you may have regarding buccal fat removal. If you’re feeling anxious about your anticipated new look or the operation itself, be sure to discuss those feelings with us. A little anxiety, by the way, is completely normal prior to any procedure.

Dr. Zelken will insist that you stop smoking prior to the procedure. We will also go over the risks associated with buccal fat removal, and you will be asked to sign consent forms to ensure that you fully understand the procedure, risks and potential complications. We may also ask that you get a lab test or a medical evaluation, take certain medications or adjust your current medications, and avoid taking aspirin, anti-inflammatory drugs, herbal supplements and other medications that may increase bleeding during surgery.

You will have to decide if the benefits will achieve your goals and if the risks and potential complications of cheek reduction surgery are outweighed by those benefits. Following your procedure, we will work with you to coordinate care with one of our post-operative care consultants. You should, however, arrange for someone to drive you to and from our facility.

YOUR BUCCAL FAT REMOVAL PROCEDURE

Depending on your individual situation, Dr. Zelken will recommend either local anesthesia (wide-awake, most common), intravenous sedation or general anesthesia for your comfort during the surgical procedure. Buccal fat removal surgery requires an incision on the inner portion of the cheek inside of your mouth. However, if you are having a cheek reduction procedure in conjunction with a facelift, Dr. Zelken may remove the buccal fat pad during the facelift, obviating the need for an incision inside the mouth.

Sutures will be used to close the incisions inside your mouth. Dr. Zelken typically uses sutures that are absorbable, but it’s still important that you not play with the sutures with your tongue until cleared by Dr. Zelken. You will experience some swelling from the procedure, but your buccal fat removal surgery will result in a slimmer, more contoured cheek almost immediately.

RECOVERING FROM BUCCAL FAT REMOVAL SURGERY

After your buccal fat removal surgery, healing will continue for several weeks as the swelling in your face decreases. It may take several months for you to see the final results, as your cheeks gradually contour to their new appearance. That said, the cheeks should appear less full or chubby shortly after the procedure.

Dr. Zelken will give you detailed instructions regarding how to care for the surgical site, medications to take or apply and concerns to look out for. It’s important that you follow all of the postoperative instructions he gives you. The success of your procedure depends, in part, on your willingness to follow directions and on your commitment to lead a healthy, active lifestyle.

YOU MUST ASK THE FOLLOWING QUESTIONS IF CONSIDERING THIS PROCEDURE:

• Are you certified by the American Board of Plastic Surgery?
• Were you trained specifically in the field of plastic surgery?
• What specific training do you have in buccal fat removal techniques?
• How many years of plastic surgery training have you had?
• Do you have hospital privileges to perform this procedure? If so, at which hospitals?
• Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
• Am I a good candidate for this procedure?
• What will be expected of me to get the best results?
• Where and how will you perform my procedure?
• What surgical technique is recommended for me?
• How long of a recovery period can I expect, and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How are complications handled?
• How can I expect my buccal fat removal surgery to look over time?
• What are my options if I am dissatisfied with the outcome?
• Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?

ARE YOU READY FOR A CONSULTATION?

If you’re considering buccal fat removal or if you have questions about cheek reduction procedures, don’t hesitate to contact us or schedule a consultation with Dr. Zelken. We’re located at 1617 Westcliff Drive in Newport Beach, CA, and we can be reached at (949) 432-4730. We serve patients from across the world — we have a Mandarin Chinese-speaking physician — along with clients in Newport Beach, Huntington Beach, Irvine and Laguna Beach, California.