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Recently, the buccal fat removal procedure has gained a lot of fame (and notoriety). A dozen articles in top fashion magazines like Vogue and Cosmopolitan were published in the last month alone. Moreover, the procedure has gained just as much press on social media, blogs, and YouTube videos. Prominent YouTuber-surgeons like Dr. Gary Linkov and influencers from around the world like Stephanie Lange are speaking up about the potential permanence of a procedure that has the supposed potential to predispose to facial aging, hollowness, and gauntness. Unfortunately, niche procedures like buccal fat pad removal (bichectomy) are mostly performed in the private arena, and this may explain why there is little in the scientific literature to better quantify or qualify the effects of buccal fat pad removal in the short-term and in the long-term. While many naysayers of the procedure balance their arguments by stating that the procedure does generate “model-esque” or “fashionable” cheeks, there is a tendency to select early and late photographs in different lighting, with different makeup, and opponents of the operation do not reflect other procedures that may have been performed.
In this video, Dr. Zelken tackles the not-so-age-old question: will I regret buccal fat pad removal when I am older? In his simple experiment, Dr. Zelken compares the quantity and quality of buccal fat removed from a mother and daughter separated by 23 years, as well as their early and 6-month postoperative results in two- and three dimensions. No other procedures were performed in these two women, and both are wearing makeup in the postoperative photos. In this mother-daughter combination, it was apparent that buccal fat pad removal as a standalone procedure generated subtle results in both. Neither mother nor her daughter looks gaunt postoperatively. The mother’s buccal fat pads were bigger than her daughter’s. As a standalone procedure, subtle beautification resulted, but the mother might consider facelift for more drastic changes, and the daughter could consider liposculpture and radiofrequency skin tightening if she were to desire more.