Buccal fat removal is everywhere—but what is it and should you avoid it?

Remember when fox eye surgery became a thing? Now it’s buccal fat removal that’s taking over the aesthetics world. Late in 2022, searches for the surgical procedure soared on Google, with many looking up, “what is buccal fat removal” and “buccal fat removal celebrities”. On social media, speculation around which famous faces have and haven’t had the procedure is rife and on TikTok, the tag #buccalfatremoval has amassed 167.5 million views (and counting).

We've done it all when it comes to our skincare routine, but this trend goes a bit deeper. So what is buccal fat removal and why is it such a hot topic? Carried out for cosmetic reasons, the goal of surgery is to give the face a more chiselled and sculpted appearance—a look that’s currently "trending". “Surgery to conform to trends is a dangerous path to follow for both the individual as well as in wider society," says Dr Catharine Denning, advanced aesthetics doctor. "I would never advocate for this to be a reason to seek this procedure, nor any injectable treatments to accentuate facial contour."

As we know, trends come and go but, unlike most other 2023 skincare trends, buccal fat removal is permanent and cannot be reversed. “What if the trend changes and fuller cheeks come back in vogue?” muses Mr Naveen Cavale, plastic surgeon and co-founder of REAL Clinic. Trends aside, there are also serious risks to consider and, as Denning points out, "undergoing a major surgical procedure should never be taken lightly." Ahead, the experts shed light on everything there is to know about buccal fat removal.

Meet the experts on buccal fat

• Dr Catharine Denning is a London-based aesthetics doctor who specializes in advanced medical aesthetics and cosmetic dermatology. She has explained what buccal fat is and why removal is trending, as well as sharing how it works and the best alternatives.
• Mr Naveen Cavale is a plastic surgeon who practices both in the NHS and privately, having co-founded the REAL Clinic in London. He has explained how buccal fat removal works and more about its safety, as well as why he thinks its popularity is on the rise.
• Dr Maryam Zamani is an oculoplastic surgeon, facial aesthetics doctor and founder of skincare brand MZ Skin. She has also shared more insights into buccal fat and what happens during its removal. 

What is buccal fat?

Let’s start by unpacking what buccal fat is, exactly. “In the human face there are five distinct layers; two of which are sheets of fat that are divided into sections or pads,” says Denning. These two fat layers can be described as a deep layer (under the facial muscles) and superficial layer (above the muscle layer). “Buccal fat is a deep fat pad that’s found between your cheekbone and jawbone, and it varies in size from person to person.”

“The buccal fat pad is a soft, spongy tissue that is made up of fat cells, connective tissue and blood vessels,” says Dr Maryam Zamani, facial aesthetics doctor and founder of MZ Skin. Its primary function, according to Zamani, "is to provide support and cushioning to the face, particularly the cheek area.” Denning adds that “it also allows for the many muscles of smiling and eating to glide smoothly when contracting and relaxing."

So...what is buccal fat removal?

"It is essentially what it says on the tin," says Cavale, "the surgical procedure involves removing a portion of the buccal fat pad from the cheek area of the face.”

Typically, this procedure is performed for cosmetic purposes, "as it can help to reduce the appearance of fullness or roundness in the cheek area, creating a more defined and sculpted facial contour," adds Zamani.

Why has buccal fat removal started trending? 

Buccal fat removal is not new—skilled surgeons have been performing this procedure for some time. But recently, it’s gained popularity with more and more of us searching for ways to achieve a chiseled appearance. "Society, in general, has gained more awareness and interest in facial appearance since social media and video calls have become part of daily life,” says Denning. “Interactive facial filters (found on apps like Snapchat and Instagram) have had a big impact too,” says Cavale, who compares buccal fat removal to other surgical trends like the fox eye lift, “which again, has been fuelled by social media.”

Alongside social media and face-altering filters, “celebrities endorsing these types of procedures mean that more people are aware of what is available to them,” says Denning. Back in 2021, Chrissy Teigen spoke openly about having the procedure on Instagram. In the video, the model says, “I did that Dr Diamond buccal fat removal thing and I’m really seeing the results, I like it.” There’s speculation that other celebrities, such Bella Hadid, Lea Michelle and Kylie Jenner, have had facial slimming transformations that are in keeping with the appearance of buccal fat removal, too. “Because of this, the public have greater visibility of what can be achieved by having the procedure,” says Denning.

Is the procedure safe? 

“In the right hands, i.e. a surgeon who does this very regularly, this procedure can be quick and simple and will more often than not go without a hitch,” says Denning. As with any surgery, however, there are potential risks involved. “It is a very complex area of the face from an anatomical point of view,” she adds. “The fat pad is associated with major arteries, nerves, and important muscles that can potentially become damaged during surgery.” While this is rare, Denning says that damage can leave a patient with facial disfigurement.

“Another, longer-term risk is that this procedure may accelerate aging of the face in time,” warns Denning. “We know that fat in the face can help give tissue support and structure as the skin overlying it ages and so if that supportive structure is removed, this may age the face in years to come.” Cavale agrees and says, “I don’t think it should be removed on its own, especially in young people. As you age, you lose fat in the face, and this is why people have facelifts and fat transfers as they get older. If you remove a lot of fat from the face when someone is young, you have no idea how they will age, especially as fat depletes with age anyway. There is a risk that it could give a skeletal appearance.”

What does buccal fat removal involve?

“The procedure takes 30 to 45 minutes and can be done under a general anaesthetic,” says Denning. “It involves entering the buccal cavity via an incision on the inside of the mouth to access the fat pad which can then be removed,” she continues. “By making the incision inside the mouth, scarring is minimised, and the incisions are not visible after the procedure is complete,” adds Zamani.

In terms of recovery, “most patients can return to their normal activities within a few days of the procedure,” says Zamani. Denning notes that it takes three to four weeks to fully heal and, for some, the swelling and bruising can take a few months to resolve. “While the incision site repairs, patients must consume a largely liquid diet,” adds Denning, “and regular use of a medicated mouthwash can help reduce the likelihood of infection post procedure.”

How much does buccal fat removal cost?

“The cost of buccal fat pad removal can vary widely depending on a number of factors, including the location of the practice, the experience and reputation of the surgeon, and the specific techniques and technologies used,” says Zamani. “In general, buccal fat pad removal can cost anywhere from £2,000 to £4,000.”

Advice for anyone considering buccal fat removal

As it's a big procedure that could permanently alter your face shape and get rid of essential fats that you may need in the future, buccal fat removal is best considered as a last resort option—especially as there are less risky non-surgical options to consider first. “Skin tightening devices such as micro-current technology and high intensity focal ultrasound can help contour the face on a temporary basis, and many people swear by facial massage to exacerbate their cheekbones and jawline,” suggests Denning. Makeup can also be used to help highlight cheekbones and contour under-cheek hollows—if that’s the look you’re after—without setting you back several grand in the process.

“If, on the other hand, facial shape has been a long-term concern then (non-permanent) non-surgical treatments with soft tissue filler to enhance bone structure and anti-wrinkle injections into the masseter muscle can both help slim the lower face and contour the face,” adds Denning.

Before any surgical or non-surgical procedure, make sure you do your research first and always visit an experienced, reputable doctor.