Buccal fat removal, also called buccal fat pad removal or buccal lipectomy, reduces the deep pad of fat in the lower cheek that keeps some faces looking round even at a stable weight. It is done through a small incision inside the mouth, usually as a day-care procedure under local anaesthesia, so there is no scar on the face. The result is a subtle contour change below the cheekbone, not weight loss. It suits fewer faces than social media suggests: thin faces, jaw-muscle (masseter) bulk and early midface volume loss are reasons not to do it.
Key points
- Partial, conservative removal planned with future ageing in mind
- Face screened first for thin cheeks, jaw-muscle bulk or general facial fat
- Incision inside the mouth, so no scar on the face
- Usually day-care under local anaesthesia, about 30 to 60 minutes
- Desk work usually within a week; contour judged fairly at about 3 months
- Removed fat does not grow back, though weight change and ageing still shape the face
What buccal fat removal is, and what it can and cannot change
The buccal fat pad is a deep compartment of fat that sits between the cheek muscles, separate from the fat just under the skin. It has several extensions, and the one that matters here is the part that bulges forward into the lower cheek. Buccal fat removal, sometimes searched as buccal pad fat removal or cheek fat removal, takes out a controlled portion of that part, not the whole pad.
The effect is a slight softening of fullness below the cheekbone, seen most clearly in three-quarter view. The cheekbones can look more defined by contrast, but the bone itself does not change. Because the fat sits deep and only a portion is removed, facial expression and movement are normally preserved.
What it does not do matters just as much. It does not reduce overall facial fat, lift jowls or loose skin, shrink a bulky jaw muscle, or treat fullness under the chin, which is the job of double chin liposuction. A round face usually has more than one cause, and the examination separates them before any plan is made.
Who is a good candidate for buccal fat removal
A good candidate is an adult whose fullness is concentrated in the lower cheek and persists at a stable, healthy weight. Good skin elasticity helps the cheek settle smoothly, while a healthy mouth and gums and being a non-smoker, or able to stop around the surgery date, support healing inside the mouth. The aim should be subtle refinement rather than a dramatic hollow under the cheekbone.
Candidates should also have realistic expectations about the procedure’s outcome: the change is a softening of the lower cheek, not a new face shape. A thorough consultation assesses facial anatomy, skin quality and aesthetic goals to decide whether buccal fat removal is appropriate for that specific facial structure, or whether the fullness has a different cause that needs a different plan.
Who should not have buccal fat removal
Saying no is a normal outcome of a buccal fat consultation. The procedure is not recommended for very thin faces, because removing the fat pads can leave a hollowed appearance, especially with age-related volume loss. Other causes of fullness need other routes: masseter bulk is usually treated with botulinum toxin injections to the jaw muscle (a widely used but off-label use of the drug), fullness under the chin with double chin liposuction, general facial fat with weight stabilisation first, and existing hollowness with volume restoration through fat grafting or dermal fillers.
Lasers and HIFU work on the skin and the layers just beneath it, and face exercises work the muscles, so none of them is a way to reduce the deep buccal pad.
- A naturally thin or narrow face, or cheeks that already look hollow below the cheekbone - removal can make the face look gaunt.
- Early midface volume loss, often from the late 30s onward - the priority is usually restoring volume, not removing it.
- Width at the angle of the jaw that comes from the chewing muscle (masseter) rather than cheek fat.
- A round face from general facial fat or excess weight - the buccal pad is one small compartment.
- Weight that is still changing, or planned major weight loss.
- Under 18 - cheek fat is still changing and often reduces naturally through the late teens and twenties.
- Expecting a celebrity-style hollow cheek, a sharper jawline, or a fix for jowls or a double chin.
Talk it through with Dr. Shikha
Book a consultation at Dr. Shikha Aesthetics in Sushant Lok 1. Bring your questions about buccal fat removal, and any previous reports.
How buccal fat removal is done: an incision inside the mouth, usually under local anaesthesia
The consultation comes first, with standardised photographs. On the procedure day, local anaesthetic is injected inside the cheek. Sedation can be discussed for anxious patients, and general anaesthesia is usually needed only when buccal fat removal is combined with a larger procedure.
An incision of roughly 1 to 2 cm is made on each side in the upper cheek lining, between cheek and gum near the upper second molar, placed away from the opening of the parotid (salivary) duct. Working inside the mouth leaves no external scar. The fat pad is gently teased out, only the portion that presents easily is removed, and the amounts are compared side to side for symmetry. Deep, aggressive dissection is avoided because branches of the facial nerve and the duct run nearby.
Absorbable sutures close the incisions. Both sides usually take 30 to 60 minutes, and the patient goes home the same day with a plan for rinses, a soft diet and medicines.
Buccal fat removal recovery, from day 1 to month 3
Recovery happens mostly inside the mouth. An antiseptic rinse after meals keeps the incisions clean, and smoking is avoided because it slows healing. Discomfort is usually mild to moderate and managed with prescribed medicines for the first few days. A review is usually booked at about 1 week. The clinic should be called if swelling increases on one side, if there is fever or pus, or if pain gets worse after day 3 instead of better.- Day 0 to 3: swelling and tightness build and usually peak around day 2 to 3; cold compresses, head raised, liquid or soft diet.
- Day 3 to 7: soft diet continues; most people return to desk work within the week; some tightness when opening the mouth wide is normal.
- Week 2 to 3: most visible swelling and bruising settle and absorbable stitches dissolve; gym and strenuous exercise usually resume after 2 to 3 weeks.
- Month 1 to 3: the new contour shows as the last swelling settles; month 3 is the first fair comparison.
- Up to month 6: subtle settling can continue.
Buccal fat removal before and after: what changes, and when to judge it
The change after buccal fat removal is subtle. It is easiest to see in three-quarter view and in photographs, and less obvious in a mirror straight on. For the first 2 to 3 weeks, swelling can make the cheeks look fuller than before surgery, or uneven from side to side, so nothing is judged early. Photographs are taken at consultation and again at about 3 months with the same distance, angle, lighting and a neutral expression. That pair is the fair before-and-after comparison.
Before-and-after photos online are chosen cases, often shot at flattering angles and in flattering light. How visible the change is depends on face shape, skin and how much the buccal pad contributes to the fullness in the first place, so no specific result is promised. The consultation explains what is realistic for that particular face.
Buccal fat removal side effects, risks and the long-term ageing question
Some effects are common and temporary: swelling, bruising, a tight feeling in the cheeks, briefly limited mouth opening, and altered sensation inside the cheek. These usually settle over the first few weeks.
Less common problems include bleeding or a collection of blood (haematoma), infection, asymmetry between the two sides, and under-correction, where the change is smaller than hoped. Rarely, the parotid (salivary) duct can be injured, which can cause a collection of saliva in the cheek (sialocele), or a branch of the facial nerve, which can weaken the smile or cheek movement, usually temporarily. Careful incision placement and limited, gentle dissection are used to reduce these risks.
The long-term question sits behind most regret stories. Over-removal can leave a hollow or gaunt look that becomes more visible as the face naturally loses volume with age. Removed fat cannot be put back, although volume can be partly restored with fat grafting or dermal fillers. That is why conservative, partial removal, planned for how the face will age, is the main safeguard, rather than taking as much as possible.
Buccal fat removal in Gurgaon and Delhi NCR: what to expect
The clinic is in Sector 43, Sushant Lok 1, Gurgaon, and sees patients from across Gurgaon and nearby Delhi, including Dwarka and South Delhi. Dr. Shikha Bansal (MCh Plastic & Reconstructive Surgery, Haryana Medical Council Reg. No. 24859) performs the procedure. Consultations are by appointment, and the procedure is usually booked for a separate day so there is time to decide.
Follow-ups are at about 1 week and 3 months. Patients who live further away can send progress photos over WhatsApp after the first in-person review. Because visible swelling can last 2 to 3 weeks, booking at least a month before a wedding or other event is advised, and ideally about 3 months if the new contour should show on the day.
