Up until the tail-end of 2022 buccal fat, and specifically buccal fat removal, were not words that had entered into my vocabulary. That December my, and the world’s, lexicon expanded thanks to a certain Chrissy Teigen. The model, who is married to singer John Legend revealed - via a selfie on Instagram because, what else - that she had undergone something she called ‘that buccal fat removal thing’.
Buccal what? ‘Buccal fat is a pad of fat in the lower face area,’ explains the founder of Skin Doctor Clinics and Expert at Teoxane, Dr Saleen Zimri, it sits in the area between the cheekbones and the jawbones, providing fullness (read: structure) to the face. While its exact purpose isn’t known, Mr Naveen Cavale, Consultant Plastic Surgeon at REAL Clinic tells me that there are ‘theories that it is there to serve as a cushion to protect facial muscles and/or teeth.’ The balls of fat are something that we all have, aren’t linked to body weight, and because of the beauty of human differences it varies in size and prominence from person to person.
Interest in buccal fat removal, done via a surgical operation, peaked with Teigen’s revelation but is showing little sign of slowing down. A quick google brings up video after video of TikTokers sharing their buccal fat removal experience, with #buccalfat clocking up over 70 million views. Need further proof? Plastic surgeons have reported a three fold increase in buccal fat removal procedures. Teigen even tagged her plastic surgeon, Dr. Jason Diamond, when she shared the results of her surgery joking, ‘since I quit drinking I’m really seeing the results and I like it.’
Ah, the results. ‘Generally the procedure aims to achieve a more sculpted and defined facial contour by reducing the fullness in the cheek area,’ says Cavale who is keen to point out that the procedure is permanent and that ‘as you age, the face tends to thin. If you have had buccal fat removed, you can end up looking over-thin, almost skeleton-like.’
The obsession with buccal fat removal is tied to the worrying cultural shift towards a perceived ideal of thinness. The controversial weight loss drug Ozempicand the lemon bottle fat dissolving injections are just two of the other culprits that are normalising ‘quick fixes' in the pursuit of unrealistic beauty standards. Particularly worrying for surgeons is the rise in younger people requesting buccal fat removal. Aesthetic surgeonDr. Mo Hamed,referred to in the biz as Dr Motox, links it to the ‘Bella Hadid effect’ with potential patients trying to mimic “more prominent cheekbones and jawline, with an indent between the cheeks and jawline similar to the Bella Hadid look where she has a sunken area just underneath the cheekbone.”
If you’re familiar with the makeup term contouringthe effect is similar, but permanent. Buccal fat removal aims to create the illusion of a natural shadow which, according to Dr. Hamed, is “becoming very very popular because people are chasing that model high cheekbone look.”
Although there are no health benefits to having your buccal fat removed, the reality is that treatments that promise immediate ‘sculpted’, ‘snatched’, or, to quote TikTok ‘sucking-on-a-straw’ results are happening all over the world. If it’s something that you’re considering, or just intrigued by, then it’s necessary to arm yourself with all the right information. Knowing the pros and cons of buccal fat removal is especially important given that the procedure is irreversible and has been linked, ironically, to premature signs of ageing.
Watch: Chrissy Teigen Discuss Her Buccal Fat Removal Procedure
Main image: Instagram @chrissyteigen
The Procedure
First things first it’s pronounced ‘buckle’, people! Now we’ve established that let’s get into the nitty gritty. What actually is buccal fat removal? The short version of how the surgical procedure works is given by aesthetic surgeonDr. Mo Hamedwho explains that during buccal fat removal “the surgeon makes a cut inside the mouth and removes the fat pad located between the cheekbones and jawline.” According to Dr. Mo Hamed the easiest way to access the buccal fat pad “is from inside the mouth,” which also minimises any scarring or visible marks on the outside of the face .
Despite sounding like a drastic procedure buccal fat removal can be done under local anaesthetic, although you can opt to have it done under general anaesthetic if that’s your preference. In terms of pain and downtime that’s also dependent on the individual. However, given that the procedure involves only a small incision and stitches the pain is generally minimal. Be warned though, “there is likely to be a lot of swelling, bruising and, as with all surgery, there’s risk of infection,” says Dr Hamed. Although he does point out that once swelling has resolved (usually after a couple of weeks) and the stitches have dissolved, most people can expect to recover quickly from this type of surgery.
Buccal Fat Removal Before And After
Spotting someone who may or may not have had buccal fat removal has become something of a sick internet sport. In actual aesthetic terms though Dr Hamed explains that:
“Typical results include more defined cheekbones and a hollow beneath them, between the cheek and the jawline. This gives the face a lifted appearance, a natural contour, and the illusion of higher cheekbones.”
Buccal Fat and Ageing
“The impact of buccal fat removal on ageing is a topic of debate among plastic surgeons,” admits Cavale who argues that “removing buccal fat may lead to premature ageing by reducing the volume in the mid-face area, which could potentially contribute to a hollow or gaunt appearance over time.”
Indeed, Dr Hamed says that one of the major side effects of the procedure “could be the over-removal of buccal fat, which can be ageing and is irreversible.” He adds that while “initially, it may not age a young person with ample fat,” the problems arise the older you get when “the lack of support in the cheek and jowl area can lead to sagging skin and worsen the appearance of jowls.”
Is Buccal Fat Removal Permanent?
“The key thing to note with buccal fat removal is that once it’s gone, it’s gone,” warns Cavale, “it is a permanent procedure”. It is for this reason that he largely veers away from performing buccal fat removal unless it is part of a wider face and / or neck lift. Why? Because, “with a face lift you can see the whole fat pad, so you know exactly how much buccal fat you’ve got to work with,” whereas, “when you do buccal fat removal as a stand alone procedure, you can’t actually see the fat pad as a whole, so you can’t tell how big or small it is.” Herein lies the risk of removing too much buccal fat or removing it unnecessarily, i.e when you don’t have excess buccal fat in the first place.
In theory, you could add volume back in if the effect was too hollow. Fat transfer and injections are generally the go-to’s here. However, Cavale warns that “you won’t ever be able to fully replicate what they looked like naturally before removing them.”
Can You Lose Buccal Fat Naturally?
Remember, buccal fat isn’t linked to body weight. However ,Dr Cavale points out that, “if you are the type of person who tends to easily gain weight on your face, you might see a difference here.”
Alternatives To Buccal Fat Removal
Reputable surgeons usually advise against buccal fat removal in younger patients. In fact, Dr Hamed says that, “a responsible surgeon will refuse the treatment if the patient doesn't have excess buccal fat and might suggest alternative, non-surgical treatment.”
“As you age, you lose fat in the face and this is why people have face lifts and fat transfers as they get older,” explains Cavale, “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.”
A little botox in the master muscle is one of the temporary non-surgical procedures that surgeons recommend to those not suitable for buccal fat removal. This, along with filler, can “help to sink that part of the face and give you the appearance of a more contoured and lifted cheekbone,” says Dr Hamed.
How Much Does Buccal Fat Removal Cost?
There are different things to factor in when considering buccal fat removal; location, surgeon and individual needs will all alter the final cost but generally you can expect to pay anywhere from two to five thousand pounds and if you’re getting it done under general anaesthetic the price will be considerably more.
A Word Of Warning
If you're considering buccal fat removal yourself, know that this is an invasive procedure and it's imperative to proceed with caution. Take ample time to do your research, both into the procedure itself and your chosen practitioner. No cosmetic procedure is ever 100% risk free. Keep in mind that a good surgeon normally insists on two consultations prior to booking in, and these consultations should always be with the surgeon who will be performing the operation. Specialist plastic surgeons should have the FCRS (Plast) qualification and be listed on the Specialist Register of Plastic Surgeons with the General Medical Council. You can search the GMC here.