Buccal Fat Removal (Bichectomy)

When we are young, ample, round cheeks are perceived as a marker of good health and many consider the rounded face to be a desirable feature. With age, some may prefer a less rounded face. This is where buccal fat removal or cheek fat removal may be able to help address your concerns. Buccal fat extraction, bichectomy, buccal fat excision, and buccal fat removal involve carefully removing defined amounts of fat tissue from the buccal fat pads in the cheeks. The fat tissue is responsible for the rounded appearance of the cheeks. For some people, this results in prominent cheeks that may be out of balance with the rest of their facial features giving rise to unpleasant nicknames such as ‘chipmunk cheeks’ or ‘hamster cheeks’. If excessively rounded cheeks troubles you, with an associated loss of self-esteem, buccal fat removal may be a solution to help balance your facial features and restore your confidence.

All our surgeons are on the GMC specialist register. Our London clinic at 106 Crawford Street was recently inspected and rated as good across all 5 domains.

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What is included in my treatment package?

• As many preoperative consultations with your surgeon as you like to make sure the procedure is right for you
• Treatment at a specialist day surgery facility recently rated ‘Good’ by the CQC
• Enhanced same-day discharge with the added benefits of recovering in your own home
• 24/7 clinical support from your surgeon for the first 48 hours and our expert postoperative support team
• Your very own dedicated patient coordinator
• In-depth preoperative medical assessment to make sure you are fully fit for the rhinoplasty procedure
• Exceptionally high standards of postoperative care described as ‘outstanding’ by the CQC with regular telephone and face-to-face checks by our expert postoperative support team

RealSelf Top Doctors

RealSelf top doctor status is awarded to less than 10% of the RealSelf doctor community.  This status is earned by achieving consistently high patient satisfaction (from RealSelf reviews), getting excellent feedback on expert answers to patient questions, and after investing significant time in Q&A and other doctor activity. RealSelf top doctors are rated among the very best surgeons in the UK.

Based on 135 reviews

Zara Khan

19/11/2021

Amazing from start to finish, the communication was the main thing was fully informed and looked after, on the day of my breast augmentation, the staff were fab and made me feel at ease through out the whole process. Thank you so much.

Mohammed Farid

18/11/2021

I’ve had such a great experience with excellent advice, care and attention and surgical treatment (gynaecomastia) - I can fully endorse the treatment I have received from Centre for Surgery with absolutely no qualms at all. Brilliant in every way - thank you all so much.

Caroline Thorpe

14/11/2021

Very pleased with my whole experience of having a procedure. Was so nervous about getting treatment and i was reassured and felt so comfortable throughout thanks to the amazing nurses. I definitely made the right decision to have breast augmentation at centre for surgery with dr erel.

Melissa Briggs

08/11/2021

So glad I went with centre for surgery, the whole process went very smoothly from the consultations down to the actual day of the procedure. I was so nervous on the day but the whole team put me at ease and I’m happy with my results as I feel a lot more comfortable wearing certain clothes now. My surgeon was Alberto Di Giuseppe who performed a breast Augmentation on me, and I would definitely recommend as he was very clear on what the outcome of the surgery would be and which size would look the best for my frame.

Raphinha kiki

08/11/2021

Couldn’t be happier with Dr Tillo work,i had my breast surgery one week ago and so happy with the results so far,all the staff are extremely nice and very supportive,i would definitely recommend their services,thank so much

Grace Olafemi

15/10/2021

From start to the finish everything was perfect for tummy tuck surgery. All staff is very friendly and the aftercare has been good. The Doctor and the nurse team was fantastic. I'm so happy...result is amazing. Thank you!!!

Ranjit Singh

14/10/2021

This was overall a great experience, all the staff at Centre for Surgery were friendly and put me at ease. It is a nerve wracking thing to go through an op but the staff were so nice. Mr Ertan has got a great team around him. On the day of the operation everything went smoothly to plan, there was no delay or holdups, I had another consultation with Mr Ertan who confirmed what was going to be done and that I was still happy to proceed. I was prepped for the procedure, I met with the anaesthetist who again was really nice and put me at ease explaining his role. After the procedure I woke up with the nurse by my side making sure I was OK and checking on me, I was able to stay in the clinic until I was ready to leave and was not rushed at all. I was well looked after from the start to the point when I was discharged. Post operation I was staying at a local hotel it was so close there was no point in even getting a taxi and I was able to walk back where my partner was waiting for me. I was expecting a lot of bruising to both my eyes but there was very little if any by the time the cast came off after 7 days, I am now at the two week post operation point and it is healing well with no outwardly visible bruising or scaring. The next milestone is a checkup at the 6 week point with my surgeon. If you're thinking of having something like this done I would highly recommend getting in touch with Centre for Surgery.

Layla Karami

13/10/2021

The staff at Centre for Surgery were very kind and accommodating. They answered any questions I had about the procedure and were constantly checking up on me. A special thank you to Christina for all her support throughout.

Gemma Small

08/10/2021

I would just like to state the quality of care received from the nurses at Centre for Surgery was beyond the highest level. Sophie takes her patient care to another level beyond words. She always puts me at ease. She is there for me even at awkward hours just when I mostly needed reassurance and she is one of the most compassionate nurses I have come across and demonstrates her passion naturally for caring for others. She totally deserves recognition at its finest and thank you for always being there for me. 😍

Buccal fat removal surgery is a delicate surgical procedure and our surgeons are highly experienced to undertake surgery on the delicate cheek area.

• Samet Sendur
• Alok Misra
• Ertan Erel

The buccal fat pad is located in each cheek beneath the cheekbones and is a normally occurring pad of fat. The buccal fat pad functions to provide a protective cushioning effect and also to enhance the function of the muscles responsible for chewing food in the lower aspect of the cheeks. Although we all have buccal fat pads, the amount of buccal fat differs between individuals with some people having much more pronounced pads than others. These patients will have more volume in the lower part of the cheeks. The presence of prominent buccal fat pads can be genetic with many slim people having quite large buccal fat pads. If you are keen to have slimmer cheek contour with the enhancement of cheek definition then you may be an ideal candidate for buccal fat pad removal.

Buccal fat removal is a minimally invasive surgical procedure where the buccal fat pad is carefully removed either partially or completely which gives rise to permanent results which may be noticed straight away. With the removal of significant collections of fat from the lower face, it is possible to achieve a more slender and defined lower facial shape with particular emphasis on the jawline. An additional enhancement is possible when combined with liposuction of the submental region and jawline. It is important to bear in mind that the buccal fat removal procedure may lead to the increased prominence of nasolabial or nose to mouth lines and also lines when smiling. The buccal fat pad helps to smoothen out these areas of the face. Removing too much fat may lead to a wasted or gaunt appearance which is exacerbated by the ageing process. The removal of the supporting collagen and fat framework may explain why this could happen. This is why it is very important to have the procedure performed by a highly skilled and experienced consultant plastic surgeon who is able to assess you in detail and provide an honest opinion of what can be achieved with the buccal fat reduction procedure.

Expected results after buccal fat pad removal:

• A contoured and more defined lower face
• More prominent cheekbones which appear higher
• More sculpted look especially when combined with liposuction of the lower face

Buccal fat reduction is the process of surgically removing the fat pads within the cheek. This fat sits on either side of the cheek and under the cheekbones. This fat can remain even after a person loses weight, and is often perceived as giving someone a child-like appearance. As such, a buccal fat reduction is often an appealing choice.

All patients should be in good health and have realistic expectations about what can be achieved with buccal fat removal surgery.

• We do not treat patients below the age of 18 years of age.
• Healing is better if patients refrain from or quit smoking.

The buccal fat removal procedure is performed for cosmetic and functional purposes, to help improve one’s image and self-esteem and relieve pain and discomfort.

• The ideal candidate for the procedure are people in their mid-20s to 40s who wish to get rid of their ‘chipmunk cheek’
• Also for those who wish to achieve a more delicate, chiselled appearance

Prior to the surgery, you will have a consultation with a surgeon. You will be able to discuss your reasons for wanting this procedure, your wants, needs and desired outcomes, as well as your full medical history to establish whether or not you are an appropriate candidate.

Buccal fat removal is not suitable for everyone and patients who may not be suitable for surgery include:

• People with very thin faces. If you have a naturally narrow face then buccal fat removal may exacerbate the appearance of sunken cheeks which also occur during the natural ageing process.
• Patients who suffer from progressive hemifacial atrophy. This is a rare condition which results in half of the face appearing shrunken and thin with a reduction of the buccal fat pad.
• The natural ageing process results in the loss of soft tissue volume. Removal of the buccal fat pad exacerbates the appearance of jowls and sunken cheeks which may result in a person appearing much older than they actually are. Patients who are over the age of 45 may not be suitable for buccal fat removal.

Buccal fat removal is also known as cheek contouring or cheek reduction surgery. The procedure is designed to make the face look slimmer and enhance cheek contour. Buccal fat pad removal gives permanent results and is a highly effective procedure for getting rid of chubby cheeks. Buccal fat reduction can also be combined with other facial cosmetic surgery procedures such as a facelift or rhinoplasty.

Buccal fat removal can be safely and effectively performed under local anaesthesia so you will be relaxed and comfortable throughout, The procedure takes about an hour for completion.

The surgeon makes a small (2-4 cm) cut between the inner cheek and the gum near the second molar from the back. The outer cheek is then pressed on to enable an adequate amount of buccal fat to protrude through the incision, which is teased out with surgical forceps. Depending on the desired results the surgeon may remove the entire buccal fat pad or just a portion of it.  When the buccal fat pads are removed, they appear as small globules of fat. The incision is then carefully closed with dissolvable sutures.

Buccal fat pad removal can also be performed simultaneously with other facial plastic surgery procedures including submental liposuction, rhinoplasty or dimple creation. The procedure is delicate in nature and only a surgeon with significant experience of performing the procedure should be chosen to ensure a careful removal of the buccal fat pad and the final result is one that is natural and in harmony with the patient’s face.

What is the difference between full and partial removal of the buccal fat pad?

During the procedure, the amount of tissue to be removed will vary depending on what the patient would like to achieve. Partial removal of the buccal fat pad will result in residual fat remaining in the lower cheek area. For those who have a partial removal, if they gain weight in future, the results of the surgery will be affected by the potential recurrence of the fat pad prominence. A partial buccal fat pad removal is ideal for older patients who want an appearance of high cheekbones but without the risk of looking gaunt after the procedure. For younger patients with more volume in the lower face. it may be a better option to opt for the total removal of the buccal fat pad to attain a more dramatic result.

Are the results of buccal fat removal permanent?

Yes. The results of buccal fat removal are permanent providing the patient does gain a large amount of weight. The best candidates for buccal fat surgery are those with a stable healthy weight and who are able to maintain their weight over time.

Can liposuction be used to remove the buccal fat pad?

Liposuction cannot be used to remove buccal fat even with the micro liposuction technique. This is because there are many important structures deep in the face that could be injured by a liposuction cannula. The consistency of buccal fat is also different from regular fat in the chin and neck area.

It is possible to combine buccal fat removal with neck liposuction to achieve more definition of the jawline and submental area (area beneath the chin).

When you have decided to proceed with a consultation for buccal fat removal, the first step is to have a consultation with one of our expert plastic surgeons to assess your suitability for the buccal fat removal procedure. At your consultation, your surgeon will examine you thoroughly and may recommend a combination procedure with submental liposuction.

Before the buccal fat removal procedure

• Stop use of tobacco as smoking increases the risk of wound healing complications
• Have a preoperative consultation to go over the details of the procedure with your surgeon
• Avoid any medicines which could increase the risk of bleeding such as aspirin and NSAIDs
• Use paracetamol for pain relief if required
• Collect your prescription for postoperative antibiotics
• Start taking Arnica tablets 2 days before the procedure
• If you are having surgery under GA, you will be required to fast for 6 hours for food and 2 hours for clear liquids beforehand
• Set up your home recovery area with comfortable bedding and pillows
• Avoid the use of lotions or scented perfumes before the procedure
• Use mouthwash before the procedure
• Wear comfortable clothing on the day of the procedure
• Avoid wearing make-up and remove all face and body piercings

After the procedure, it is common to experience a mild discomfort and associated swelling of the face but this will rapidly settle within 2 weeks. The appearance of the cheeks will start to look thinner and have more definition once the swelling has settled and there will be no visible scarring as the incisions are made inside the mouth. Final results should start to appear after about 4 weeks to 12 weeks and will continue to improve with time as the swelling fully settles. The incisions inside the mouth require about 7-10 days to fully heal and it is important during this time to eat a soft diet in the first few days after surgery. Ice packs and simple painkillers like paracetamol are recommended for the first 3 days after buccal fat removal.

The surgeon uses non-absorbable sutures as standard and there is no requirement to have the sutures removed at your postoperative appointment. The surgeon recommends that you sleep on your back for the first 3 nights to help recovery. It is important to avoid all strenuous activities including the gym for at least 1 week after the procedure. Patients can return to their normal activities after 2 weeks.

What can I eat following buccal fat removal?

Our surgeons recommend that foods with a granular consistency are avoided after buccal fat surgery as the two small incisions within the mouth may allow foods with finer consistency to get stuck in them. You should focus on soft foods like mashed potatoes or fully blended smoothies which should not affect the incision sites.

One of the significant benefits of having buccal fat removal is that it does not result in any visible scarring as all surgical incisions are made inside the mouth. The incisions are small in length heal very well.

Risks of buccal fat surgery

Although the procedure is considered to be very safe, there are several recognised complications of buccal fat surgery including but not limited to:

• Bleeding
• Infection
• Seroma
• Haematoma
• Injury to saliva glands
• Facial nerve injury

If you have been thinking about having buccal fat removal at Centre for Surgery, we would recommend having a personal consultation with an expert surgeon to gain a complete understanding of what the procedure involves and what to expect from buccal fat removal surgery to help achieve the best possible results.

There are several factors which will determine the overall cost of the buccal fat reduction procedure and the final quotation will be given after your face-to-face consultation with your specialist plastic surgeon.

Centre for Surgery is the leading cosmetic surgery clinic located in the heart of London. Our state-of-the-art surgical facility is located on Baker Street in Marylebone.

We are home to some of the leading consultant plastic surgeons in the UK with expertise in facial cosmetic surgery. Our practice philosophy is focused on achieving outstanding outcomes and providing the highest levels of service. We are considered the top choice for cosmetic surgery treatments in the UK with many patients travelling from overseas to receive excellent medical care from our consultant specialists.