Buccal fat
19 December 2022
Buccal fat removal- You might have been inundated by this term on social media in the past few days. The reason? Controversy ridden Glee- alumnus Lea Michele posted a sultry looking selfie on Instagram, which flaunted her sculpted looking face. The appearance of her very prominently hollow cheeks sparked internet discussion on whether Lea Michele had work done and reignited interest in buccal fat removal surgery.
Removing buccal fat for a thinner looking face and to create a more angular facial appearance has been growing in popularity in recent years. Celebrities sporting the contoured looking face of the moment, such as Bella Hadid, Zoe Kravitz, Ariana Grande and Sophie Turner, have invited public speculation about whether they received cosmetic work, including buccal fat removal to achieve their sharp, sculptured faces. One celebrity that has publicly admitted to undergoing buccal fat surgery is model and cookbook author, Chrissy Teigen. In 2021, she shared on her Instagram stories with Dr Jason Diamond, a plastic surgeon from Beverly Hills.
Across TikTok, buccal fat removal surgery may come across as a simple surgery for an instant looking sharper and slimmer face. However, removing buccal fat is not without its complications and long term consequences. This review will take you through everything you know about this trending surgery and why you should consider preserving your facial fats instead.
The buccal fat pad is a naturally occuring fat pad between the cheekbones and jawbones. The buccal fat pad gives shape to the sides of the cheeks. It has a complex anatomical structure with close relations to vital structures in the face, including major blood vessels, nerves and a salivary duct. The size of the buccal fat pad varies from person to person. For some people with greater volume in their buccal fat pad, their face may appear wider. For others with a smaller volume in their buccal fat pads, their faces may look smaller or hollow at the sides.
The “baby face” look or “baby fats” is largely due to the size of the buccal fat pad in the face. In babies, the buccal fat is especially prominent. The primary function of the buccal fat pad is thought to be in supporting the suckling and chewing function in children; and to cushion important nerves and blood vessels in the face.
Buccal fat removal surgery is performed for cosmetic reasons to create a slimmer face with more hollow cheeks. This has the effect of accentuating the contours of the cheekbones and the jawbones. If you were to suck in your cheeks, you would get a similar look.
Although buccal fat removal may be social media’s surgery du jour; buccal fat removal has a longer, more complex history for therapeutic purposes. One of the therapeutic indications for buccal fat removal is the treatment of oroantral fistulas. An oroantral fistula is an open communication between the sinus and the oral cavity; occurring as result of teeth extractions, trauma or infections. In large defects, surgical closure with buccal fat is needed.
In Singapore, buccal fat removal surgery is performed only by plastic surgeons. Typically, an incision through the mouth is used to hide the incision. A portion of the buccal fat is removed; and the incision is removed.
There is no non-surgical treatment to remove the buccal fat. Mesotherapy (injection lipolysis) or fat dissolving injections is banned in Singapore.
Related blogposts:
Why are Mesotherapy Fat Dissolving Injections Banned in Singapore?
Instead, for non-surgical alternatives to buccal fat removal surgery in Singapore; the options focus on addressing other areas of the face that could contribute to a widened and sagging appearance; and improving the facial contours. Some of the non-surgical alternatives to buccal fat removal in Singapore include:
• Jaw botox:
Individuals who have enlarged jaw muscles (masseteric hypertrophic) or jaw clenching/grinding (bruxism), their face may look broad and wide. The jaw muscles are located at the slides of the face, adjacent to the buccal fat pad; and can contribute to a wide face. Botox injections to the jaw to relax the masseter muscles can treat teeth grinding/clench and slim down the sides of the face for a more contoured look. You can learn more about jaw botox for bruxism and see how its done in Bruxism & Treatments for Teeth Grinding.
• Cheek fillers
Individuals looking for a snatched or prominent cheekbones can consider getting fillers to their cheekbones. Cheekbone fillers can give a sculpted look; and are effective in restoring lost volume to the cheeks and cheekbones to improve definition in the cheek area. You can learn all about cheek fillers in Getting Cheeky: A Guide to Cheek Filler Injections.
• Jawline fillers or face threadlift
To enhance or create definition in the jawline, jawline fillers are employed to sculpt the jaw. Where sagging skin and jowls obscure the jawline, a non-surgical face threadlift in the jawline can lift the sagging for a tighter and sharper looking jawline. More about face threadlift in Silhouette Soft Face Threadlift.
The complication rate of buccal fat removal surgery is quoted between 8.45-18%. Because of the close relationship of the buccal fat pad to multiple blood vessels, the facial nerve, and one salivary gland duct (parotid duct), surgery to remove the buccal fat pad can damage these vital structures. Some of the reported complications of buccal fat removal surgery are: haemorrhage, facial asymmetry, parotid duct injury, hematoma, trismus, neuromotor deficits, and infection. In 2012, one patient almost died from massive bleeding after intraoral buccal fat removal.
Buccal fat removal surgery could lead to a premature hollowing of the face, predisposing the individual to premature facial ageing and distortion with a gaunt and haggard look.
Volume loss in the face is a naturally occurring phenomenon due to fat atrophy and bone resorption. In the cheeks, this leads to hollow and flat looking midface. Increasing skin laxity causing sagging of the cheek also accentuates this process. Hence, with buccal fat removal surgery on board; the hollow and aged look can be more pronounced. In treating signs of ageing in the face, replenishing this natural volume loss with dermal fillers is part of restoring lift and a youthful look. Cheek fillers, as part of the Liquid Facelift technique, are done for this purpose. For individuals who look gaunt and hollow after buccal fat pad removal surgery; they may need cheek fillers to correct this look.
A hollow, sculpted look may be Hollywood’s latest trend, but getting buccal fat removal is a permanent treatment that is not without its risks. Removal of this fat pad in the cheek to create a hollow look can also cause one to look gaunt and old. For non-surgical alternatives to buccal fat removal, consider jaw botox, cheek fillers, jawlines fillers and jawline threadlift.
References:
1. Buccal Fat Pad Reduction. Davis and Serra. StatPearls, Pubmed 2022.
2. Buccal fat pad removal to improve facial aesthetics: an established technique? Moura et al. Med Oral Patol Oral Cir Bucal. 2018 Jul; 23(4): e478–e484.