Buccal Fat Pad Removal

The buccal fat pad is in the intraoral fat tissues rather than in the subcutaneous fat. It is located between the masseter muscle and the mandible, around the middle one-third of the lower face; the main function of this fat pad is acting as a buffer between the cheeks and gum to protect the teeth from being hit. However, because of congenital overgrowth, obesity, over-chewing, degenerative bulge, or even postoperative fat pad loosening, these fats will bulge out of the cheeks, which makes the lateral cheeks seem fleshy (the so-called “cubby face” or “baby fat”) or make patients look old with a sagged lower face when the fat blocks next to the mouth corners show up when smiling. In addition, the bone reduction procedure itself can cause skin loosening around the cheeks or jawline, making the buccal fat look more sagging. Therefore, Dr. Zhuang will consider combined buccal fat pad removal with zygomatic or mandible reduction to reduce the fat amount inside the cheeks and prevent the possibility of postoperative cheek sagging. The procedure can be performed through the same gum incision as bone reduction; intraoral fat pads next to the masseter muscle can be identified and completely removed. In some patients with bony prominence but not really a round face, Dr. Chuang will preserve one-third of the fat pad in place to avoid depressed cheeks in the future. Because this procedure does not need an extra incision, it will not increase the swelling extent or recovery time. In aged patients for facial bone reductions, Dr. Chuang will perform either midface or jawline lift in combination with buccal fat pad removal to augment the best facial contouring results.

Surgical conditions


  • Type of anesthesia: IV sedation or general anesthesia
  • Type of incision: Intraoral gum (same as the incision of bone reduction)
  • Recovery: 5–7 days
  • Removal of stitches: None

General instructions

No food and water on the day of surgery

  • Consumption of hard or rough food should be avoided for 1 week postoperatively.
  • Smoking, alcohol consumption, or other irritating foods should be avoided for 1 month postoperatively.

Ideal candidates

  • Those who have obvious baby fat or chubby face before bone reductions.
  • Those who have round faces or “pancake faces” with fleshy cheeks.
  • Those who present with cheek loosening or sagging after bone reduction.
  • Those who pursue obvious slim or V-shaped faces.

Potential complications

  • Over correction
  • Depressed cheeks
  • Premature skin loosening

Surgical advantages

  1. Will enhance the result of reducing or slimming the face and making the facial contour more oval- or V-shaped in bone reductions.

  2. Will avoid round and chubby cheeks or loose skins after bone reduction procedures.

  3. Will reduce the skin burden on the cheeks and prevent premature skin drooping after bone reductions.

  4. Will improve congenital baby fat.

Surgical drawbacks

  1. Will cause the face to be overly slim if it is over-corrected.

  2. Will result in depressed cheeks in the future if too much fat is removed.