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.