Buccal fat pad extraction or buccal fat removal is a

plastic surgery Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes cranio ...

procedure that removes a grape-size piece buccal fat-pad tissue from each side of the face in order to reduce the appearance of cheek puffiness. It is a strictly cosmetic surgery.

History

The buccal fat pad was firstly described by

Lorenz Heister Lorenz Heister (Latin: ''Laurentius Heister'') (19 September 1683 – 18 April 1758) was a German anatomist, surgeon and botanist born in Frankfurt am Main. Biography From 1702 to 1706 Heister studied at the Universities of Giessen and Wetz ...

as a glandular tissue in 1732. However, in 1802

Xavier Bichat Marie François Xavier Bichat (; ; 14 November 1771 – 22 July 1802) was a French anatomist and pathologist, known as the father of modern histology. Although he worked without a microscope, Bichat distinguished 21 types of elementary tissues ...

popularized and defined the structure as fat tissue. The American Society of Plastic Surgery does not keep statistics on the procedure. On December 16, 2022, ''

The New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid d ...

'' reported that the procedure was gaining popularity on

Twitter Twitter is an online social media and social networking service owned and operated by American company Twitter, Inc., on which users post and interact with 280-character-long messages known as "tweets". Registered users can post, like, and ...

and

TikTok TikTok, known in China as Douyin (), is a short-form video hosting service owned by the Chinese company ByteDance. It hosts user-submitted videos, which can range in duration from 15 seconds to 10 minutes. TikTok is an international version o ...

. It is widely suspected that celebrities like

Bella Hadid Isabella Khairiah Hadid (born October 9, 1996) is an American model. In 2016, she was voted "Model of the Year" by industry professionals for Models.com. Over the span of four years, Hadid has made twenty-seven appearances on international '' ...

, Lea Michele have had the procedure to obtain high, contoured, and chiseled cheekbones. In 2021,

Chrissy Teigen Christine Diane Teigen (born November 30, 1985) is an American model and television personality. She made her professional modeling debut in the annual ''Sports Illustrated'' Swimsuit Issue in 2010 and later appeared on the 50th anniversary co ...

revealed that she had undergone the procedure.

Surgical procedure

Cost

Buccal fat removal is considered a cosmetic procedure and is rarely covered by insurance. It is typically performed by plastic surgeons. According to RealSelf, the average cost was $2,400 in 2019. Interviewed by ''The New York Times'' in 2022, one plastic surgeon stated he charged $40,000 for the procedure, while other surgeons said they typically charged between $7,000 and $16,000.

Associated procedures

Buccal fat removal is often performed as a solo procedure but can be done alongside a facelift, chin implant, neck lift or any surgery attempting to add definition to the face. It is often also done in combination with chin liposuction and fat grafting.

Technique

The reduction of buccal fat pad is usually performed under local anesthesia with the patient completely awake. The typical approach for removing the buccal fat pad is through an incision in the mouth, towards the back of the oral cavity, near the second upper molar. The

buccinator muscle The buccinator () is a thin quadrilateral muscle occupying the interval between the maxilla and the mandible at the side of the face. It forms the anterior part of the cheek or the lateral wall of the oral cavity.Illustrated Anatomy of the Head ...

is then encountered and without making an incision, the fibers are separated until the buccal fat is seen. Once the buccal fat is visualized, a thin casing over the fat is opened and the fat is gently teased out while gentle pressure is applied externally. The fat is then cauterized at the base and removed. The remainder of the buccal fat pad then is replaced to its anatomic site and the oral mucosa is sutured close, and the two incisions are sutured. Typically the procedure takes about 30 minutes to complete.

Recovery

Patients typically have swelling for a few days, but often this swelling is not visible externally. Typically, self absorbing sutures that dissolve on their own are used. The final results can take up to 3 months to manifest.

Risks

Injury to the buccal branch of the

facial nerve The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste ...

is a risk; the buccal branch nerves that might be affected control facial functions, therefore, such damage might result in partial facial paralysis, regional facial numbness, loss of

taste The gustatory system or sense of taste is the sensory system that is partially responsible for the perception of taste (flavor). Taste is the perception produced or stimulated when a substance in the mouth reacts chemically with taste receptor ...

, et cetera. Likewise, damage to the

parotid duct The parotid duct, or Stensen duct, is a salivary duct. It is the route that saliva takes from the major salivary gland, the parotid gland, into the mouth. Structure The parotid duct is formed when several interlobular ducts, the largest ducts in ...

also might occur in men and women whose

s run deep to the buccal fat pad, which can lead to a salivary fistula or buildup of saliva. File:Buccal Fat Diagram.jpg, Cheek reduction: Anatomic illustration of the fat pads of the mouth (buccal fat pads). File:Location of Buccal Fat Pad.jpg, Buccal fat-pad reduction: The anatomic locale of the buccal fat pads in the human face. File:Extracted buccal fat.jpg, Cheek reduction: The buccal fat pads extracted from a patient who underwent bilateral cheek reduction

In popular culture

The surgery became a trend in the early 2020s, and people colloquially named it "Handsome Squidward surgery."

References

{{reflist Plastic surgery