Thanks to one hell of a lot of TikTok beauty trends and unhinged Twitter threads, this past year has presented no shortage of cosmetic surgeries sweeping the internet. According to recent data from the American Society of Plastic Surgeons, the plastic-surgery industry is on the rise and three of the top five most-performed plastic-surgery procedures were on the face: rhinoplasty, eyelid surgeries, and face-lifts. The latest facial procedure to enter the group chat? Buccal fat removal.
Before we get into all of the internet tea, let’s go back to the basics of what this aesthetic treatment actually is. “Buccal fat removal is a cosmetic surgical procedure in which excess fat from the buccal fat pads, which are located deep in the cheeks under the buccinator muscle, is removed,” says New York City–based double-board-certified facial plastic surgeon Hardik Doshi. “The procedure is typically performed to give the face a more chiseled or defined appearance.”
This face-slimming fad has been all over your feed recently for a reason. It all started when Lea Michele posted a selfie earlier this month, causing a stir of speculation from Twitter users claiming she apparently had the procedure done. A viral tweet that garnered nearly 17,000 likes brought up other big names in the thread, like Bella Hadid and Miley Cyrus, claiming they’ve also undergone the procedure. But the only celeb who has outright confirmed this to be true is Chrissy Teigen, who admitted on her Instagram stories last year that she got the procedure done by plastic surgeon Dr. Jason Diamond.
Although the procedure is resurfacing online now, buccal fat removal has been around for decades. “The first recorded procedure was being performed in the 1930s,” says Doshi. “However, it has gained more popularity in recent years as more people have become interested in cosmetic surgery and in enhancing their appearance, especially with the rise of social media and filters.”
Some people are pushing back on social media, like pop culture commentator Olivia Broussard, who posted a video on TikTok that has since been viewed over 260,000 times standing up for the “chubby-cheek hotties” who aren’t into having a contoured face shape to look more desirable. “If my random silly little video managed to change even one person’s mind on getting the surgery, then that makes me happy,” she tells the Cut. “I would just hate for anyone to get influenced into altering their face to fit into a ‘trend’ that may go away as quickly as it appeared and then end up having regrets later on.” Ahead, experts reveal everything there is to know about this cosmetic procedure.
What Else Happens During the Actual Procedure?
In terms of time spent under the knife, the treatment is definitely not an all-day thing. “This whole process can take as little as five minutes per cheek,” says facial plastic surgeon Dr. Alex Montague, adding that it depends on how much fat needs to be removed. “The procedure itself is fairly quick and can be done in one of two ways,” he continues. “When performed as a solo procedure, it is done under local anesthesia through a small, intraoral incision on the inside of the cheek. The buccal space is entered and the fat pad is actually delivered into the mouth where it is gently cauterized and removed. The incision is then closed with a few absorbable sutures.” Buccal fat can also be removed as part of a face-lift — in those cases, it can take much longer to complete.
Doshi describes the surgical steps in a similar way: The surgeon will make a small incision inside the cheek, near the back of the molars, and remove a marshmallow-size amount of fat from the buccal fat pads. The incision is then closed with sutures or dissolvable stitches.
How Safe Is This Treatment?
If you’re thinking about making permanent changes to your face, be sure to do your research and go to a surgeon with the necessary credentials that you trust. When this treatment is performed by a qualified and experienced facial plastic surgeon, it’s generally safe. However, like all surgical procedures, it comes with potential complications “Some of the potential risks of buccal fat removal include infection, bleeding, and scarring,” says Doshi. “In rare cases, the procedure may cause numbness or loss of sensation in the cheek area or damage to muscles that help with smiling. The procedure may also result in an uneven or asymmetric result or in an excessively sunken change in the appearance of the face if too much fat is removed or removed in an unqualified individual.” Montague agrees that the procedure is a safe, marginally effective tool, but he emphasizes the importance of being clear with your provider about the desired results. “We must be very open and honest with our patients about expectations and judicious with our patient selection,” he says.
Is There an Ideal Face Shape or Age Range for Buccal Fat Removal?
The thing about buccal fat removal is the results are going to grant you the appearance of an even thinner face shape, so if you naturally have a gaunt jaw structure, it is going to result in an even more sunken, hollow appearance. “The procedure is typically more appropriate for patients who have full or rounded facial structures and are interested in reducing the fullness in their cheeks to give their face a more defined and chiseled appearance,” recommends Doshi. And if you’re wondering which celebrity faces patients reference the most for resemblance, Montague’s findings are not at all surprising: “Bella Hadid has been the one most referenced for me.”
As far as age range, Dr. Ellen Marmur, board-certified dermatologist and founder of MMSkincare, does not suggest you wait if you’re considering it. “The buccal fat pad reduction can backfire as early as the age of 40,” she says. “The chiseled cheekbone and jawline look awesome until things change, like weight, teeth, bones, soft tissue — and then it looks gaunt. All day long I recreate this area with fillers and other techniques to lift and replenish for a soft glow.” Montague mostly gets this request from female patients in their 20s. Doshi agrees, stating that it is generally more appropriate for patients who have completed their facial growth and development, which typically occurs in the early 20s. “However, completion of facial growth does not mean a patient should undergo this procedure in their early 20s,” he clarifies.
There’s an ongoing debate on whether or not this facial treatment can accelerate signs of aging. “Some studies have suggested that removing the buccal fat pads may cause the face to look more sunken or hollow over time, as the fat pads may help to support the cheek structure and maintain a full, youthful appearance,” he says. “On the other hand, other studies have found that buccal fat removal does not have a significant effect on the aging process of the face. In fact, research has found that the procedure may actually improve the appearance of the face by giving it a more defined and chiseled look.” With that said, this claim is quite controversial and has not yet been proven.
Natural, more aesthetic results are the goal of board-certified plastic and reconstructive surgeon Dr. Andrew Cohen, who owns a practice in Beverly Hills. “If faces get too gaunt, you can definitely look older,” he believes, adding the importance of performing this treatment on a face with extra padding, a.k.a. a rounder face shape. “We get natural results by carefully removing the padding in those areas only — it can help define their features. It is also important to not ever remove all of the buccal fat pad but instead leave a minimal amount for aesthetically pleasing final results.”
How Much Does This Treatment Cost?
The cost will vary greatly from practice to practice and based on the expectation of results. But typically, it can range from $2,000 to $5,000. A few doctors charge an even higher fee of $10,000, depending on where you receive the treatment.
What’s the Downtime, Post-Op Process Like?
Like most invasive procedures, heavy exercising and weight lifting right away are not recommended. In fact, you should lay off high-intensity activities for the next few weeks, Cohen advises. You may experience bruising and swelling from the stitches in your mouth, so Cohen recommends keeping soft and lukewarm foods nearby for the foreseeable future.
What Do Experts Honestly Think of This Trend?
“My honest opinion is that this procedure is being blown out of proportion with what it can really achieve,” admits Montague. “The results are almost always subtle, and patient candidacy can be quite difficult to determine.” With that said, it would be naïve of us not to consider all of the other treatments celebrities have access to, with buccal fat removal being just one of them. “My suspicion is that when we see celebrities that have had this procedure, and we see impressive before-and-after pictures, it is likely that they have also had significant facial contouring via injectable fillers, like zygomatic augmentation and jawline contouring. Injectables are more easily tailored to patients’ needs and can achieve a sculpted, chiseled cheek contour rather impressively. This can very easily obscure the true results of the buccal fat removal itself,” Montague explains. Case in point: There’s always much more than meets the eye.
Is There Anything Else to Consider?
Lastly, this treatment is not to be confused as a quick fix for weight loss. “It is not meant to be used as a substitute for a healthy diet and regular exercise,” says Doshi. “It is also important to remember that the procedure is not reversible and that the results are permanent. Therefore, it is important to carefully consider all of the potential risks and benefits of the procedure with your surgeon before deciding to undergo it.”