Facial definition also depends on knowing which volume to preserve.
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Illustrative image; not a patient or surgical result.
At a glance
Buccal fat removal reduces part of a deep fat compartment in the cheek to change its contour. I perform the procedure through an incision inside the mouth, after assessing whether that fat actually contributes to your concern. It does not treat every cause of a round face, remove a double chin, or replace a facelift when tissue descent is the main issue. Preserving useful facial volume is an essential part of planning.
You may want a clearer transition from the cheek toward the jaw without losing the softness that makes your face familiar. That distinction matters. My assessment starts with what you see and what you would like to preserve, rather than with a goal of removing as much fat as possible.
I look at your face from the front, in profile, and during movement. I ask about weight changes, previous treatment, and how your appearance has changed over time. A photograph can help you explain your concern, but it cannot reliably tell us which anatomical structure is responsible.
Sometimes the right conclusion is that removing cheek fat would not help. In other cases, a limited reduction may contribute to a broader plan. Either way, I want you to understand the reasoning before making a decision, particularly because adding volume later is not the same as restoring the original anatomy.
A reduction may be worth discussing when deep cheek fat genuinely contributes to the contour you want to change. I assess that area in relation to the cheekbones, chin, and surrounding volume instead of considering it in isolation.
A heavy-looking lower cheek can reflect changes in tissue position. Repositioning may be more useful than removing volume. The assessment should include the jawline and neck rather than assume every fold or bulge comes from the buccal fat pad.
Further reduction can accentuate a hollow appearance. If the face is narrow or areas are already depleted, preserving volume may be the more appropriate choice. Age alone does not settle that question; distribution and anatomy matter.
The chewing muscles and the bony framework also influence facial width. A broad jaw caused mainly by muscle is not the same problem as excess cheek fat. You do not need to distinguish these possibilities yourself: bring your questions, and we will examine them together.
During a deep plane facelift assessment, I may identify a localized contribution from the buccal fat pad that is worth reducing. The purpose is to complement tissue repositioning in a selected patient, not to make buccal fat removal part of every facelift.
In another area of the same face, there may be a reason to add volume through facial fat grafting. These decisions are not contradictory. Different compartments can have different needs. A useful plan explains what will be preserved, what will be repositioned, and what—if anything—will be reduced.
I do not treat cheek reduction as a shortcut to all lower-face concerns. For example, limited chin projection and neck fullness require their own assessment. A chin implant changes local projection, while a neck procedure addresses different structures. More procedures are not inherently better; each one should have a specific purpose.
Let us assess the structures behind your concerns and whether cheek reduction belongs in your plan.
My access is through the lining inside the mouth. I identify the fat compartment and reduce it according to the plan. Nearby structures include blood vessels, branches of the facial nerve, and the duct that carries saliva from the parotid gland into the mouth. Their proximity is one reason a small incision should not be mistaken for a risk-free procedure.
I use general anesthesia for this operation in my practice. When it is combined with other facial surgery, anesthesia arrangements and hospital care follow the overall plan. This is a description of how I work, not a claim that one anesthetic approach is universally superior.
I do not perform enzymatic buccal fat removal. This page describes surgical reduction. I also do not offer injectable fillers as a substitute service. If examination shows that removing fat is not appropriate, I will explain that rather than present a procedure you do not need as the next best option.
There is no honest promise that a selected face can never become too hollow later. Careful indication matters, but it does not give us control over every change that occurs with aging, weight variation, and previous or future treatment. The question is whether the expected benefit justifies removing volume that may be valuable over time.
A 2026 systematic review included ten studies and 1,123 patients. It found reduced lower-face volume and high satisfaction, but the authors emphasized low-level evidence and short follow-up. Long-term effects were poorly assessed. Favorable early results therefore do not establish what each patient will look like many years later.1
An earlier systematic review included four studies and likewise identified limitations in study quality and long-term follow-up. Its initially favorable findings should be read with those limitations, rather than used as proof that the procedure prevents or cannot accentuate an aged appearance.2
I use that uncertainty as part of the consultation. It does not mean no one should have the procedure. It means the decision should be deliberate, and that preserving volume can be a positive treatment choice rather than a missed opportunity.
The 2026 review reported 39 complications among 921 procedures, or 4.2%, mostly described as minor. That procedure denominator is different from the review's total number of patients. The studies also had limited follow-up, so the figure cannot capture every possible later concern.1
Those published results are not my personal complication rate and are not a prediction of your risk. A pooled figure combines patients and techniques that may differ from your situation. We still need to discuss the specific structures involved, your health, the proposed combination of operations, and what would happen if a problem developed.
A small chance of a consequential complication deserves attention even when a study describes most events as minor. My responsibility is to explain the tradeoff clearly enough for you to decide whether the proposed change is worthwhile.
The cheeks may initially look fuller because of swelling. That early appearance does not show how much contour change the procedure will ultimately provide. Discomfort, pressure, and tenderness are addressed through the individualized care plan, and I assess progress during follow-up.
In my usual routine, the initial diet is liquid or soft for about five days, with oral hygiene instructions tailored to the internal wound. Do not force the mouth open or press on the cheek to test whether it has healed. The incision needs examination even when there is no visible external scar.
Return to work depends on your comfort, the type of work, and the other procedures performed. When a facelift is included, the overall recovery plan governs activity and appointments. Another person's quick recovery is not a reliable schedule for your own surgery.
We use follow-up photographs to assess the evolving result over time. I would rather compare meaningful stages of healing than have you judge every small daily change in the mirror. You will receive specific instructions rather than having to build an aftercare plan from this page.
Possible complications include bleeding or hematoma, infection, fluid accumulation, asymmetry, sensory changes, persistent pain, prolonged swelling, and poor wound healing. Injury to a salivary duct or a facial nerve branch can occur; nerve injury may cause temporary or permanent muscle weakness. The aesthetic change may be disappointing or small, and another operation may be needed.3
Excessive reduction can create unwanted hollows. Revision does not necessarily reproduce the volume or distribution you had before. Anesthesia risks and serious systemic complications, including blood clots and cardiopulmonary events, also belong in the assessment of the whole surgical plan.3
Contact the team promptly for rapidly increasing swelling, worsening pain, fever, discharge, or significant difficulty swallowing. Breathing difficulty requires emergency care rather than waiting for a message reply. We explain contact arrangements and warning signs before discharge so you know how to act if recovery differs from what you expected.
If you have already had buccal fat removal and dislike the result, bring the information and photographs you have. I need to understand what was done, how much time has passed, and whether the concern is asymmetry, depletion, tissue descent, or something else.
Fat grafting may help selected depressions, but it is not an undo button. Retention varies, and more than one approach may be needed. Similarly, removing more fat from one side is not automatically the right response to asymmetry. The cause should be assessed before another intervention is proposed.
This is one reason the first decision deserves care. The goal is a contour you can feel comfortable with, not simply the largest visible change immediately after treatment.
Bruna is your first contact for questions and scheduling. An online consultation can help us start the discussion and review your concerns before you travel. The surgical plan still requires in-person assessment; photographs and video do not replace examination of the face and mouth.
If buccal fat removal is part of your facelift, plan to arrive two days before surgery, with an in-person consultation and photographs usually arranged the day before. After surgery, allow at least twelve days in Londrina, preferably fourteen, for the planned early follow-up. These intervals belong to the combined facelift journey, not an automatic travel clearance for every cheek procedure.
Confirm the arrangements before purchasing flights and allow flexibility if additional assessment is needed. The patient journey explains how preparation, local support, appointments, and follow-up fit together. We also discuss how contact will continue after you return home and when an in-person review may be necessary.
It does not directly remove fat beneath the chin. The cheeks and neck need separate assessments, even when both contribute to your impression of facial contour.
No. I consider it only when a localized excess justifies reduction. For many faces, preserving cheek volume is a better part of the plan.
Age by itself does not determine the answer. Existing volume, tissue position, anatomy, and the change you want are more informative than a single age cutoff.
Not in its original form. Fat grafting can help some hollows, but it does not automatically restore the previous anatomy and may require further treatment.
The contour becomes easier to assess as swelling settles over weeks and months. Timing varies with the extent of surgery and any combined procedures. Early swelling can hide or distort the change.
I will explain the structure involved and whether another assessment or treatment approach makes more sense. I do not offer enzymatic cheek reduction or injectable fillers, and I will not recommend fat removal simply because it was the procedure you initially asked about.
Tell me what feels heavy, what you would like to refine, and what you do not want to lose. We can examine whether reducing, repositioning, or preserving volume best addresses that concern. Bruna can help you arrange the first conversation from outside Brazil.
These sources support the general information on this page. Descriptions of my practice explain how my team works; your surgical instructions will be individualized.