A Sydney Plastic Surgeon Weighs In On The Viral Buccal Fat Removal Procedure

It's the cosmetic surgery that's taking social media by storm and has everyone talking. Buccal fat removal is the divisive face procedure where excess fat is removed from the cheek pads for a more sculpted, chiselled appearance.
Buccal fat removal is just one of many cheek defining and contouring procedures, joining the ranks of implants, lifts, grafting and fillers. But while buccal fat removal is not new, interest has skyrocketed in the last fortnight after actor Lea Michelle shared a selfie with pronounced cheekbones, leading to much speculation on how to attain similar results.
Users on TikTok have been sharing their experiences with the overnight trend. Meanwhile, on Twitter, people are shunning the procedure and starting a countermovement to embrace fuller cheeks.
To cut through the noise, we enlisted the help of Sydney specialist plastic surgeon and author of new release The Art Of A Facelift - The Plastic Surgeon Behind The Face, Dr Jack Zoumaras, to answer all your burning questions about buccal fat removal.

What is buccal fat removal?

"Buccal fat can contour the lower face and accentuate the jawline, but it is a procedure that is one tool of many to achieve a desire that a patient has," Dr Zoumaras says. He says he has definitely noticed an increase in the number of inquiries about the procedure of late, thanks to social media.

What does the procedure involve?

At Dr Zoumaras' clinic, a consultation is always the first step — however, this isn't always the case. Some practitioners will do the procedure in their office on their first visit, without an initial assessment.
He explains that the procedure takes place under surgical conditions, meaning that while it is quick to do, it's not an in-and-out job where you can return to business as usual straight after.
Buccal fat removal is performed under local anaesthetic or can sometimes be performed under general anaesthesia during a day surgery. Plastic surgeons open your mouth up just like you're at the dentist, before making an incision and pulling and cutting the fat pockets from the inside.

Just because buccal fat is trending, it doesn’t mean you are eligible.

dr Jack Zoumaras
"Usually it takes 30 minutes," he says. "It is often an ancillary procedure rather than a standalone — often combined with a neck lift, facelift or neck liposuction".
While the cost varies based on the experience and qualifications of your chosen professional, prices start at $5,000 for Dr Zoumaras.
The recovery time for the day surgery is fast and you should have minimal discomfort, he says, sharing that recovery time should be around seven days. You can also expect some swelling and there's a chance of bruising in this period as well.

Who can get buccal fat removal?

Like all cosmetic surgery procedures in Australia, you do have to be 18 or over to be eligible. But from there, it's really down to each individual. Having said that, it's important to note that even if a patient is interested in a particular procedure, a good plastic surgeon will only go ahead with it if it's the right fit for them.
Dr Zoumaras says that anyone who would benefit from broader lower facial contouring would be suitable, sharing that people with round faces, a heavy neck or heavy lower faces form the bulk of his patients for this procedure.
"For plastic surgeons, procedures are aimed at getting a desired outcome," he says. "The procedure itself varies for each patient and is not a product — so just because buccal fat is trending, it doesn’t mean you are eligible."

Are the results reversible?

The short answer is no — buccal fat removal is a permanent procedure and unfortunately, you can't go back in to replace the lost fat. Once you're in, you're in.
"I would caution people as it is a procedure that is not reversible," says Dr Zoumaras. "Once the fat is removed, you cannot put it back. It is also worth noting that we lose fat in our face as we age."
In an age where popular procedures peak and trough — just look at BBL removals or "turkey teeth" veneers — it's worth undergoing extensive research into the surgery itself and who's performing it.

What are the associated risks?

Like all plastic surgery and non-surgical cosmetic procedures, there are possible complications you should know about. With buccal fat removal, Dr Zoumaras says you should be aware of the possibility of motor nerve injury — the parts that aid movement in the face — although this is rare in the hands of an experienced plastic surgeon.
Other health considerations include haematoma (blood clots) or injury to a major salivary gland, the parotid duct — the latter is again rare if your surgeon knows what they're doing.
On a more cosmetic note, Dr Zoumaras says there's a chance the job could be asymmetrical, or too much fat is removed in proportion to your face, leading to a gaunt appearance. His best advice is to seek an experienced face plastic surgeon to see if buccal fat removal is suitable for you. Our best advice is to really interrogate why you're considering the surgery in the first place, as one of many in a series of ridiculous beauty trends.
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