Buccal fat removal: where to have it done? Four things to check, including whether the clinic follows a conservative approach

When choosing where to have buccal fat removal, first confirm whether the clinic follows a philosophy of "not removing everything, but reducing modestly."[1]This fat lies very close to facial nerves and the salivary duct pathway, so thorough knowledge of anatomy is the foundation of safety.[2]It is also important that the clinic assesses during consultation whether the procedure is actually suited to your face.[3].

Why is a "not over-removing" approach important?

Removing too much can result in hollowed cheeks and a bony appearance.[1]For this reason, it is common practice not to remove all the fat, but to reduce only a portion.[1].

Even in younger people, it should be explained that there is a risk of the face appearing older in the future.[3]With a conservative reduction plan, this risk is thought to be minimizable.[3].

Ask during consultation, "How much will you remove?" The way the amount is discussed and whether there is an explanation of the hollowing risk is your first benchmark.

How will the clinic determine whether this procedure suits you?

It is suitable for people whose face is round and full, with volume in the front of the cheeks.[3]The result varies depending on the original size of the fat.[1].

Before surgery, it is considered important to assess the amount of fat and any asymmetry between left and right.[3]It is common for the amount to differ between the left and right sides.[3]Whether the clinic explains asymmetry during consultation is your second benchmark.

Why will the clinic ask about past treatments?

Studies have reported that in people who have had fat-dissolving injections in the cheeks, the success rate of surgery decreases and complications increase.[4]This research is limited in scale and requires further confirmation.[4].

Nevertheless, whether the clinic asks about treatment history before making a plan is your third benchmark. If you have had fat-dissolving injections or other cheek procedures, disclose this.

What is the frequency of complications, and what should I confirm?

Most are mild, and severe ones are rare.[5]In a summary of research including 1,123 people, 39 cases (4.2%) of complications occurred among 921 surgeries, and most were mild.[5].

On the other hand, in another study summarizing 308 people, 81 people (25%) experienced some form of complication.[6]The most common were swelling, difficulty opening the mouth (trismus), pain, and asymmetry.[6]The difference in numbers is thought to be because different studies counted mild symptoms such as swelling differently as complications.

Rarely, temporary facial nerve paralysis, injury to the salivary duct pathway (parotid duct), or severe bleeding can occur.[2][7][8]In a study examining cadaveric dissection, 26.3% showed branches of the facial nerve running through the protruding portion of this fat.[7].

That is why asking how complications are managed when they occur is your fourth benchmark. Also confirm the post-operative contact information and times you can be seen.

Looking long-term, what remains unclear?

Changes in appearance many years later are not yet well understood.[5]Most research has short follow-up periods, and results over longer periods have not been sufficiently investigated.[5].

Based on this article alone, you cannot decide whether this surgery is right for your cheeks or how much should be removed. During consultation, convey the amount of fat and asymmetry between left and right, the risk of hollowing as you age, and any past treatments you have had; then confirm the clinic's approach to the amount to be removed and how complications will be managed.