Buccal Fat Pad Removal (Cheek Reduction)

Buccal Fat Pad Removal (Cheek Reduction)

A Buccal Fat Pad Excision is a simple and effective procedure used to thin and shape the face. This Austin TX minimally invasive procedure is performed through a small incision inside the mouth to decrease volume in the mid cheek. Good candidates for this procedure have a full face or rounded cheeks and can improve the facial definition and balance with this slimming procedure.

  • The Buccal fat pad is a consistent pocket of fat which lays below the cheekbone in the midface region.

The best procedure for the cheeks depends on the fullness and balance in the middle third of the face along with middle cheek volume. Dr. Trussler will discuss your facial goals to help you decide which treatment option is best for you to achieve the results you desire.

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What Are My Options?

A buccal fat pad excision procedure is not for everyone and a full, rounded cheek is a necessity for a successful procedure. Age and genetics, as well as ethnicity, relate to why the cheek is full. Conservative shaping of the upper face and cheekbones may be treated with fillers designed for the cheek such as Voluma and Restylane Defyne. Most patient’s inquiring about a buccal fat pad excision have already undergone facial procedures.

Some of the lip options commonly used by Dr. Trussler for facial shaping include:

  • Hyaluronic Acid filler injections such as Voluma®
  • Fat injections using the patient’s own fat from another area of the body
  • Collagen Biostimulators such as Sculptra®
  • Midface Lift involves an incision below the lower eyelid which can naturally shape and lift the cheek
  • Lower Facelift Procedure smooths the lower face including the jawline and neck

Each of these different types of cheek augmentation and shaping offer patients benefits over other techniques, though surgical techniques are preferred. You can discuss these options further with Dr. Trussler in order to determine which procedure is best for you.


It is important to discuss all options for treatment with Dr. Trussler in order to achieve the safest and most effective results for your buccal fat pad excision procedure. A patient who presents for a buccal fat pad procedure should be conservative with the amount of fat removed.

A buccal fat pad excision will thin and shape the central face. If the upper cheek needs elevation and volume, a midface lift or injectables should be considered. A midface lift procedure could be performed at the same time as a buccal fat pad excision or as a separate procedure. A buccal fat pad excision is an effective facial shaping technique with long lasting results though it does require an incision inside the mouth which heals within one week and is nearly unoticeable.

The sutures for a buccal fat pad excision are disolvable and are usually in place for 5 to 6 days.


Through a buccal fat pad excision, the cheek shape is improved with volume reduction through a minimally invasive procedure with few side effects. With realistic expectations and good overall health, most patients are satisfied with the results of this procedure. Of note, the buccal fat pad is a constant structure with predictable volume reduction when removed.

Cheek Reduction Procedure

A buccal fat pad excision is a bilateral procedure that is performed on an outpatient basis and can usually be done in the operating room in less than an hour. Sedation and injectable anesthesia is commonly used for the procedure.

The upper cheek border is marked along the upper back gum line above the parotid duct opening. A small gum line incision is made a deepened through the buccinator muscle to reveal the buccal fat pad. The buccal fat is teased from its attachments with conservative fat excision below the cheek bone to help to thin the mid cheek. The incision is closed with dissolvable sutures inside the mouth.

Proper incision placement of buccal fat pad excision is important in order to achieve optimal results and avoid injury to the parotid duct. Ice is used immediately after to help decrease swelling.

After Care & Recovery

After a buccal fat pad excision, patients may experience mild discomfort and swelling for about one week, although these side effects usually subside on their own and are limited with the use of ice. The cheek may appear to be swollen and full at first. The final result is usually appreciated at four weeks. After a buccal fat pad excision, sutures will dissolve in 5-7 days and there is minimal scarring.

Most patients can return to work and other normal activities within one to two days after the procedure, although exercise and other strenuous activities should be avoided for a bit longer.

Revision and need for further fat excision is rare after this procedure, and the results are long lasting.


  • Trussler AP, Kawamoto HK, Wasson KL, Dickinson BP, Jackson E, Keagle JN, Jarrahy R, Bradley JP. Upper Lip Augmentation: Palmaris Longus Tendon as an Autologous. Plast Reconstr Surg 2008 Mar; 121(3): 1024-1032.

Whether you have a question or would like to setup a consultation, Dr. Trussler and his staff are here to help. Please fill out our contact form, or call our Austin office at (512) 450-1077 to schedule an appointment. Consultations and the buccal fat pad excision procedure may be performed the same day depending on time and availability.

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Andrew Trussler, MD PLLC
5656 Bee Cave Road – Suite J200
Austin, TX 78746
Phone: (512) 450-1077 | Fax: (512) 450-1817



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