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Guide To Cosmetic Surgery - Buccal Fat Removal

Buccal fat removal surgery

This is the technical name for ‘cheek reduction’ surgery. It is a procedure undertaken to remove excess fat from the cheeks.

The lower cheeks contain fat pads which help to give that characteristic bulge but for some people this is over exaggerated to the point where they have what are known as ‘chipmunk cheeks’.

This excess fat can take the form of what are now becoming popularly known as ‘Simon Cowells’ – jowls.

These are seen as unwelcome but a great many people who desire smooth, sculpted faces with clearly delineated cheekbones.

This procedure can be performed as a stand alone procedure or in combination with other facial surgeries such as facelift – full or mini, nose job (rhinoplasty) and neck liposuction.

Suitability for buccal fat removal

Before you consider surgery you may want to consider that your face will naturally start to thin as you age. If you are in your 30’s then you will start to find that your face loses fat and elasticity as part of the ageing process.

So, if you do have ‘chipmunk cheeks’ then you may find that this disappears as a result of ageing. Weight loss and reduced body fat levels will also shift this fat.

Excessively rounded cheeks are inherited so you may have inherited your parents rounded cheeks. If so then check to see if they still have this trait. You may find that this disappeared once they reached their 30’s or 40’s.

The problem with having this surgery when you are younger is that this combined with the natural ageing process can leave you with a drawn appearance.

As usual, your age, health and motivations for surgery will be taken into account. These will determine your fitness for surgery.

Basically, if you are healthy, don’t smoke and are realistic about what this procedure can achieve then you will be considered for surgery. These and other factors will be discussed between you and the surgeon.

You need to be clear why you want surgery and what you hope to gain from this. It promises good results but like all surgery it has its limitations and you need to be aware of these. As long as you are then surgery is a good choice.

Preparing for surgery

There is a fair degree of preparation before your operation. Once you have agreed to go ahead, then a date and time will be set for your surgery.

This will be followed by a set of instructions which advise you on how to prepare for your operation. They will also advise you on what will happen on the day of your operation and afterwards.

Please follow all of these instructions, even if you think some of them are not applicable or are irrelevant. They are designed for your safety and to ensure that you are fit and well enough to undergo surgery.

These instructions will include the following:

• Advice on what medications you can take. If you are already on prescribed or over the counter medicines then you may have to stop taking these until you have had surgery.
• If you take anti-inflammatory medicines or aspirin then you will have to cease taking these as per the surgeon’s advice. Some medications can cause excessive bleeding or other types of complications during or after surgery. 
• When to have your last meal, and any drinks. The general rule of thumb is no eating and drinking 6 hours before surgery.
  
• Stop smoking. Smoking can affect the body’s ability to heal and tends to slow down the healing process. It is best if you stop at least 2 weeks before and do not resume this until 2 weeks after surgery.
  
• Arrange time off work.
  
• Ask someone to keep an eye on you for the first few days, back at home. And, see if they will help you with the everyday tasks such as cleaning, shopping, tidying up, cooking etc.
  
• Make preparations for your recovery at home. This means cooking and preparing meals in advance, dealing with any household bills, asking someone to keep an eye on your children (if you have any) and your pet/s (again, if you have any).
• It is a good idea to have enough of a supply of medications and/or painkillers so that you don’t have to worry about these once you are back home.
• Arrange for a lift to and from the hospital.
  
• Prepare ice packs. These can either be frozen packs of vegetables or special gel packs, available from a pharmacy. These are great for easing any soreness or swelling.
  
• In regard to food; you will be restricted to soft food for the first 2 days and so it is a good idea to have soups, purees, juices and other easy to swallow food. Chewing will be limited for a couple of weeks so choose foods which are easily digestible. 
• Avoid salty foods as these can aggravate any swelling.
• Soft pillows and blankets. You will be asked to keep your head
  elevated for the first couple of day as this will reduce any swelling. Keep some extra pillows handy.
• Patients find that they are prone to chills following surgery so keep a few blankets or a duvet close by.

The buccal fat procedure

There is a choice of anaesthetic for this procedure which will be discussed between you and the surgeon. If you opt for a local anaesthetic then you will be injected with lidocaine, saline and epinephrine.

The surgeon will make an incision between the cheek and gums and will then expose the fibres and fascia of the ‘buccinator’ muscle. This is the main muscle of the cheek.

He or she will then apply pressure to your cheek by pressing his or her thumb right against your cheek bone which will force the cheek or ‘buccal’ fat through the incision.

He or she will use forceps to remove this fat, bit by bit.

Once this fat is removed the surgeon will close the incision with a series of stitches. These will be the non-dissolvable type which means they will have to be removed at a later date.

These stitches will be removed 10 days after surgery.

This procedure usually takes around 1 to 2 hours depending on the extent of the procedure.

Recovery

Your face will be swollen and bruised for the first 3 days. The swellings may seem rather extensive but they will ease as the days go by.

Swelling and bruising are normal following any type of surgery and do ease over time. If you are experiencing pain and/or discomfort then pain relief will be prescribed to control this.

Do not take any medication which is not recommended by your surgeon. This includes vitamin or mineral supplements, aspirin or aspirin type medicines.

For the first two to three days, elevate your head with a couple of soft pillows and apply ice packs to the treated areas. A good way of doing this is to apply an ice 10 minutes on and then 10 minutes off. Repeat this for 20 minutes to half an hour.

You can expect to do this for the first day and possibly for the next day as well but it will reduce any swelling.

Infection is a possible complication although it is very rare. Signs of infection are fever, significant redness and swelling (not the usual post-operative swelling); blisters or leaking pus from the wounds and increased pain.

If you notice any of these symptoms then contact the hospital immediately.

If you notice any of the following symptoms then also contact the hospital:

• Shortness of breath, racing or irregular heartbeat and chest pains.
  
• Bleeding
  

As regards washing or bathing you will be able to wash the face the day after surgery. If you wear make up then this can be applied.

It is a good idea to keep up your fluid intake and have light, easy to digest snacks during the first couple of days. You will find chewing food a bit awkward so it is a good idea to stick to soft foods such as soups or yoghurt. Avoid salty foods as these can affect post-operative swelling.

Every time you eat, rinse your mouth with water to flush out any food particles from the surgical incisions.

The main point here is to take things easy and rest for one to two weeks. Most patients find that they are fully recovered after three weeks although everyone is different in this aspect.

Most patients find that they are able to return to work two to three days afterwards.

If you play contact sports then abstain from these for six to eight weeks.