Will Buccal Fat Removal Make Me Look Older?

The Naderi Center · Reston, VA and Chevy Chase, MD

It is the question we hear most from patients considering buccal fat removal, and it is the right one to ask. Here is your guide to how this small surgery changes the face, how the face keeps changing afterward, and how we plan for both.

Over the last few years, buccal fat removal has gone from a quiet, specialized procedure to something people see all over social media. With that attention came a worry: will the sculpted look of today turn into a gaunt, tired look ten or fifteen years from now?

That worry is fair. The face is not static. It loses volume as we age, and any surgery that removes volume has to be planned with that in mind. The good news is that the risk depends far more on who the procedure is done on, and how much is removed, than on the procedure itself.

First, What Is the Buccal Fat Pad?

The buccal fat pad is a pocket of fat that sits deep in each cheek, below the cheekbone and in front of the chewing muscle. Part of it extends into the lower cheek, at about the level of the mouth, where it adds roundness to the lower face.

Its size is largely inherited. That is why some people have soft, round cheeks even when they are lean and fit, and why diet and exercise often do little to change them. If you have tried everything and your lower cheeks still look full, the buccal fat pad is often the reason.

Buccal fat removal takes out some or all of that lower portion through a small incision inside the mouth. There is no scar on the skin. At The Naderi Center, Dr. Shervin Naderi performs every buccal fat removal himself, in the operating room under general anesthesia.

How the Face Changes With Age

Everyone loses facial volume over time. A cheek that looks full at 25 will look different at 50, whether or not anything is removed. The cheeks flatten, the area under the cheekbone deepens and the tissues of the lower face begin to descend toward the jawline.

When buccal fat is removed, that natural change still happens. The face simply starts from a slimmer place. If the starting point is too slim, the face can reach a hollow, older look sooner than it otherwise would have.

This is the heart of the matter. The goal is never to remove as much as possible. It is to remove the right amount for your face as it is today and as it is likely to be later.

Where Is Your Fullness Really Coming From?

A round lower face does not always mean too much buccal fat. Before recommending anything, Dr. Naderi looks closely at where the fullness actually sits, because each source calls for a different answer.

This is why an honest consultation matters so much. Some patients who come in asking for buccal fat removal are better served by something else, and some are better served by waiting. Dr. Naderi will tell you plainly if that is the case.

Partial or Fuller Removal?

How much fat to remove is a planned decision, not a fixed amount. For many patients, removing part of the pad gives a subtle slimming while leaving some fat in place to support the cheek later in life.

When the cheeks are especially full, more of the pad may be removed. Men can often have a little more taken for a leaner, more chiseled look, because the goal for a male face is usually more angular. For most women, the aim is a longer, softer, more oval lower face that never looks gaunt.

Who Is a Good Candidate?

The best candidates are usually adults in their 20s to 40s with full, round cheeks that stay full at a healthy, stable weight, who want more shape under the cheekbones and a cleaner jawline. Good general health matters, and so does stopping all nicotine at least two weeks before surgery, four weeks preferred.

Patients whose cheeks are already thin, or whose main concern is jowls or loose skin, are usually better served by other options. Removing fat from a face that needs volume is the most common way buccal fat removal ages a face, and it is the one we work hardest to avoid.

Why Planning the Whole Face Matters

Because Dr. Naderi also performs rhinoplasty, deep plane facelifts and facial fat transfer, he plans the cheeks as part of the whole face rather than on their own. Sometimes the most balanced result comes from combining buccal fat removal with another procedure during the same anesthesia, and sometimes it comes from choosing a different procedure altogether.

Patients come to The Naderi Center from Reston, McLean, Great Falls, Vienna, Arlington and Alexandria in Northern Virginia, from Bethesda, Potomac and Chevy Chase in Maryland, and from across Washington, DC. Consultations are in our Reston and Chevy Chase offices, and virtual consultations are available if you are traveling in.

Learn more on our buccal fat removal page, including recovery, risks and what happens at your consultation.

Medically reviewed by Dr. Shervin Naderi, MD, FACS, double board-certified facial plastic surgeon. The Naderi Center for Plastic Surgery and Dermatology, Reston, VA and Chevy Chase, MD.