Buccal Fat Removal, Step by Step: From Your Consultation to Your Final Result

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

Buccal fat removal is a short surgery with a lasting change, and knowing exactly what to expect makes the whole experience calmer. Here is your guide to each step, from the first conversation to the day the swelling has settled.

At a glance

  • Performed by Dr. Shervin Naderi in the operating room, under general anesthesia
  • 30 minutes to an hour, home the same day
  • Small incision inside the mouth, no scar on the skin
  • Most patients are back at work in about a week

Step 1: The Consultation

Every buccal fat removal at The Naderi Center begins with a conversation with Dr. Naderi himself, in Reston, Virginia or Chevy Chase, Maryland. Virtual consultations are available for patients traveling in from farther away.

He looks at the shape of your face, cheekbones and jawline, where the fullness in your cheeks is coming from, and how your face is likely to age. Then he gives you an honest opinion. If buccal fat removal suits you, you leave with a plan for how much fat to remove. If it does not, he will tell you what would serve you better.

That honesty is the most important part of the process. Fullness at the jawline is often a facelift question, fullness under the chin is often a neck question, and cheeks that are already thin need volume rather than less of it.

Step 2: Planning How Much to Remove

There is no standard amount. For many patients, removing part of the fat pad gives a subtle, natural slimming and leaves some fat in place for later in life. When the cheeks are especially full, or for men who want a more angular look, more may be removed.

Cross-section of the cheek from the skin to the inside of the mouth: skin, the fat under the skin, the deep buccal fat pad, the cheek muscle and the mouth lining. A partial removal takes a smaller area of the deep fat pad and a fuller removal takes more; the fat under the skin is left alone. SINUS OUTSIDE OF CHEEK INSIDE OF MOUTH1234561Skin2Fat under skin3Buccal fat pad4Cheek muscle5Mouth lining6Upper molarPartial Fuller
Planning the amountA cross-section of the cheek. Only the deep buccal fat pad is reduced; the fat under the skin is left alone.
Buccal fat removal for men: a model photo marked to show the buccal fat pad, the area under the cheekbone and the jawline
For men, the goal is usually a leaner, more chiseled face. Model photo, not a patient result.

Step 3: Getting Ready

Preparation starts about two weeks before surgery. Stop all nicotine at least two weeks before, four weeks preferred, because nicotine slows healing. For the same two weeks, follow the Naderi anti-bleeding, anti-bruising diet and avoid aspirin, ibuprofen, naproxen, alcohol and blood-thinning supplements.

Plan for a responsible adult to drive you home and stay with you the first night, and stock up on soft foods you enjoy.

Step 4: Surgery Day

Buccal fat removal is done in the operating room under general anesthesia, at one of the accredited surgery centers where Dr. Naderi operates. A board-certified anesthesiologist supervises a nurse anesthetist (CRNA), who stays with you the entire time. We never perform it awake or under local anesthesia.

Anatomical side view showing the small incision inside the mouth, the protected saliva duct above it, and the buccal fat pad being gently eased out through the incision 1231Small incision inside the cheek2Saliva duct, kept protected3Fat pad gently eased out, then measuredNo incision on the skin
How it is doneA small incision inside the cheek; the saliva duct is protected and the fat pad is gently eased out

The incision is made inside the cheek near the bite line. Stensen’s duct, which carries saliva from the parotid gland, sits just above it and is protected throughout. The fat pad is freed with gentle teasing, never pulled, and the planned amount is removed. The two sides are compared for balance before the incision is closed with dissolvable sutures.

“By taking these out, the cheeks are much more developed, and he’s going to have more contour there.”Dr. Shervin Naderi, in the operating room

The surgery itself takes 30 minutes to an hour, and you go home the same day.

Step 5: Recovery, Week by Week

Your buccal fat removal timeline

  1. Your consultationAn honest look at your faceIn Reston, Chevy Chase or virtually. Dr. Naderi examines your cheeks, cheekbones and jawline and tells you whether buccal fat removal suits you.
  2. 2 weeks beforeGetting readyStop all nicotine (4 weeks is better). Follow the Naderi anti-bleeding, anti-bruising diet and avoid aspirin, ibuprofen, naproxen, alcohol and blood-thinning supplements.
  3. Surgery day30 minutes to an hourIn the operating room under general anesthesia. You go home the same day with a responsible adult.
  4. Days 1 to 3Rest and cool compressesSleep with your upper body raised. Cool compresses for 15 to 20 minutes about every hour while awake.
  5. First weekSoft foods, gentle rinsesSmall bites, mouth open no more than 1 inch, gentle rinses 3 times a day. Sutures dissolve on their own. Most patients are back at work in about a week.
  6. Weeks 2 to 3Swelling settlesMost of the swelling settles and the new shape of the cheeks shows.
  7. 1 monthBack to exercise, slowlyNo exercise or lifting over 20 pounds until now, then build back gradually.
  8. 3 monthsFull activityThe goal is full activity by about 3 months.

Recovery is gentle for most patients. The first few days are about rest, cool compresses and keeping your head raised. Through the first week, soft foods and gentle rinses protect the incisions inside your mouth as they heal.

Avoid flying for 7 to 10 days. Most patients return to work in about a week, often sooner, and most swelling settles in two to three weeks.

Step 6: Your Final Result

As the swelling settles, the new shape of the lower face comes through: more definition under the cheekbones and a cleaner line toward the jaw. The fat that is removed does not grow back, though your face will continue to change naturally with age and weight, which is exactly why the amount is planned so carefully.

Buccal fat removal can also be done during the same anesthesia as rhinoplasty or a facelift, which means one trip to the operating room and one recovery. Dr. Naderi will tell you whether combining procedures makes sense for your face.

We welcome patients from Reston, Herndon, McLean, Great Falls, Vienna, Arlington, Alexandria, Bethesda, Potomac, Chevy Chase and Washington, DC, with offices in Reston and Chevy Chase.

Common Questions

How long does buccal fat removal take?

About 30 minutes to an hour, in the operating room under general anesthesia. You go home the same day.

Will there be a scar?

No scar shows on the skin. The incision is inside the mouth and closes with dissolvable sutures.

What can I eat afterward?

Soft foods and liquids are easiest at first. Take small bites with a small spoon or fork, avoid hard foods and seeds, and don’t open your mouth more than 1 inch while the incisions heal.

How much does it cost?

Dr. Naderi’s surgeon’s fee is $10,000. Anesthesia and the surgical facility are billed separately.

Begin with a Conversation

Bring us your questions. We will bring the experience. Meet Dr. Naderi in Chevy Chase, minutes from Bethesda and Washington, DC, in Reston, or virtually.

Reston (703) 481-0002 · Chevy Chase (301) 222-2020

Read more on our buccal fat removal page, or watch Dr. Naderi perform buccal fat removal in the operating room.

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.

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