Explaining buccal fat removal surgery

It's the latest cosmetic procedure taking over social media ... And it's sparking controversy. What exactly is buccal fat removal surgery? Dr. Andrew Youn explains.

The trending surgery doesn’t come without controversy

Buccal fat removal is the latest cosmetic procedure taking over social media with online users speculating whether certain celebrities have had the face-chiseling procedure and others sharing their own results. But the trending surgery doesn’t come without controversy… 

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“The buccal fat removal is a surgery that's been around for decades. It's interesting because a lot of people think it's a new procedure because all of a sudden people are talking about it”, said Dr. Anthony Youn, Board-certified plastic surgeon. As with other cosmetic procedures like lip fillers, fox eye lifts, or BBLs, the buccal fat removal trend has largely been fueled by social media. 

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“I think social media is really powering this trend as well as celebrities. Now, we know that Chrissy Teigen has admitted to having this done not that long ago. But we've also seen some celebrities who have had pretty almost impossibly sculpted faces who have not admitted to having this procedure done, but people think they may have had it done. You combine that with social media showing this operation being so easy and so simple, which in general it usually is, and now you've got what's going on now”.

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Like all surgical operations, it comes with risks

So what exactly is buccal fat and why do surgeons remove it to achieve that accentuated cheekbone look that so many seem to be after? “Buccal fat is a collection of fat that we all have inside our cheek. If you take your finger and you go right in front of that, there's a little hole there where you can actually feel your upper teeth and that's your buccal space. The buccal fat ranges in size from literally the size of a pea to the size of a gumball”, said Dr. Anthony Youn. 

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But Dr. Youn warns that although the procedure is relatively simple, like all surgical operations, it comes with risks : “There is a nerve called the facial nerve that runs in that space. So if you damage that nerve, you could cause some major problems with how your muscles move in your face. There's also a salivary duct that comes right through there as well. If you damage that, then now you can have major issues with your salivary glands. The main complication, though, that we may see with buccal fat removal is a hematoma, is bleeding afterwards, and now they have a huge cheek just filled with blood and that can take months for that to settle down”.  

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Some say the craze is the latest example of an internet trend that promotes impossible beauty standards. Where it really gets tricky though is that unlike cosmetic procedures like implants that can be removed, or fillers that can be dissolved, buccal fat removal is irreversible. “The surgery results are permanent and therein lies the major issue, because it will change the shape of your face. And we all know that as we get older, the face does change shape on its own. So this is an operation that I do not recommend for somebody who has a facial shape like mine. As I get older, I've got a bit of a longer, more narrow face. As I get older, my face is going to get more narrow. You take that buccal fat out and I'm going to start looking real gaunt and even older than I would if that fat was still there. So typically this is an operation that I recommend for people who feel that their face is a bit bottom heavy or even excessively round because it can help to contour the cheeks in and get a bit more of that contour if they're looking for that. But you definitely do not do this on somebody with a more narrow, thinner face. It can actually make them look older as they get older”, stated Dr. Anthony Youn.