Buccal Fat Removal in Pune: Cheek Fat Pad Reduction

What is buccal fat removal?

The buccal fat pads (also called Bichat’s fat pads) sit deep in each cheek, between the cheekbone and the jaw. They help to give the face its fullness and cushion the chewing muscles. Some people have large pads that make the lower face look round even when they are slim.

Buccal fat removal, also called bichectomy or buccal fat pad excision, takes out part of each pad through a small cut inside the mouth. The aim is a gentle hollow below the cheekbone and a more defined jawline. It is a modest change, not a dramatic one, and it works on fat only: it does not change bone, chewing muscles or skin.

Who may benefit, and how is suitability assessed?

You may be suitable if your cheeks look full because of this deep fat, your weight is stable, and you understand that the change is subtle.

At consultation the surgeon will:

1. Look at your whole face: cheekbones, jawline, skin quality and how much fat is in the cheeks compared with the rest of the face.
2. Check the cause of fullness: overall body fat, large masseter (chewing) muscles or a wide jaw are not treated by this operation.
3. Consider your age and face shape: faces lose volume over time, so a long or already thin face may look hollow later.
4. Ask about health and medicines, including blood thinners, smoking and dental or gum infections.
5. Discuss alternatives and whether another procedure would help more.

What are the options for a fuller lower face?

Option	What it can do	Limitations
Buccal fat removal	Reduces deep cheek fat for a more contoured lower face	Subtle; cannot be undone easily; may look hollow with ageing if overdone
Liposuction of the chin and neck	Reduces fat under the chin and along the jaw	Does not treat the deep cheek pad
Weight loss	Reduces facial fat along with body fat	Deep pad may stay relatively full
Botulinum toxin to the masseter	Slims a wide jaw caused by large chewing muscles	Temporary; repeated every few months
Facelift	Lifts sagging cheeks and jowls in older faces	A larger operation with longer recovery
No treatment	Accept the current shape	None

For loose skin and jowls rather than fullness, see facelift surgery. If a face needs volume rather than less of it, fat grafting is the opposite approach.

How is buccal fat removal performed?

1. Anaesthesia: local anaesthetic is injected inside the cheek, sometimes with sedation. General anaesthesia is used if it is combined with other surgery.
2. Incision: a cut of about a centimetre or two is made on the inner cheek, away from the opening of the salivary duct.
3. Removal: the fat pad is gently teased out and a measured portion is removed. The amount is matched on both sides.
4. Closure: the cut is closed with dissolvable stitches.

You usually go home the same day.

How should you prepare, and what should you ask?

• Treat any tooth or gum infection first, and have a dental check if one is due.
• Tell your surgeon about all medicines and supplements; some increase bleeding. Do not stop prescribed medicines without advice.
• Stop smoking; it slows healing inside the mouth.
• Stock soft foods and an antiseptic mouthwash if advised.

Questions to ask:

• Is my cheek fullness caused by the buccal fat pad?
• How much will you remove, and how might my face look in 10 to 20 years?
• What is your plan if one side looks different after swelling settles?
• What can I eat, and when can I brush near the stitches?

What is recovery like?

Time	What to expect for most patients
Days 1-3	Swelling and tightness of the cheeks; soft diet; rinse after meals as advised
Week 1	Swelling begins to fall; many people return to desk work
Weeks 2-3	Most visible swelling has gone; stitches dissolve
Around 3 months	The new contour is usually clear

Sleep with your head raised for a few nights, avoid very hot or hard foods for a few days, and keep the mouth clean.

What are the risks of buccal fat removal?

Swelling, bruising and mild discomfort are expected. Less common risks include:

• Bleeding or haematoma (a collection of blood) in the cheek.
• Infection, usually treated with antibiotics.
• Asymmetry between the two sides.
• Over-hollowing, especially in thin faces or with ageing.
• Injury to the parotid duct or the buccal branch of the facial nerve, which can affect saliva flow or movement of the upper lip and cheek. These are rare, and nerve weakness is often temporary when it occurs.
• Anaesthetic risks, which are low with local anaesthesia.

Call your surgeon promptly if one cheek swells rapidly or becomes very painful, you develop fever or pus from the cut, or you notice weakness when smiling.

What results can you expect?

Most people see a subtle slimming of the lower cheeks once swelling settles. Results depend on how much of your fullness came from the fat pad. Because the evidence base for this operation is small, outcomes vary, and a conservative plan is wiser than removing as much as possible.

What affects the cost of buccal fat removal in Pune?

• Anaesthesia: local anaesthesia alone, sedation, or general anaesthesia.
• Combined procedures, such as chin liposuction or a facelift at the same time.
• Facility and theatre time.
• Medicines, tests and follow-up visits.

Cosmetic procedures like this are usually not covered by health insurance. Ask for a written estimate that lists what is included, such as follow-up visits.