The buccal fat pad was firstly described by Heister as a glandular tissue in 1732. However, in 1802 Xavier Bichat popularized and defined the structure as fat tissue. It is widely suspected that celebrities like Bella Hadid and other models have had the procedure to obtain the high, contoured and chiseled cheekbones they have. The procedure is also known as cheek fat reduction, buccal fat removal, or bichetomia in Spanish. The American Society of Plastic Surgery does not keep statistics on the procedure.
Surgical procedure
Cost
Buccal fat removal is considered a cosmetic procedure and is not covered by insurance. It is typically performed by plastic surgeons. According to RealSelf, the average cost is $2,400.
Associated Procedures
Buccal fat removal is often performed as a solo procedure but can be done alongside a facelift. It is often also done in combination with chin liposuction and fat grafting. According to Beverly Hills facial plastic surgeon, Sagar Patel MD, the buccal fat processed and reinjected into the face. Dr. Patel performs "Sagar Sculpting" on patients to use the buccal fat to build the cheek bones.
Technique
The reduction of buccal fat pad is usually performed under local anesthesia with the patient completely awake. The typical approach for removing the buccal fat pad is through an incision in the mouth, towards the back of the oral cavity, near the second upper molar. The buccinator muscle is then encountered and without making an incision, the fibers are separate until the buccal fat is seen. Once the buccal fat is visualized, a thin casing over the fat is opened and the fat in gently teased out while gentle pressure is applied externally. The fat is then cauterized at the base and removed. The remainder of the buccal fat pad then is replaced to its anatomic site and the oral mucosa is sutured close, and the two incisions are sutured. Typically the procedure takes about 30 minutes to complete.
Recovery
Patients typically have swelling for a few days, but often this swelling is not visible externally. Typically, self absorbing sutures that dissolve on their own are used. The final results can take up to 3 months to manifest.
