What is buccal fat removal?
Buccal fat removal (bichectomy) is the partial excision of the buccal fat pads — deep fat structures that each of us has inside the cheeks. Reducing them slims the mid-to-lower third of the face, accentuates the cheekbones and creates a more defined jawline contour.
It is performed through an intraoral approach, with no visible scars, in 30–45 minutes, under local anaesthesia with sedation.
It is not always a good idea
Buccal fat naturally diminishes with age. A buccal fat removal performed on a very young face or without a clear indication can lead to a gaunt appearance at age 40–50. In consultation we honestly assess whether your face truly needs it, or whether alternatives such as contouring with hyaluronic acid or lipofilling are a better fit.
Are you a candidate?
- Your face has real volume in the cheek-to-jaw area, not just "it feels round to me"
- You have genetically defined cheekbones that buccal fat removal will highlight
- Your weight is stable
- You have ruled out non-surgical alternatives with an aesthetic doctor
- You are over 25 (at younger ages the indication is rarely genuine)
Recovery
Swelling
Soft, cold diet. Prophylactic antibiotics. Antiseptic mouthwash.
Back to work
Some swelling still visible. Returning to work is possible.
Residual swelling
Barely noticeable by now. A photo at week 4 is quite representative.
Final result
Defined contour. Stable from 6 months onwards.
Buccal fat removal in Barcelona: who it suits and who it does not
Buccal fat pads (Bichat's fat pads) are two pockets of encapsulated fat inside the cheeks. Buccal fat removal (bichectomy) reduces them through a small incision inside the mouth, with no visible scars, in about 30 to 45 minutes under local anaesthesia. It is a technically simple operation, but it is not for everyone, and it is permanent.
- Good candidate: a young person with round cheeks due to large buccal fat pads, a stable weight and firm skin.
- Poor candidate: a slim face, or someone over 35 to 40. With age the face naturally loses fat; removing buccal fat can make it look more hollow and aged years later.
- Round face due to excess weight or the jaw: buccal fat removal will not correct it. Sometimes the right option is double chin liposuction, or treating the masseter muscle with aesthetic medicine.
That is why the consultation does not just look at the cheek: we assess bone structure, skin thickness and how your face will age. If buccal fat removal is not right for you, we will tell you. If you want more definition in the cheekbones, facial lipofilling can do the opposite: add volume where it is missing.
Swelling lasts one to two weeks and the final result can be seen at three months. The consultation is free, at Av. Diagonal 399 (Eixample, Barcelona) or by video call.
Risks and complications of buccal fat removal
Every operation carries risks. Most complications are uncommon and can be treated, but you have the right to know them before deciding: they are part of the informed consent you will sign with Dr. Liuzza. For buccal fat removal, the most relevant are:
- Haematoma or prolonged swelling: the cheeks can stay swollen for up to 2–3 weeks.
- Infection: the incision is inside the mouth; oral hygiene and antibiotics prevent it.
- Injury to the parotid duct or a branch of the facial nerve: uncommon; it can cause saliva collection or temporary cheek weakness.
- Asymmetry: if a different amount of fat is removed on each side.
- Excessive hollowing over the years: buccal fat does not grow back; in slim faces it can accentuate ageing. That is why it is indicated conservatively.
- Numbness: of the cheek or lip, almost always temporary.
How we reduce these risks
A complete pre-operative work-up (blood tests and anaesthetic assessment), surgery in an authorised healthcare centre with an accredited operating theatre, meticulous surgical technique, antibiotic and anti-thrombotic prophylaxis when indicated, clear written instructions and direct follow-up by the surgeon herself at every check-up. If after surgery you notice fever, increasing pain, bleeding or sudden swelling, contact the clinic without waiting for your next appointment.