TürkçeThe before and after process of buccal fat removal begins with a preparation phase that includes lifestyle adjustments accompanied by a clinical examination and covers an average six-month recovery schedule after the surgical intervention, during which tissue swelling is managed, special nutrition protocols are followed, and the face takes on its final V shape. When cheek slimming aesthetics are targeted, patient compliance with this timeline determines the quality of the resulting facial contour as much as the surgical approach does. In this structural transformation, in which the cheekbones become more prominent and the lower jawline becomes clearer, the steps that prepare the body for recovery before the operation and the delicate wound care principles applied afterward play a fundamental role in revealing the natural dynamics of the face.
| What Is Buccal Fat Removal? | Buccal fat removal is an aesthetic surgical procedure that aims to make facial contours more defined by surgically removing the buccal fat pads located inside the cheeks. |
| Pre-Procedure Evaluation | The patient’s general health condition, facial anatomy, skin elasticity, expectations, and whether they are a suitable candidate are evaluated in detail. Laboratory tests may be requested when deemed necessary. |
| Suitable Candidates | Individuals who have completed facial development, are in good general health, have full cheeks, and have realistic expectations may be suitable candidates. It may not always be appropriate for individuals with very thin facial structures. |
| Anesthesia Used | The procedure is usually performed under local anesthesia. In some cases, sedation or general anesthesia may be preferred. |
| Pre-Procedure Preparation | According to the doctor’s recommendation, blood-thinning medications and certain herbal supplements may be discontinued for a specified period beforehand. Reducing or stopping smoking and alcohol consumption before the procedure may positively affect healing. |
| Day of the Operation | The buccal fat tissue is removed in a controlled manner through small incisions made inside the mouth. The procedure generally does not leave a visible external scar. |
| Procedure Duration | The surgical procedure is usually completed within 30–60 minutes. The duration may vary depending on any additional procedures to be performed. |
| Hospital Stay | Buccal fat removal is generally performed as a day procedure. Patients are usually discharged on the same day. |
| Expected Conditions in the First Hours | Mild pain, swelling in the cheeks, edema, and slight bruising may occur. These findings are generally temporary. |
| Nutrition Process | Soft and lukewarm foods are recommended during the first few days. Very hot, hard, spicy, or irritating foods may need to be avoided. |
| Oral Hygiene | To reduce the risk of infection, oral care products recommended by the doctor should be used, and attention should be paid to oral hygiene. |
| Pain Control | Painkillers recommended by the doctor and, when deemed necessary, other medications should be used regularly. |
| Swelling and Edema | Swelling may increase during the first few days and then gradually decrease. The final facial appearance should be evaluated after the edema has completely subsided. |
| Return to Daily Life | Most patients can return to their daily activities within a few days. The period recommended by the doctor should be observed before resuming strenuous physical activities. |
| Sutures | Self-dissolving sutures are generally used inside the mouth, and they usually do not need to be removed. |
| Recovery Process | While initial recovery occurs within a few weeks, the final shape of the facial contours generally becomes apparent within several months. |
| Expected Results | The aim is to achieve slimmer cheeks and a more prominent appearance of the cheekbones and jawline. Results may vary according to the individual’s facial structure. |
| Possible Risks | Although rare, infection, bleeding, asymmetry, prolonged edema, nerve damage, injury to the salivary gland duct, and undesirable aesthetic results may occur. |
| Points to Consider | Avoiding smoking, maintaining oral care, attending regular doctor’s appointments, and following recommendations support the recovery process. |
| Follow-Up Examinations | Attending follow-up appointments determined by the surgeon is important for evaluating recovery and detecting possible complications early. |
| When Should Medical Assistance Be Sought? | If severe pain, uncontrolled bleeding, high fever, foul-smelling discharge, clear signs of infection, or rapidly increasing one-sided swelling develops, a healthcare institution should be contacted without delay. |
Who Is Buccal Fat Removal, a Facial Slimming Aesthetic Procedure, a Suitable Option For?
Achieving the desired benefit from surgical procedures is closely related to identifying the right candidate for the procedure. According to plastic surgery standards, one of the suitable profiles for buccal fat removal surgery is individuals whose body mass index is within normal limits but whose cheeks are full and whose face is round or square due to genetic predisposition. The human face continues to develop until a certain age, and the fat pads in the face naturally decrease in size over time. It is important in candidate selection that the individual has passed the age range in which the facial contours have largely settled and this natural change has slowed. Interventions performed at an early age before facial development is complete may create the basis for an undesirable facial appearance in later years. It may also provide functional relief for patients who have a habit of biting the inner cheek mucosa while chewing or sleeping. Having realistic expectations is one of the main factors determining whether a candidate is suitable. The main physical characteristics considered during the evaluation are as follows:
- Body mass index
- Cheek fullness
- Face shape
- Bone structure
- Age range
Who Should Not Undergo Buccal Fat Removal or In Which Cases Should It Be Postponed?
As with every aesthetic surgical procedure, there are conditions that make buccal fat removal difficult to perform or require it to be postponed. Performing this procedure on patients with structural tissue deficiency in the cheek area may cause greater hollowing beneath the cheekbones and make the face appear tired. With the aging process and the effect of gravity, fat tissue may shift downward and accumulate along the lower jawline. In older patients who have lost skin elasticity, performing the procedure alone may make existing skin sagging more noticeable. In such cases, combining the procedure with other methods such as a facelift may be considered. In individuals who experience frequent changes in body weight, the fat volume in the face also changes continuously, making it difficult to predict the long-term results of the operation. It is recommended to postpone the operation until weight stabilization is achieved. The main conditions that may require the procedure to be postponed or cancelled are as follows:
- Thin facial structure
- Advanced skin sagging
- Irregular weight fluctuations
- Unrealistic expectations
- Uncontrolled systemic diseases
- Ongoing facial development
Which Other Surgical and Medical Procedures Can Be Performed Together With Buccal Fat Removal?
In aesthetic procedures, the face is evaluated as a whole. Sometimes reducing fat volume only from the cheeks may not be sufficient by itself to create the desired defined facial contours. To achieve a holistic appearance, buccal fat removal can be combined with various procedures. Increasing the projection of the lower jaw angle and chin tip with fillers may make the facial contour more balanced. As the cheeks become slimmer, a slight enhancement of the chin creates aesthetic harmony. Similarly, removing excess fat tissue from the submental and neck areas clarifies the transition between the neck and jaw. Since the persistence of a double chin problem in a face with slimmer cheeks may affect overall harmony, these procedures are often planned together. Medical methods applied during the operation to improve skin quality may support the tissue-tightening process. Other aesthetic applications combined with buccal fat removal are as follows:
- Chin tip filler
- Jawline filler
- Chin implant
- Neck liposuction
- Double chin liposuction
- Mesotherapy
- Skin quality injections
How Does the Preparation Process Before Buccal Fat Removal Surgery Begin and What Should Be Considered?
For the surgical process to proceed safely and for wound healing to be completed without problems, a preparation protocol that begins several weeks before the operation is initiated. During this process, the medications used by the individual, nutritional habits, and lifestyle are examined in detail. At the clinical evaluation stage, the patient’s bone structure, soft tissue thickness, and existing facial asymmetries are reviewed. The human face naturally has a certain degree of asymmetry, and recognizing these conditions before the operation creates a basis for healthy expectations. Blood tests are requested before the operation to evaluate the general health condition. The bleeding profile is examined to determine whether there is any condition that would prevent surgery. Prescription medications used and chronic diseases must be explained to the physician in detail. Accurate information sharing plays a major role in preventing adverse events that may occur during surgery. In light of this information shared with the doctor, a personalized schedule is created. The conditions that must be disclosed beforehand are as follows:
- Chronic diseases
- Medications used
- Previous operations
- Allergic reactions
- Bleeding disorders
What Should Habits and Nutrition Be Like During the Preparation Process Before Buccal Fat Removal Surgery?
During the preoperative period, certain habits are expected to be discontinued to support the tissue repair mechanisms. Tobacco products have a powerful vasoconstrictive effect due to the chemical substances they contain. This directly affects the oxygenation and nourishment of the oral mucosa, which is the surgical area, and may create the basis for serious healing problems. Alcohol consumption may affect liver functions and increase the amount of edema that may occur after the operation. Certain painkillers and herbal supplements may prolong bleeding time. On the other hand, consuming foods rich in protein and vitamins to support cellular repair contributes to the healing potential of the tissues. Adequate fluid intake helps support skin elasticity. In the hours before surgery, no food intake is allowed under any circumstances for anesthesia safety. Having an empty stomach prevents problems that may occur during the procedure. It is important to store in advance the building blocks the body needs during the preparation process. The substances that should be discontinued during the preoperative period are as follows:
- Smoking
- Alcohol
- Aspirin
- Painkillers
- Green tea
- St. John’s wort
- Vitamin E
- Fish oil
What Should the Patient Expect During Buccal Fat Removal Surgery and How Does the Process Proceed?
Buccal fat removal is an intraoral surgical procedure generally performed under local anesthesia or intravenous sedation and does not create any incision on the skin. After the patient’s preparation stage is completed, the procedure area is disinfected. Once anesthesia has been administered, a small incision is created in the inner cheek mucosa in the area corresponding to the back level of the teeth. This area is not selected randomly; a safe zone is determined according to anatomical structures. The surgeon follows anatomical landmarks to reach the relevant area. During the procedure, the patient generally does not feel pain and may only notice a sensation of touch in the area. Since the surgical field is inside the mouth and in a narrow area, good lighting and the use of specific instruments are required. The process continues by gently separating the tissues in the cheek area and reaching the targeted fat pad. By performing the steps in sequence, the procedure is usually completed in less than one hour. The main methods and materials used during the operation are as follows:
- Local anesthesia
- Sedation
- Surgical lighting
- Intraoral instruments
- Absorbable sutures
Which Techniques Are Used to Remove the Fat Tissue Inside the Cheek During Buccal Fat Removal Surgery?
After creating the entry point inside the mouth, the surgeon advances toward the muscle fibers that control facial expressions. To avoid damaging the tissues, blunt-tipped instruments are inserted between the muscle fibers, and the muscles are gently separated parallel to their natural direction. The aim is to reach the target area without placing pressure on the vascular and nerve networks passing through the region. After passing through the muscle layer, the thin membrane structure surrounding the fat pad becomes visible. This membrane is gently opened with surgical instruments, and the fat tissue is directed toward the inside of the mouth with light pressure applied to the cheek. Not all of this fat tissue is removed; only the main body that gives fullness to the cheek area is evaluated for removal. The root portions of the fat extending into the deep planes of the face are generally not disturbed. After the amount to be removed is planned, the tissue connection is separated and the procedure is completed. At the end of the procedure, bleeding control is carefully performed in the area, and the small incision inside the mouth is closed. The main technical steps applied during the procedure are as follows:
- Mucosal incision
- Blunt tissue dissection
- Opening the membrane
- Herniating the fat
- Partial removal
- Bleeding control
- Suturing
Which Anatomical Risks Are Managed During Buccal Fat Removal Surgery?
The facial region has a dense anatomical structure in which complex nerve and vascular networks are intertwined. Therefore, extremely careful work is carried out during the procedure to avoid damaging neighboring structures. One of the important structures in the area is the salivary gland duct. The course of this duct, which may vary anatomically from person to person, is carefully monitored during surgery and its preservation is intended. Likewise, the nerve branches that move the facial muscles may also be located close to the fat pad. Sudden movements are avoided during tissue separation, and excessive stretching force is not applied to the tissues. When heat is used to stop bleeding, the treatment area is kept as limited as possible in an effort to prevent thermal effects on the surrounding tissues. Tissue planes are passed through slowly to prevent unexpected situations. Knowledge of anatomy and respect for the tissues are prioritized. The main anatomical structures that must be protected and carefully considered during surgery are as follows:
- Parotid duct
- Salivary gland duct
- Facial nerve branches
- Chewing muscles
- Facial expression muscles
- Facial arteries
- Venous networks
How Do the First Day and First Week After Buccal Fat Removal Surgery Progress?
After the operation is completed and the incision area is closed, a bandage that applies light pressure to the area may be placed to limit possible tissue swelling. During the first days following this process, inflammation, which is the body’s natural repair mechanism, begins. A certain amount of swelling or a mild aching sensation in the facial area is expected. Using the prescribed standard medications provides relief during this period. Applying cold externally to the cheeks is one of the best-known methods of slowing the increase in edema. Keeping the head slightly above heart level while sleeping helps reduce blood pooling in the area. In the following days, due to swelling in the cheeks, individuals may encounter a fuller facial appearance than before the operation. There may be slight restriction in opening the mouth or a feeling of tightness in the chewing muscles. The physiological reactions shown by the body during the initial stage of recovery are largely temporary. The conditions frequently encountered during the first days are as follows:
- Swelling
- Edema
- Mild aching
- Difficulty chewing
- Restriction in opening the mouth
- Tightness in the suture areas
- Tenderness in the cheek mucosa
What Should Nutrition and Oral Hygiene Be Like After Buccal Fat Removal Surgery?
Although the inside of the mouth is an area with a high healing capacity, it is also very dense in terms of bacterial diversity. After the operation, liquid or pureed foods that will not irritate the wound area or strain the chewing function should be emphasized. While cold foods may help provide relief, hot foods may accelerate blood circulation and increase swelling. Hard, crumbly, or spicy foods should be removed from the menu for a while because they may cause sensitivity in the mucosa. After food consumption, gentle rinsing with alcohol-free solutions recommended by the physician is advised to remove food residues that may remain inside the mouth. Mouthwashes with a high alcohol content are generally not recommended because they may dry the mucosal tissue. Great care should be taken when resuming the toothbrushing routine. Cleaning should be performed with soft-bristled brushes, touching only the tooth surfaces and without stretching the cheeks. As the hygiene of the suture areas is maintained, the recovery process of the tissues in the area accelerates. The foods and beverages that should be avoided during this process are as follows:
- Hot tea
- Hot coffee
- Hot soup
- Chips
- Nuts
- Carbonated beverages
- Spicy foods
- Tough meats
Which Physical Activities Should Be Avoided During the Recovery Period After Buccal Fat Removal?
Actions that suddenly increase heart rate and blood pressure may cause the capillaries undergoing repair to be exposed to pressure. During the period following surgery, activities that increase pressure in the facial area may disrupt the healing balance. Physical strain such as lifting weights, participating in demanding fitness programs, or performing heavy work while bending over may increase the amount of edema. In addition, these activities may raise body temperature, causing vascular dilation and fluid leakage. Prolonged exposure to intense sunlight and entering excessively hot environments such as saunas or steam rooms also have a similar vasodilating effect and should be avoided for a while. During this period, short, light walks that do not strain the body may support blood circulation and facilitate healing. Patients should generally return to their normal pace gradually. The activities that should be avoided temporarily during the recovery period are as follows:
- Lifting weights
- Cardio exercises
- Working while bending over
- Straining
- Sauna
- Turkish bath
- Steam room
- Sunbathing
- Strenuous sports
How Should the Process Progress for a Permanent Result After Buccal Fat Removal?
The emergence of the desired appearance after buccal fat removal is a journey that requires time and patience. As most of the edema subsides during the first weeks, patients return to their daily lives more comfortably. However, it generally takes several months for the tissues beneath the skin to adapt to their new positions and for the subtle effect in the area to become noticeable. From the second and third months onward, the overall form of the facial contours begins to be perceived clearly. The most important factor that preserves the long-term effect of the surgical procedure is the individual’s lifestyle. Maintaining the achieved facial contour is closely dependent on keeping body weight stable. Excessive weight gain may enlarge other fat compartments in the face and alter the slimmer appearance achieved. Maintaining healthy eating habits in daily life, making adequate fluid intake a routine, and adopting an active lifestyle are factors that significantly support the gains of the surgical procedure. Attention to general health plays a major role in making the changes brought about by the operation permanent. The factors that support recovery and permanence are as follows:
- Patience
- Regular sleep
- Healthy nutrition
- Weight control
- Water consumption
- Balanced lifestyle
Frequently Asked Questions
The buccal fat removal process consists of the initial examination, facial analysis, surgical planning, operation, and regular follow-up appointments. The recovery process may vary depending on the individual’s tissue structure, age, and the surgical technique applied.
Before surgery, the facial shape, cheek volume, skin structure, general health condition, and aesthetic expectations are evaluated. In light of this information, the suitability of buccal fat removal and the surgical plan are prepared individually.
Stopping smoking, regulating blood-thinning medications according to the doctor’s recommendation, paying attention to oral hygiene, and following the surgical preparation instructions may positively support the recovery process.
During the first days, swelling in the cheeks, mild pain, tenderness, and discomfort while chewing may occur. These symptoms generally decrease within a short time and can be controlled with the recommended treatment.
Soft and lukewarm foods should be preferred during the first days, and attention should be paid to oral hygiene. Temporarily avoiding hard and irritating foods may support healing inside the mouth.
Most people can return to their daily lives within a few days. It is recommended to wait for the period advised by the surgeon before performing strenuous exercises and activities that carry a risk of impact to the facial area.
During the first weeks, the results may not be fully evaluated due to edema. As the swelling decreases, the facial contours become more defined, and the final appearance generally emerges within several months.
If severe pain, high fever, excessive bleeding, foul-smelling discharge, marked swelling, or non-healing wounds inside the mouth develop, the surgeon who performed the operation should be contacted without delay.
The fat tissue removed through buccal fat removal is permanently removed. However, maintaining an ideal weight, continuing healthy eating habits, and adopting regular lifestyle changes may contribute to preserving facial contours.
Individuals who want their cheeks to appear slimmer and more defined are advised to consult a plastic, reconstructive, and aesthetic surgery specialist for a detailed evaluation and personalized surgical planning.
He completed his medical education at Ankara University Faculty of Medicine in 1996 and his specialty training between 1996–2002 at Hacettepe University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery.
Between 2002–2009, he worked at Süleyman Demirel University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery.
Since 2009, he has been working at Hacettepe University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery. He received the title of Associate Professor in 2011. Dr. Nasır became a Professor in 2019 and continues to work as a faculty member in this position.
Between 2006–2008, he conducted studies on composite tissue transplantation at the Cleveland Clinic in Ohio, USA, together with Dr. Siemionow, who performed the first face transplant in the United States and the second in the world.
In 2012, he successfully performed Turkey’s second face transplant, which was the third among full face transplants in the world and the 22nd overall. Simultaneously with this face transplant, the world’s first quadruple limb transplant was carried out at Hacettepe University by a large team under his leadership.
He won second-place awards in the experimental and clinical specialist competitions at the 31st and 32nd National Plastic, Reconstructive and Aesthetic Surgery Congresses. In 2023, he completed his doctorate in Hand Surgery at Hacettepe University Faculty of Medicine.
He is a member of the American Society of Reconstructive Microsurgery, Plastic Surgery Research Council, Turkish Society of Plastic, Reconstructive and Aesthetic Surgery, Reconstructive Microsurgery Association, and Turkish Society for Surgery of the Hand and Upper Extremity.
