Buccal fat removal (bichectomy) is a short procedure that removes part of the buccal fat pad in the lower cheek, aiming to reduce roundness and make the cheekbone and jaw line look more defined. It is performed inside the mouth, so no skin incision is made; it is usually done under local anesthesia, with light sedation if needed, and takes about 30–45 minutes.
| At a Glance | Details |
|---|---|
| Procedure | Buccal fat removal (bichectomy) — through the mouth |
| Duration | About 30–45 minutes |
| Anesthesia | Local anesthesia, with light sedation if needed |
| Stay | Usually home the same day |
| Back to work | Desk work usually after 2–3 days |
| Incision/scar | Inside the mouth; no incision on the skin |
| How long it lasts | Long-lasting; long-term data are limited |
| Who it suits | Full lower cheeks, fullness below the cheekbones |
Contents— 22 sections
What Is Buccal Fat Removal?
The buccal fat pad is a rounded fat compartment in the lower cheek, between the facial muscles. In some people it makes the mid-face look full, round or “babyish” and softens the cheekbone line. Buccal fat removal (bichectomy) removes a measured portion of this pad through a small incision inside the mouth; the aim is a less full lower cheek and a more defined cheekbone and jaw line.
Because the incision is inside the mouth, no skin incision is made. The aim is not a “hollow” look but a natural, balanced refinement. For overall contouring it can be planned together with facial implants or fat injection, and with double-chin liposuction when the area under the chin is also full.
What does the evidence say? The close relationship of the buccal fat pad to branches of the facial nerve and the parotid (salivary) duct has been described in detail, and the intraoral approach was developed from this anatomy (Stuzin et al., 1990). A 2021 systematic review of cosmetic buccal fat removal reported mostly favourable early results but found few, low-quality studies and no long-term follow-up data (Traboulsi-Garet et al., 2021).
Who Is a Good Candidate — and Who Is Not?
Suitable candidates
- Full, round mid-face that you would like to see more defined
- Prominent buccal fat despite a normal body weight
- Realistic goals and stable weight
- Good general and oral health
Situations to reconsider
- Naturally thin or narrow face (risk of a gaunt, aged look)
- Older age with already reduced facial fat
- Active dental/gum infection
- Expectation of a very extreme “sunken” result
Because facial volume changes with age, a conservative removal is preferred; over-removal can increase the risk of a hollow look later.
Assessment by Face Shape
Suitability depends on where the lower-cheek fullness comes from (buccal fat, fat under the skin, the chewing muscle or bone structure), on facial proportions and on weight. The drawings below show common face shapes; the final decision is made at the examination.
Buccal fat removal is usually not needed; removing fat could risk a gaunt look later. For more cheekbone definition, facial implants or cheek filler may be considered.
The profile most often assessed for buccal fat removal; a measured reduction aims to slim the cheeks and sharpen the cheekbone-to-jaw transition.
Part of the fullness may decrease on its own at a young age or relate to weight; the amount removed is planned with particular care.
Related reading: hollow cheeks and mid-face ageing · masseter Botox for a wide jaw · why the jawline fades with age
Where the Buccal Fat Pad Is and How It Is Removed
The buccal fat pad lies deep in the lower cheek, in front of the chewing muscle. It is reached through a small incision inside the mouth (level with the upper back teeth); a measured portion is freed and removed, and the incision is closed with dissolving stitches. Nearby branches of the facial nerve and the salivary duct are protected throughout.
Options to Slim the Face: Quick Comparison
| Option | Suitable for | How long the effect lasts |
|---|---|---|
| Buccal fat removal | Full lower cheeks, fullness below the cheekbone | Long-lasting; long-term data are limited |
| Double-chin liposuction | Fullness under the chin / along the jaw | Long-lasting for the fat removed |
| Masseter Botox | Wide jaw from muscle bulk | Temporary (needs repeating) |
Buccal fat removal targets cheek fat; it does not change the chewing muscle, the area under the chin or loose skin. Options are sometimes planned together for a full contour.
How Is Buccal Fat Removal Done? (Step by Step)
- Planning: Cheek fullness, the cheekbone line and facial proportions are assessed; the amount to remove is planned conservatively.
- Anesthesia: Local anesthesia, with light sedation for comfort if needed.
- Intraoral incision: A small incision is made inside the cheek near the upper back teeth.
- Fat removal: A measured portion of the buccal fat pad is gently freed and removed, and symmetry is checked.
- Closure: The incision is closed with dissolving stitches; no skin scar is created.
- Going home: After a short rest you usually go home the same day; a soft diet and mouth rinses follow.
Your Treatment Journey — From First Message to Check-up
- 1
First contact
Message us on WhatsApp or call; consultations are possible in English, German and Turkish.
- 2
Pre-assessment
Front and side photos give preliminary information; they do not replace a face-to-face examination.
- 3
Examination and plan
The source of the cheek fullness, facial proportions and the amount to remove are assessed.
- 4
Written plan
The planned procedure, where it takes place, the type of anesthesia and what the fee includes are confirmed in writing.
- 5
Procedure day
About 30–45 minutes under local anesthesia ± light sedation; usually home the same day.
- 6
Check-up
Check-ups in the first days and weeks to follow the swelling and the healing of the incision inside the mouth.
- 7
Result
Swelling settles over the following weeks; the final look usually appears within 3–6 months.
Recovery — Day by Day, Week by Week
- 0–3d
Cheek swelling and mild soreness; soft diet and mouth rinses.
- 2–3d
Back to desk work for most patients.
- 1–2 wk
Most swelling eases; normal diet resumes gradually.
- 4–6 wk
Cheeks look settled; contour keeps refining.
- 3–6 mo
The final look becomes clear.
After the Procedure: What to Do and What to Avoid
✓ Do
- Use the prescribed antiseptic mouth rinse
- Eat a soft, lukewarm diet for the first days
- Keep the head slightly elevated and use cold packs early
- Keep your follow-up appointments
✕ Avoid
- Smoking and alcohol (delay healing)
- Hot, hard, spicy or crunchy foods early on
- Vigorous exercise for about 2 weeks
- Touching the incision with your tongue or fingers
Back to Daily Life
- Eating: Soft, lukewarm food for the first days; a gradual return to a normal diet over 1–2 weeks.
- Oral care: Use the recommended rinse and brush gently; do not touch the incision.
- Exercise: Light walking from the first days; strenuous exercise is usually postponed for about 2 weeks.
- Work: Desk work usually after 2–3 days.
- Flying: Usually after the first check-up.
Timings vary from person to person; your surgeon sets the exact schedule.
Check-up Schedule and When to Call Immediately
The first check-up is usually within the first week; further check-ups are planned over the following weeks and months depending on how you heal. If you travel from elsewhere, remote follow-up and photo assessment are agreed in advance.
Call without waiting if you notice
- Rapidly increasing, firm swelling and growing pain in one cheek
- Fever of 38 °C or higher, increasing swelling, a bad taste or discharge inside the mouth
- Increasing difficulty opening your mouth
- New weakness of the face when smiling or moving the lips
- Bleeding that does not stop with pressure
In an emergency such as difficulty breathing or swallowing, call 112 in Turkey (or your local emergency number) first, then let our team know.
Possible Risks and What You Should Know
Buccal fat removal is a short procedure, but like any surgery it carries risks; it is important to know them in advance:
- Swelling, pain and temporary difficulty opening the mouth (trismus): common in the first days and weeks; they usually resolve on their own.
- Asymmetry: differences between the two sides can occur and are usually mild.
- Over-removal / hollow look: taking too much can make the cheek look hollow and the face look older over time — which is why a conservative approach matters.
- Infection and bleeding (hematoma): rare; good oral hygiene and following the aftercare advice reduce the risk.
- Injury to a facial nerve branch or the parotid (salivary) duct: rare; because these structures lie close to the buccal fat pad, careful technique is needed (Stuzin et al., 1990).
A 2025 meta-analysis pooling 12 studies with 308 patients reported a post-operative complication in about one in four patients; the most common were swelling, difficulty opening the mouth, pain and asymmetry, while facial nerve palsy, infection and hematoma were rare. The authors noted large differences between studies and advised that the procedure be recommended with caution (Albuquerque et al., 2025).
The fat removed does not come back, but data on long-term results are limited and the face continues to change with age. The warning signs are in the “Check-up Schedule and When to Call Immediately” section above.
What Buccal Fat Removal Can and Cannot Correct
What it can correct
- Lower-cheek fullness caused by the buccal fat pad
- A more defined transition below the cheekbone
- A less round face shape (in suitable patients)
Its limits
- Fat under the chin: double-chin liposuction
- A wide jaw from the chewing muscle: masseter Botox
- General excess weight and loose skin
- A thin face, or one that has recently lost weight quickly (see the “Ozempic face” section below)
- Long-term results: evidence is limited; in a cross-sectional CT study, buccal fat volume was higher at older ages and with a higher body-mass index, so how this fat changes with age is debated (Akşamoğlu et al., 2025)
Preparing for Surgery
Preparation is short but helps lower the risk of bleeding and infection; you receive exact instructions at your examination.
Aspirin, blood thinners and some herbal products (omega-3, ginkgo) are stopped 7–10 days before, with your doctor’s approval. Tell us about all medicines and supplements you take; do not stop your regular medicines without asking your doctor.
Smoking slows the healing of the wound inside the mouth; if possible, stop 2–3 weeks before.
As the incision is inside the mouth, gum inflammation, an abscess or a dental problem awaiting treatment is treated first.
Have soft, lukewarm food ready for the first days. If sedation is planned, you are told in advance how long to fast and whether someone needs to take you home.
Expected Change (Medical Illustration)
The images in this section are not photos of real patients. The schematic illustration below shows the typical front-view change: from full, round lower cheeks to a more defined cheek and jaw line.
The illustrations are schematic drawings for information only. With any surgical or interventional procedure, results may vary from person to person.
Op. Dr. Ali Çetinkaya: Specialty and Professional Background
Specialist in Plastic, Reconstructive and Aesthetic Surgery (2017); working in plastic surgery since 2012, including specialty training. Member of TPRECD (Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons) — member record. Biography: about me.
Buccal Fat Removal in Istanbul: For Patients Travelling From Abroad or Other Cities
If you are coming to Istanbul, the online pre-consultation, procedure, first check-up and travel home are planned together. Buccal fat removal is usually a day-case procedure; staying in Istanbul for a few days until the first check-up is advised, and the exact length is set at the examination.
Online pre-consultation
Photos or a video call give preliminary information; they do not replace a face-to-face examination.
Written plan
The planned procedure, where it takes place, the type of anesthesia and what the fee includes are confirmed in writing.
Short programme
Usually a day-case procedure; travel home after the first check-up.
Follow-up
Agree in advance how remote follow-up will work after you return and how to reach us if there is a problem.
Weight Loss, “Ozempic Face” and When Buccal Fat Removal Is Not Advisable
Rapid weight loss — including from medications such as semaglutide, the so-called “Ozempic face” — already thins the cheeks and mid-face. If your face has recently become gaunt or hollow, removing buccal fat can over-thin it and add years to your appearance. In that situation, restoring volume with fat transfer is usually the better choice, not removal.
Buccal fat removal is designed for a genuinely full, round lower cheek at a stable weight — not for a face that is already slim or changing quickly. Because the face keeps changing with age, the amount removed is planned conservatively so the result still looks natural in later years.
Buccal Fat Removal Price: What Determines the Cost?
A firm price is given after the examination, because the amount removed, whether it is combined with other procedures, the type of anesthesia and where it takes place vary from person to person.
Usually included in the fee
- Surgeon’s fee
- Local anesthesia (sedation if needed)
- Post-procedure medication and mouth rinse
- Follow-up check-ups
If you see a very low price, ask in writing where the procedure will take place, under which anesthesia conditions and what is included.
Confirm in Writing Before Booking
- Who will perform the procedure and who is on the team
- Where the procedure takes place and the type of anesthesia
- The planned procedure(s) — and what is not included
- Check-ups, including remote follow-up after you return home
- Medication and mouth rinse
- What happens, and what it costs, if a complication needs further treatment or a correction is needed
- Transfer or accommodation — only if offered, and exactly what it covers
- Payment, deposit and cancellation terms
No prices or packages are published on this page; the fee is given after the examination, based on your individual plan.
Appointment & Contact
Quick Appointment
WhatsApp is fastest: send a front and a side photo and your goal; photos give preliminary information, and the plan and fee are confirmed at the examination.
Op. Dr. Ali Çetinkaya Aesthetic Surgery Clinic
📍 Barbaros Mah. Başak Cengiz Sok. Varyap Meridian B Blok No:2 D:5, Ataşehir / Istanbul
📞 +90 532 663 43 60 · ✉️ bilgi@dralicetinkaya.com
🕘 Monday–Friday 10:00–19:00 · Saturday 10:00–17:00
Frequently Asked Questions
Can buccal fat removal be reversed if too much is taken?
What is the right age for buccal fat removal?
How long does buccal fat removal take?
Is there a visible scar?
When can I return to work?
How long does the effect last?
Will it make me look older in the future?
When will I see the final result?
Can it be combined with other procedures?
Does buccal fat removal make you lose weight or slim the whole face?
Can non-surgical fat-dissolving treatments replace buccal fat removal?
Will it be hard to open my mouth afterwards?
Glossary
- Bichectomy
- The medical name for buccal fat pad removal.
- Buccal fat pad
- A rounded fat compartment in the lower cheek.
- Intraoral incision
- An incision made inside the mouth, so no skin incision is needed.
- Mid-face
- The cheek region between the eyes and the mouth.
- Parotid duct
- The salivary duct near the cheek that is carefully avoided.
- Contouring
- Shaping facial proportions, sometimes by combining procedures.
- Trismus
- Temporary difficulty opening the mouth.
Videos
Explore our channels for video explanations and short-form content:
Medically reviewed by
Specialist in Aesthetic, Plastic and Reconstructive Surgery
- Specialist since 2017
- Member of TPRECD
- Ataşehir, Istanbul
- Türkçe · English · Deutsch
Op. Dr. Ali Çetinkaya is a specialist in Plastic, Reconstructive and Aesthetic Surgery. Member of TPRECD (Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons). He completed his residency in 2017 and practices at his private clinic in Ataşehir, Istanbul, specializing in deep plane facelift, neck lift, rhinoplasty, and eyelid surgery (blepharoplasty). He offers consultations in Turkish, English, and German for international patients.
Last updated:
This page is for information and does not replace medical advice.
Sources
- TPRECD — Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons
- Stuzin JM, Wagstrom L, Kawamoto HK, Baker TJ, Wolfe SA. The anatomy and clinical applications of the buccal fat pad. Plast Reconstr Surg 1990;85(1):29–37. doi:10.1097/00006534-199001000-00006
- Traboulsi-Garet B, Camps-Font O, Traboulsi-Garet M, Gay-Escoda C. Buccal fat pad excision for cheek refinement: A systematic review. Med Oral Patol Oral Cir Bucal 2021;26(4):e474–e481. doi:10.4317/medoral.24335
- Rohrich RJ, Stuzin JM, Savetsky IL, Avashia YJ, Agrawal NA, Prada M. The Role of the Buccal Fat Pad in Facial Aesthetic Surgery. Plast Reconstr Surg 2021;148(2):334–338. doi:10.1097/PRS.0000000000008230
- Albuquerque MC, Arruda KAR, Xavier Junior GF, Cerqueira ACDSG, Massignan C, Rocha FS. Prevalence of complications of buccal fat removal: A systematic review and meta-analysis. J Craniomaxillofac Surg 2025;53(4):363–369. doi:10.1016/j.jcms.2024.12.014
- Akşamoğlu M, Bayar Muluk N, Şahan MH. Changes of the Buccal Fat Pad Volume According to the Different Age Groups, Gender, and Body Mass Index: An Evaluation With Computed Tomography. J Comput Assist Tomogr 2025;49(1):156–164. doi:10.1097/RCT.0000000000001659
