Buccal Fat Pad Excision

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Buccal Fat Pad Excision

A buccal fat extraction (usually pronounced like a buckle) is the procedure to remove the fat pads that augment the lower part of the cheeks. Oftentimes, if you purse your lips to whistle, you will notice a more chiseled, hollow look. It is also a procedure that is often sought to remedy a condition often referred to as “chipmunk cheeks.” You may have heard it called “cheek reduction surgery,” as well. It is an appearance that individuals in their late 20s to early 30s begin to see naturally as they age. It’s also interesting to note that treatment of this condition is popular with many fashion runway models. The procedure requires special expertise and artistic capability. Fortunately, Dr. Romano has both of these assets and is experienced in creating a natural result.

Dr. Romano Explains

The more men study their facial features, the more often very subtle features become very noticeable.


The look of a very round middle face, puffy cheeks, and loss of cheek bone contour are very good reasons that men don’t like their look and come to me and seek this surgery. I understand this concern of yours, and can cure it for you.


The anatomy of the middle face, often called the midface, is composed of its bony foundations (cheekbones and below), the surface fat, and the deep fat pocket—called the “buccal fat pad,” “Bichat’s fat pad,” or “fat pad of Bichat.” This is what I address very carefully when evaluating fullness in this area. It is not the fat more commonly seen below and along the jawline, called the “jowl fat.” This is different. It is intimately related to the lower cheekbone contour above and the jawline and jowl below, so that there are many different anatomic features of each of these areas that must be addressed prior to your surgery. I will coordinate the features of your anatomy with your expectations, formulate a plan with you, and guide you through this process. There is a very specific technique for removal of this fat pad through a half-inch incision in the mouth, or the removal can be combined with a facelift. Surgery involves a relatively short procedure under a light general anesthetic and is performed where I do surgery, which is in a hospital setting. The surgery is safe and predictable. There is very little swelling. All of the stitches are dissolvable, and you can return to work in as little as one to two days and to some physical exercise within the first week.


This is an extremely technical procedure and it takes very special expertise, first, to accurately identify IF the fat pad is involved and, second, to carefully and artistically remove it. I have this expertise in buccal fat pad removal in men, and I spend a great deal of time discussing your anatomy, listening to your expectations, and interpreting for you what your anatomy and tissues will safely and predictably allow me to do. In addition I consider your body as a whole when I build a system into every facial surgery that, initially, allows you to recover much more quickly and, secondly, preserves your surgical results. This system includes a special diet, special attention to blood clotting, vitamins, supplements, special garments, skin products, physical training, and knowing what to avoid. Together all of this allows me to create results that are consistently very beautiful, quick to heal, and exceptionally natural. I use minimal incisions, especially in the face, an area of such major importance. I am delighted to surgically provide you with such profound yet natural facial image changes, ones that have so consistently pleased my male patients and changed their lives.

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