What is cheek fat removal surgery?
Cheek fat removal is an outpatient surgery that can be used to remove fat from under your cheekbones giving the appearance of a slimmer face. Buccal fat removal risks are typically the same as most surgery but there are some specific ones to know about.

Does buccal Fat Removal Surgery Have Risks?
Every surgery has risks: bleeding, infection scar. The only way to avoid risks is to not operate. It is never the intention of a surgeon to cause injury (ignoring crazy people like Dr. Death). Prior to going into any procedure, no matter how minor, you should understand specific risks and their likelihood. You should also know if you are at a higher risk than other people for any of these.
Bleeding After Buccal Fat Removal

Bleeding into the cheek after buccal fat removal would cause a hematoma. This is an emergency that requires reopening the incision and finding the cause of bleeding. Severe single-sided swelling associated with a warm, extremely tender, and liquid feeling in the cheek are all signs of a hematoma. This typically shows up during the first few hours of surgery. It is rare.
For this patient (left), the photo was taken from a review on RealSelf where the surgeon did not identify this complication. If this amount of blood is left alone, a patient will be left with scarring and possible infection. Typically, there is an increased risk of bleeding in patients who have A LOT of fat removedd, males, and high blood pressure. All complications are much more common in patients with fat that is difficult to locate and requires more dissection. Also, this risk is a very important reason to avoid NSAIDs, alcohol, smoking, and straws after your surgery.
Buccal Fat Removal Risks: Infection
Infection after cheek fat removal is rare and self-resolving. Typically, it is seen if saliva gets inside your incision during surgery. It is not always avoidable and antibiotics will help resolve minor infections. Sometimes a slight tenderness with develops a week or so after surgery. In these cases, it is best to use warm compresses, take a second course of antibiotics and perhaps reopen the incision to allow the pus to drain out.
Salivary Injury After Buccal Fat Removal
The patient here reported increased swelling after a meal one week after surgery only in the left cheek. Though her surgery went smoothly, she had an obvious spit gland issue. She entered my specialized protocol (botulinum, glycopyrrolate, antibiotics, warm compresses, and a clear liquid diet) for this type of complication and three days later you can see most of her swelling has resolved.
In severe cases of salivary gland injury (when the duct draining the gland is injured), surgery or more significant intervention may be needed.


Will Buccal Fat Removal Make me Look Older?
You can read more on this specific topic here. The short answer is that this is not the case for the vast majority of patients. If you have a skin face, are skinny, are Caucasian, and have thin skin the answer is likely yes. Other than that you need a personalized evaluation via consultation from a buccal fat removal expert.
No Difference After Buccal Fat Removal
While dreaded, this is what can be considered a “safe complication.” Nothing got better; but also nothing got worse. Chances are that your skin is thick and the results are minimal. If that is not the case, then perhaps you have a significant amount of fat superficial to the buccal fat pad which is hiding the results. Only weight loss can help with that. While some surgeons are more conservative than others, chances are that if you see no result after buccal fat removal, an extra milliliter of fat would have not made a huge difference. Unfortunately, this is the most common risk and while disappointing, it is hard to predict, not likely the fault of your surgeon, and not the worst of things that can happen.
Cheek Fat Removal Risks: Nerve Damage
There is a movement nerve that runs deep to the fat. While it can be injured, it is very rare to have a disfiguring permanent injury (knock on wood I have never seen one). There are also sensory nerves in the cheeks. An injury here would cause numbness and this can take weeks to months to heal. Unfortunately, there is no easy solution to this other than continuing to give your nerves time to heal.
Buccal Fat Removal Risk: Is it Worth It?
According to Realself, the surgery has a “worth it” rating of 91%. This makes it one of the surgeries with the highest satisfaction rating in all plastic surgery. There are other risks not listed here but overall your surgeon should discuss these specific issues during your consultation.