Buccal Fat Removal in Brazil

Defining the face means knowing which volume is worth keeping.

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At a glance

Buccal fat removal in Londrina, Brazil: at a glance

What is buccal fat removal?

Buccal fat removal is the partial removal of the buccal fat pad, a deep fat pad in the cheek, through an incision inside the mouth, to slim the facial contour in carefully selected patients. I don’t perform buccal fat removal on its own, only combined with another facial surgery. It is not a weight-loss procedure, it does not treat a double chin, and it is no substitute for a facelift. The fat that is removed does not come back.

Candidacy: a true excess of deep fat; caution with thin faces or faces that have lost volume.
Anesthesia: total intravenous anesthesia (TIVA) in a hospital; the buccal fat removal itself takes about 20 minutes.
Recovery: a liquid diet for about five days; light exercise after one month, any activity after two.
Risks: swelling, difficulty opening the mouth, asymmetry, injury to a salivary duct or a nerve; a 4.2% complication rate in a 2026 review.
Long term: there are not enough studies on how the face ages afterward.
Combined procedures: always with another facial surgery; follow-up visits for one year.

By Dr. Walter Zamarian Jr. · CRM-PR 17.388 · RQE 15.688

Contour

A slimmer face isn’t the only path to definition

You may want a crisper transition between your cheek and your jawline without ending up with a hollow face. That difference is what I try to understand. Reduction surgery needs to preserve the volume that visually supports your expression, rather than aim to remove as much as possible.

I examine your face from the front, in profile, and in motion. I ask about weight changes, previous treatments, and what has changed over the years. The area that looks full is not always the buccal fat pad: the chewing muscle, the bone structure, and fat in other layers also shape the face.

If reducing it would not benefit your face as a whole, I explain why. A good consultation may end with a different plan from the one you had in mind, including one without buccal fat removal.

Who it's for

The diagnosis changes the plan entirely

A true excess of deep volume

Reduction may be considered if this component contributes to your concern and stays in balance with the rest of the face.

Sagging and tissue descent

Repositioning may matter more than removing. The assessment should include the jawline and the neck.

A face that has already lost volume

Removing more fat can deepen hollows. I look at how much volume you have in reserve and at your pattern of aging before recommending anything.

I also assess the cheekbones, the chin, and the muscles. A jaw that is wider because of muscle, or a chin that lacks projection, is not the same problem just because both get described as a round face.

Buccal fat removal is not a way to lose weight, either: according to the ASPS, good candidates are healthy nonsmokers at a stable weight with realistic expectations, and the procedure is typically not performed on thin, narrow faces. A systematic review lists underdeveloped cheekbones as a contraindication and warns that the buccal fat pad shrinks with age and that removing it may make tissue descent more pronounced (Traboulsi-Garet and colleagues). ASPS candidate criteria and ASPS overview.

That is why I don’t choose the procedure based on a selfie or a celebrity’s jawline. An in-person exam helps identify which structure is creating the look you notice.

With a facelift

When it can be part of my facelift plan

In some patients, the volume of the buccal fat pad adds to the visual heaviness of the lower cheek. I may consider reducing it as part of a deep plane facelift plan when I believe it will add definition to the repositioning.

This is a targeted decision. It does not mean removing fat from every face that undergoes a facelift, or assuming that every fold along the jawline comes from the buccal fat pad. Another area of the same face may be lacking volume and call for fat grafting.

An apparent excess in one area and volume loss in another are not contradictory. The point is to map each component and explain what each procedure is for. I want you to know what we will preserve, what we will reposition and, if needed, what we will reduce.

Shall we find out what really defines your contour?

I want to hear what bothers you and assess whether reducing, repositioning, or preserving volume is the right path.

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Technique

How I reach the cheek

The incision is made in the lining inside the mouth. Through this approach, I identify the fat and reduce it according to the plan. The area calls for care around blood vessels, nerve branches, and the duct that carries saliva from the parotid gland into the mouth.

I don’t perform buccal fat removal on its own: it is only done as part of another facial surgery. I use total intravenous anesthesia (TIVA), as in almost all my surgeries, and in my hands the buccal fat removal step takes about 20 minutes. Your hospital stay follows that of the combined surgery; with a facelift, you go home the next morning. A small incision does not make buccal fat removal a risk-free procedure.

I don’t perform enzymatic buccal fat reduction. This page describes surgical reduction, with an anatomical assessment and direct control during the operation. The scar is inside the mouth, but it still needs careful hygiene and attention to what you eat.

Evidence

What we know, and what we don’t yet know, about aging afterward

A 2026 review analyzed ten studies and 1,123 patients. The authors found a reduction in lower facial volume and high satisfaction, but highlighted the low quality of the studies and the inadequate assessment of long-term outcomes. Shapiro and colleagues, 2026.

An earlier review also pointed to a lack of robust evidence. So I don’t think it is right to promise that buccal fat removal will never make future volume loss more noticeable, even when it seems well indicated. Careful patient selection reduces uncertainty, but it does not let us predict decades of facial change. Review by Traboulsi-Garet and colleagues.

That limitation does not make the surgery pointless. It changes the conversation: the benefit you want has to outweigh removing volume you may come to value in the future. Taking your time to decide is especially important here.

Recovery

Give the contour time to show

In the first few days, swelling can make your cheeks look fuller than before. This is not the time to judge how much your face has changed. Pain, pressure, and tenderness are usually managed with your aftercare plan while the tissues gradually settle.

I routinely start you on a liquid diet for about five days, with oral hygiene instructions to protect the incision. Light exercise is allowed after one month, and any physical activity, including contact sports, after two months. When you can go back to work depends on your discomfort, how you look, and the kind of work you do. Try not to measure your recovery against someone else’s, especially if you also had a facelift.

Don’t press on your cheek or force your mouth open to test how it is healing. At follow-up visits, I compare the two sides, examine the lining of the mouth, and check that you are healing as expected. Later photos tell you more than small day-to-day comparisons in the mirror.

If you live far away, see how follow-up visits and support are organized. The team’s availability is part of planning before surgery.

Risks

Removing volume calls for an informed decision

Possible complications include bleeding, hematoma, infection, difficulty opening the mouth, asymmetry, injury to a salivary duct, or altered movement due to nerve injury. Removing too much can leave hollows; a revision cannot always restore the original volume and distribution.

The numbers vary with what each study counts as a complication. In the review by Shapiro and colleagues, there were 39 complications in 921 procedures, 4.2%, mostly minor; one of the studies reported a gaunt appearance in 1.6% of cases. The review by Traboulsi-Garet and colleagues found 3.3%, with difficulty opening the mouth and temporary paralysis of a facial nerve branch among the most frequently reported. A meta-analysis that also counted swelling and pain as complications concluded that one in four patients has some postoperative complication, mainly swelling, difficulty opening the mouth, and pain. Meta-analysis of buccal fat removal complications. The ASPS list of risks also includes injury to a salivary duct, changes in sensation, persistent pain, and the possibility of revision surgery.

Fat grafting may be considered to correct some hollowing, but it is not an undo button for the surgery. How much fat survives varies, and more than one procedure may be needed.

Swelling that increases quickly, worsening pain, fever, discharge, or significant difficulty swallowing need to be evaluated. If you have trouble breathing, seek emergency care. Take these instructions seriously even if the surgery was described to you as minor. Follow-up visits continue for one year.

Pricing

What goes into your quote

I don’t publish surgical fees. Your quote is individual and prepared after the evaluation. Because I only perform buccal fat removal combined with another facial surgery, it is part of the quote for that combined plan. When it is indicated together with a facelift, it does not increase the cost of the surgery.

I only see private-pay patients; I don’t accept health insurance or Brazil’s public health system (SUS). The pricing page shows how the items are presented, and the first consultation can be done online.

Questions

Your questions deserve a careful answer.

Do you perform buccal fat removal on its own?

No. I only perform buccal fat removal combined with another facial surgery, such as a facelift, when the reduction adds something to the plan. If buccal fat removal is all you want, I can evaluate your face and explain what I see, but I don’t perform the procedure on its own.

Does buccal fat removal treat a double chin?

It is not a direct treatment for fat under the chin. The cheek and the neck each need their own assessment, even if both contribute to the same overall impression of your contour.

Does every facelift include buccal fat removal?

No. I only consider it when a localized excess justifies the reduction. For many people, it is preferable to keep the fat.

Does it still make sense after 40?

Age alone doesn’t decide it. How your volume is distributed, how much sagging you have, and what you expect are more useful in judging whether removing fat could help or harm.

Can what was removed be put back?

Not in the same way. Grafts can help with some hollows, but they don’t automatically restore the original anatomy. That is why the initial decision deserves caution.

How will I know if it’s worth it for me?

At the consultation, I will show you which structure contributes to your concern and explain the benefit you can expect from the reduction. We will also discuss what can be preserved or treated another way.

When will I see the result?

The contour emerges as the swelling goes down, over weeks and months. The pace varies with the extent of the surgery and the combined procedures.

Does biting the inside of my cheek mean I need buccal fat removal?

I don’t draw that conclusion from the complaint alone. Before considering fat removal, it is important to examine the lining of the mouth and the teeth: biting, teeth with sharp edges, and braces or dentures that rub can all cause sores. A sore that lasts longer than three weeks should be examined by a dentist or doctor, as the NHS advises. Don’t wait for a cosmetic consultation to have a persistent sore checked.

Before considering removing volume, I want to assess whether that volume actually contributes to what bothers you and how the decision may play out over the years.