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Buccal Fat Removal

Some people have an enlarged fat pad (Bichat’s fat pad) that makes their faces look round and heavy. They may feel self-conscious about the “bottom-heavy” appearance of their faces, which can create a “cheeky” look or a heavy or sad expression. Since this issue is not related to weight and is instead determined by a person’s genetics, it can’t be treated through diet and exercise and must be addressed through surgery to achieve significant improvements. Removing a portion of this fat to reduce its size helps eliminate the “chipmunk” look, slims the cheeks, and provides additional definition to the cheekbones, jawline, and chin.

When performed by a skillful, experienced surgeon, the procedure is very effective in achieving a slimmer and more defined face. Buccal fat removal is an often-overlooked option for patients because many surgeons do not perform the procedure and so do not suggest it to their patients as a viable treatment option.

Dr. Samaha is an expert in facial plastic surgery and performs buccal fat removal at his Montreal plastic surgery centre. He uses both finesse and precision to remove just the right amount of fat to deliver subtle but noticeable results to his patients from Montreal, Ottawa, and Gatineau.

Meet Dr. Mark Samaha

A double board-certified otolaryngologist whose practice focuses exclusively on facial plastic surgery, Dr. Samaha is highly qualified in facial aesthetics. Learn more about our physician and how he’s carefully refined his skills to sculpt your beautiful face.

Meet Dr. Samaha

Dr. Mark Samaha

Meet Dr. Mark Samaha

A double board-certified otolaryngologist whose practice focuses exclusively on facial plastic surgery, Dr. Samaha is highly qualified in facial aesthetics. Learn more about our physician and how he’s carefully refined his skills to sculpt your beautiful face.

Meet Dr. Samaha

What is the best age for buccal fat removal?

Buccal fat removal is often performed in younger patients with good skin quality. It can also be performed in older patients, usually in conjunction with a facelift, to further enhance the result of facelift surgery by reducing a sagging fat pad, giving more definition to the cheek and jawline.

Before and after buccel fat removal

Who is a candidate for buccal fat removal?

The procedure is ideally suited for patients with a fullness and roundness in the lower cheek area and who wish to have a slimming effect to enhance the definition of the cheek area. The procedure can be performed for both men and women.

Areas improved by buccel fat

Is buccal fat removal surgery performed under general anesthesia?

No. Many patients have the procedure done under local anesthesia, similar to the dentist’s office. For those who choose to have a sedative, it is available. In those cases, patients are placed under sedation anesthesia (also called “twilight anesthesia”) by Dr. Samaha at the beginning of the procedure. This results in patients being asleep in a dream-like state without the use of a general anesthetic. Learn more about our anesthesia methods.

The Buccal Fat Removal Procedure

Dr. Samaha removes buccal fat pads after making small incisions inside the mouth. Dr. Samaha completely numbs the cheeks with a local anesthetic injected through the mouth, similar to the experience at a dentist’s office.

Dr. Samaha makes a small incision then carefully locates the areas of excess buccal. He carefully and meticulously removes the correct amount of fat to ensure natural-looking results. The amount of fat removed depends on the person and their unique anatomy, to ensure a natural, well-defined contour. He then uses dissolving sutures to close the small incisions.

No dressing is necessary, and patients can leave the clinic to return home within an hour of the surgery.

Will buccal fat removal leave a scar?

No. Dr. Samaha makes small incisions inside the mouth near the cheeks, so there is no visible scar.

How long will it take to recover from buccal fat removal?

Most patients are usually comfortable returning to their daily activities within 4 to 5 days after surgery.

There is some mild swelling after surgery that gradually resolves in the ensuing few days. As it does, the new, more defined, facial contours emerge. Gently applying cold compresses can help reduce swelling faster. Within 1 to 2 weeks, the swelling has sufficiently resolved to reveal the result. Cheek definition continues to improve over a 4 to 6-month period.

It takes about 7 days for the sutures inside the mouth to completely dissolve and fall out. We schedule a follow-up appointment with all patients approximately a week after the surgery.


Dr. Samaha has developed techniques and methods to minimize swelling and bruising after surgery for his patients to shorten their recovery. This has culminated in his Maximum Result Minimum Recovery system.

Learn More

These photos are published for information only in order to provide information on the nature of the intervention. They do not constitute a guarantee of results.

Frequently Asked Questions

How long does buccal fat removal surgery take?

The surgery takes approximately 45 minutes for both sides of the face to be treated. Patients are comfortable throughout the procedure.

Is buccal fat removal painful?

Buccal fat removal performed in our Montreal clinic is not painful, and patients remain comfortable both during and after the procedure. There is only a sensation like having a canker sore (aphthous sore) inside the cheeks.

What are the restrictions after buccal fat removal surgery?

The main restriction is avoiding strenuous physical activity and vigorous exercise. Avoiding acidic foods and liquids is also recommended because the small incisions inside the cheeks feel like small sores. Patients will need to rinse their mouths with saltwater to keep the small incisions inside the mouth clean during the healing process.

Will I have bruising after buccal fat removal?

Bruising is very rare after a buccal fat removal procedure. There may be a small bruise inside the mouth at the incision site, but it is very rare to see any bruising on the skin.

How long does it take to see the final result after buccal fat removal?

Most of the swelling from the surgery disappears after 1 to 2 weeks. The healing continues under the skin as the tissues settle. The final result is evident after 4 to 6 months.

Does the cheek fat come back after the procedure?

No. Once the fat is removed, it does not grow back.

What if I gain weight after buccal fat removal?

This particular fat pad (the fat pad of Bichat) does not fluctuate with weight gain or loss, unlike the fat under the skin, so gaining weight will not undo the results of your buccal fat removal procedure.

How long does buccal fat removal last?

The result of a buccal fat extraction is permanent. The fat does not return. Of course, if someone gains a significant amount of weight, the entire face will look fuller, although the fat removed in the lower cheek area does not return.

I hear that there could be hollowing after buccal fat removal. Is that true?

When performed by a skillful surgeon who removes the fat with care and precision, buccal fat removal should not create any hollowing. Hollowing develops when too much fat is removed or when it is removed from the upper cheek area, rather than taking care to remove it from the lower part of the cheek. Dr. Samaha’s specialization and experience in facial surgery, including buccal fat removal, allows him to expertly judge the location and amount of fat to remove for a proportionate, harmonious result.

Are there other options for reducing the volume of the cheeks?

Not exactly. Although using dermal fillers to enhance volume in the cheekbone and jawline areas can help create a better balance for certain patients, it does not work very well for those who have fullness in the cheek region. For this reason, buccal fat removal is the best option for unwanted fat in the lower cheek region.

Would you like to discover how buccal fat removal in Montreal, Quebec, could enhance your look? Request your consultation with Dr. Samaha online or call us at (514) 613-3004 to make your appointment. Dr. Samaha attracts patients from Quebec City, Laval, and Gatineau.