What is buccal fat removal?

Buccal fat removal is a surgical procedure used to reduce fullness in the lower cheeks. It is sometimes described as cheek fat removal or cheek reduction surgery. During removal, the surgeon makes a small cut inside the mouth and removes part of the buccal fat pad from each side of the face. The aim is usually to create a more sculpted face, more sharply contoured cheeks and a slimmer lower face.

The buccal fat pad is one of several fat pads in the face. These fat pads sit deeper than the fat closer to the surface of the skin. Buccal fat helps give the cheeks softness and fullness, and it plays a part in facial harmony. The size of the buccal fat pad varies from person to person, just as bone structure, facial structure and facial fat vary naturally.

Because of this, buccal fat removal is not suitable for everyone. Someone with naturally slim cheeks, low facial fat or reduced skin elasticity may be at greater risk of looking hollow after removing buccal fat.

What does the buccal fat pad do?

The buccal fat pad helps support natural cheek fullness. Along with other fat pads, facial muscles, skin elasticity and bone structure, it contributes to facial shape and facial aesthetics. Buccal fat does not only affect how full the cheeks look today. It also affects how the face may age over time.

This is important because the ageing process naturally reduces facial fat. Baby fat fades, soft facial volume changes, and the face often becomes leaner with age. If too much buccal fat is removed early on, the person may later feel they have lost volume too quickly. Ageing and weight fluctuation can make buccal fat removal results look more severe over time. A person who later experiences drastic weight loss may find their cheeks look even more hollow. That is one reason younger patients should be assessed particularly carefully before buccal fat removal.

What can go wrong after buccal fat removal?

As with any cosmetic procedure, there are certain risks and side effects to consider during the recovery process. Some side effects are considered normal and part of the healing journey, including:

• Swelling and bruising as part of the normal healing process.
• Discomfort during the recovery period.
• Bleeding or infection, which can occur even with proper care.
• Slow healing and temporary unevenness as the face settles.

These effects are generally temporary and should improve over time as the body heals.

However, there are also potential risks that should be actively prevented by your surgeon. These include:

• Hollow cheeks or a cheek dent, leading to an undesirable appearance.
• Overly angular appearance or uneven cheeks, indicating that the fat removal was not balanced.
• A result that does not suit the person’s facial structure, causing the face to look unnatural.
• Excessive removal of facial fat, which may leave the face looking older than expected.
• Nerve-related symptoms, such as persistent numbness, which may signal nerve damage.

Your surgeon should take all necessary precautions to minimise these risks by employing the most appropriate surgical techniques, implementing careful planning and execution and providing clear aftercare instructions.

Can buccal fat removal make you look older?

Yes, it can. That does not automatically mean negligence, but it is one of the main reasons people later regret removing buccal fat. Buccal fat contributes to cheek volume and softer facial aesthetics. As the ageing process continues, the face usually loses facial fat anyway. If buccal fat has already been reduced through fat removal, the cheeks may look hollow sooner than expected.

This is why concerns about premature ageing are often raised in relation to buccal fat removal. A result that looks fashionable in the short term may not age well. Buccal fat removed from someone with limited facial volume can create a gaunt look later on, especially if body weight falls or the person’s natural beauty already relied on softer cheek contours rather than sharply defined ones.

A surgeon should discuss this before surgery. Informed consent is not just about the immediate risks of a cosmetic procedure. It should also include realistic discussion of how buccal fat removal may affect facial harmony in the future. If that conversation never happened, and the patient was left with a result they were not warned about, that may be relevant when considering negligence.

Are hollow cheeks after buccal fat removal a sign of negligence?

Sometimes they are simply a disappointing result or a recognised risk. In other cases, hollow cheeks may suggest negligent care.

The question is whether the final result is so hollow, severe or unbalanced that it suggests the wrong patient was chosen, too much buccal fat was taken away or the likely outcome was not properly explained.

A patient with low facial fat, fine facial structure or prominent bone structure may never have been a good candidate for removing buccal fat. Younger patients may also be at risk because their face will continue to change over time. If a facial plastic surgeon or plastic surgeon failed to assess those points properly, and the result is an avoidably hollow face, that could support a claim.

Can asymmetry after buccal fat removal be negligence?

Mild asymmetry can happen during healing. Many people naturally have some difference between one side of the face and the other. A surgeon should also explain that perfect symmetry is rarely possible in plastic surgery.

However, marked or lasting asymmetry after buccal fat removal may be a warning sign. If one side appears more hollow, flatter or more sunken than the other after full healing, it may suggest uneven fat removal or poor surgical planning. Buccal fat should be approached carefully because too much removal on one side can affect facial contouring in a very obvious way.

The same applies if there is a visible cheek dent, contour deformity or a result that clearly does not reflect what should have been expected from the consultation process.

What is the difference between a complication and negligence?

This is one of the most important questions in any cosmetic surgery claim. A complication is a recognised risk that can happen even when the surgeon acts properly and negligence happens when the surgeon or clinic fails to meet the expected standard of care, and that failure causes avoidable harm.

With buccal fat removal, the fact that a person is unhappy with the result does not in itself prove negligence. Equally, the fact that a complication happened does not automatically mean the treatment was acceptable. The real issue is whether the surgeon met their duty of care before, during and after buccal fat removal.

Understanding your surgeon's legal obligations to prevent complications

What is a surgeon’s duty of care before buccal fat removal?

Before proceeding with buccal fat removal, a responsible surgeon must thoroughly assess whether the patient is suitable for the procedure. This evaluation should include:

• Facial structure and fat distribution
• Skin elasticity
• Bone structure
• Age and overall health
• Long-term effects of the procedure

A detailed consultation is essential to make sure that the patient understands all aspects of the surgery, including:

• The alternatives to buccal fat removal.
• Realistic outcomes and the expected results.
• Recognised risks and potential complications of the procedure.

The surgeon should communicate that buccal fat removal is permanent. The patient should fully understand:

• This procedure permanently reduces cheek volume.
• The effects may become more noticeable with time, especially if the patient loses additional facial fat as they age.

If the surgeon fails to properly explain the realistic risks of the procedure, downplays the potential for a hollow appearance, or recommends the procedure to someone who is unsuitable, these actions could be considered a breach of duty. Such negligence may form the basis for a legal claim, as the surgeon has a responsibility to provide clear and accurate information to be sure the patient makes an informed decision.

What is a surgeon’s duty of care during buccal fat removal?

During buccal fat removal, the surgeon must perform the procedure to the highest standard including:

• Proper technique to achieve the desired outcome while avoiding complications.
• Maintaining proper hygiene to reduce the risk of infection.
• Careful handling of surrounding anatomical structures to prevent unnecessary damage.

The surgeon must also:

• Avoid excessive fat removal, which could lead to unsatisfactory results.
• Ensure that the fat removal does not cause asymmetry or damage to the facial structures.

The cheek area contains important anatomy, and poor technique can lead to:

• Internal scarring
• Damage to the mouth area
• Problems related to nearby nerves or tissues

This highlights why buccal fat removal should not be treated lightly, despite its portrayal online as a quick solution for a sculpted face. The surgeon’s duty is to perform the procedure safely and to the highest standard.

What is a surgeon’s duty of care after buccal fat removal?

After surgery, the surgeon’s duty of care continues, and you should receive appropriate aftercare guidance, including:

• Oral hygiene advice to prevent complications.
• Recovery instructions, including managing pain and swelling.
• Signs of infection and how to address them.
• What to do if problems arise during the recovery process.

Your surgeon should also schedule follow-up appointments to monitor proper post-operative care. These appointments are essential for assessing your healing progress and addressing potential issues. They allow the surgeon to identify complications early, helping to prevent long-term problems and ensuring that any concerns are addressed promptly. Regular check-ups are a key part of enabling the success of the procedure and your overall recovery.

Can buccal fat removal gone wrong be corrected?

Correction after buccal fat removal can be challenging. Once the fat is removed, it doesn’t grow back, leaving some individuals who regret their procedure seeking ways to restore lost volume. Options such as fat grafting or dermal fillers may be considered, depending on the specific case.

• Fat grafting involves taking fat from another area of the body to restore facial volume.
• Dermal fillers can sometimes be used to soften a hollow appearance.

However, neither option is a guaranteed fix. The face may not fully return to its previous look, and corrective treatments can come with added cost, inconvenience and risks.

This is why negligent buccal fat removal can have a lasting impact. While corrective procedures may help, they cannot always reverse the avoidable harm caused by poor surgical advice or inadequate technique. This is why it is vital that patients are fully informed about the risks before opting for this procedure.

What should you do if you think buccal fat removal has gone wrong?

If you are concerned about your buccal fat removal results, taking the following steps can help you address the issue promptly and properly.

Seek medical attention

If you notice ongoing symptoms such as infection, increasing pain or worrying swelling, it’s important to seek appropriate medical advice immediately. These symptoms should be assessed by a healthcare professional to ensure proper care and treatment. A medical report may also serve as evidence later on should you pursue a compensation claim.

Notify your surgeon

Contact your surgeon or the clinic as soon as possible to express your concerns. Discuss any problems you are experiencing and request an evaluation of the situation. Timely follow-up appointments can help prevent further complications.

Document your experience

It’s important to document how you’ve been feeling throughout your recovery. Keep track of the following:

• Pain levels: record any pain you experience, noting the intensity, duration, and location.
• Side effects: track any side effects such as swelling, redness or changes in sensation, and when they occurred.
• Dates and times: make a note of when symptoms or concerns started, and document the timeline of any changes you observe.
• Emotional impact: consider how the procedure has affected you emotionally and mentally, especially if there is a sense of dissatisfaction or frustration.

This detailed account can be valuable in understanding the recovery process and may also help if further action is required.

Gather evidence

Collecting evidence is an essential step in strengthening any potential compensation claim. Examples of evidence to collate include:

• Photographs: take clear and dated photos of your face as it heals, highlighting any visible issues or changes.
• Receipts and invoices: keep any receipts or invoices for additional treatments or medications you may have had to pay for as a result of complications.
• Travel expenses: document travel to and from follow-up appointments, as these costs may be relevant.
• Communication with the surgeon: save emails, messages or any written communication between you and your surgeon regarding your concerns or aftercare.
• Medical reports: obtain copies of any medical reports or second opinions from healthcare professionals who have assessed your condition.

Having thorough evidence will help to build a stronger case and ensure your voice is heard if you choose to move forward with a compensation claim.

Seek a second opinion

If you feel that your concerns are not being properly addressed or if you're uncertain about the advice you've received, it can be highly beneficial to consult with another qualified medical professional for a second opinion. A second opinion allows you to have your situation reassessed by an independent expert who can provide a fresh perspective.

They can evaluate your results and determine whether they fall within normal expectations or if there are underlying issues that may require corrective measures. This additional assessment can help you make a more informed decision about the next steps, whether that involves further treatment, adjustments or exploring legal options.

Get legal advice

If you believe the outcome of your buccal fat removal procedure was caused by negligence rather than an accepted risk, seeking specialist legal advice is an important step in understanding your options and potential next steps. Legal experts, such as the team at Cosmetic Surgery Solicitors can guide you through the process with clear and empathetic advice. They can help assess whether you have grounds for a claim by reviewing your case, gathering relevant evidence and determining whether the surgeon’s actions fell short of the expected duty of care.