Buccal Fat Removal Surgery Procedure


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Buccal fat removal is a relatively simple, and quick, surgical process. In fact it’s so quick and easy that you will go in as an outpatient, and thus will be in the hospital for less than 24 hours. This is because the procedure isn’t very invasive and should only take about an hour to 90 minutes to complete.

Anaesthesia and IVs

The procedure will start with you being administered the anaesthetic that you discussed with your surgeon in your consultation.

If you are being sedated orally following the sedation you will probably have an IV drip inserted, containing saline to ensure you are hydrated and create an entry into your blood vessels, in case one is needed. The drip will probably be inserted in the wrist, or possibly the elbow, and is done by inserting a needle into the vein, pulling it back out, and replacing it with a small plastic tube. This tube, known as a catheter, will be taped down to make sure it doesn’t come out. This catheter will then be used to allow anything the doctor deems necessary to enter your blood, via the vein.

If you are not being orally sedated this IV process will be used to administer your anaesthetic and can be a little distressing and might sting. More often than not this process takes place outside of the operating room, and will generally be executed by a nurse, who’ll have had plenty of practice doing this as quickly and painlessly as possible.

If you’re not there already, after having your catheter inserted and a saline drip applied you will be taken to the operating room. It is at this point, if you are receiving a liquid IV sedative, that this will be administered either by inserting a syringe into the catheter tube or by attaching a bag of the sedative to the drip system. When the doctors open the stopper, or injects the sedation solution, allowing the sedative into your body, the results are quickly felt; usually within seconds. A warm sensation will run through your veins in your arm and up to the shoulders. You’ll then have a metallic-like taste in your mouth and from then on you are sedated.

The Buccal Fat Extraction

Once you are sedated the procedure can begin. The surgeon will start by making a 2-4 cm incision on the inside of your mouth, running from the cheek to the gums. The incision will start just above the second molar and move backwards along the cheek. Blunt dissection will then be used to reveal the buccinator muscle and its fascia and fibers. At this point the surgeon will use their thumb to push on the outside of your cheek, just under the cheek-bone, to squeeze the buccal fat out of the incision. They will then use surgical tweezers to pull the fat out slowly, bit by bit. The surgeon will do this until a sufficient amount of fat has been removed. It’s worth noting that although you may not feel enough has been removed after recovery, this is often a conscious decision on the part of the surgeon, who has accounted for further fat loss as you age.

Once the surgeon has removed a sufficient amount of fat, they will repeat the process on the other side for the other cheek.

The Post-Surgery

Once the fat has been extracted the surgical team will conduct a sponge and instrument count. After this you’ll be stitched up. This is now often done with dissolvable sutures, but not always. A piece of gauze soaked with antibiotics may also be placed in your mouth around the incision area, and a pressure dressing wrapped, length ways, around the head. This will all depend upon your surgeon’s preferences and methods.

Once this has been done you’ll be gently wakened and taken to the recovery room from which you will be monitored by the nurses to ensure you are able to be released safely, up to 2 hours later. You may feel a bit dazed as you come round and your face might feel a little bit sensitive as you wake properly.

Some people can also have some strange reactions to anaesthesia. You could feel a bit emotional or upset, and some people shiver or shake, sometimes uncontrollably. The latter is often a side effect of the medication you’ve been administered. If you experience the latter, and you’ve not already been provided with one, you should ask for a warm blanket. If you experience the former mentioned emotional side-effect, don’t be embarrassed. The nurses will have seen it all before.

If you’ve been under general anaesthetic you may feel slightly sick but aside from this there are few immediate side effects. In fact many people don’t experience any of this.  

Some discomfort is normal, although the pain should be managed by your prescribed medication. However if, once you’re home, you find that this pain is exceptional you should call the surgery right way.

Once you’ve been given the all clear to go home by the nurses or your surgeon you will need to be driven home by someone else, ideally someone who will be staying at home with you to take care of you. Please don’t even entertain the idea of being able to drive yourself, you’ll barely be able to see properly, let alone drive.


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