Expert Doctor

Surgical Facial Contouring: Buccal Fat Removal, Cheek Augmentation and Neck Liposuction

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Sagar Patel, MD

Beverly Hills, CA

facial sculpting

With the rise of selfies, doctors have seen an increase in requests for particular plastic surgery options that provide surgical facial contouring.  When people look at the angles that make selfies look their best, they often visualize high and sharp cheekbones as well as a well contoured jawline. These areas of the face can be surgically enhanced by performing buccal fat removal, cheek augmentation or neck liposuction. When this group of surgeries is performed in combination with each other, it is known as “selfie sculpting.”  

Am I a Good Candidate for Surgical Facial Contouring?

A GOOD CANDIDATE for surgical facial contouring is:

  • Someone who is at their ideal body weight
  • A person that has completed puberty but still has stubborn baby fat in his or her cheeks
  • Someone with a slight definition to the jawline since having naturally higher and rounder cheekbones will make the results more dramatic (this isn’t always required)

Patients that are NOT GOOD CANDIDATES for surgical facial contouring include:

  • Patients who are extremely thin
  • Patients that will have issues with volume loss as they age since buccal fat provides volume that may not be ideal for a young person but it provides an important shape to the face as a person ages
  • Patents with dimples can be impacted by buccal fat removal

How is Surgical Facial Contouring Performed?

The combination of procedures involved in facial sculpting can be performed using local anesthesia with, or without, the addition of light oral sedative medications. The procedure begins with the numbing of the neck using dilute local anesthetic. This is followed by a jawline liposuction with a particular focus on the contours under the lateral jaw. Next, the oral mucosa is injected and a small incision is made inside the mouth. Once visualized, the fat is pushed out and gently teased from its pocket. This fat is then washed, sterilized and micronized using a filter. The fat is then injected into the lateral cheek completing the entirety of the procedure in less than one hour.

What is the cost of Surgical Facial Contouring?

The cost of the procedure varies by region. In addition to any fees charged by the surgeon, the larger variable is the addition of anesthesia costs. This can be minimized by using local anesthesia. By itself, buccal fat removal ranges from $2000 to $8000. The costs of fat grafting and chin liposuction are in a similar price range but, with discounts for combined procedures, all three procedures can often be done for $3500-$4000.

Recovery and Downtime

When buccal lipectomy is performed alone, there is minimal downtime. It is similar to a dental procedure so patients can often go back to work the same day. There will be some numbness and soreness inside the mouth. The sutures that are placed will dissolve on their own and the patient will likely be given a combination of pain medication, antibiotics, a mouth rinse and steroids to help with swelling. There is significant variability in instructions from surgeons after neck liposuction but, in general a compression garment will need to be worn for about a week and some bruising and light swelling can be expected.


Facial Sculpting can provide a model-like sculpted look when performed on the right patient. Though there is no such thing as a “bad result”, in select patients the difference might not be as evident as in others. The results will last for a lifetime as the buccal fat does not return. However, weight gain can negate the results of buccal fat removal and submental liposuction. Though all three procedures do not need to be performed at the same time, in the right candidate, the combination of the procedures can provide drastic and stunning results.

Limitations of Surgical Facial Contouring

Limitations of surgical facial contouring include:

  • Sculpting the face is contingent on fat in other areas as well as bone structure and overall facial balancing
  • Buccal fat removal produces a rather subtle enhancement of the lower cheekbones instead of dramatic results
  • Neck liposuction is not a permanent cure to weight gain as fat can easily become an issue in areas where the liposuction was not performed.

Risks of Surgical Facial Contouring

Some of the common risks of surgical facial contouring include:

  • Bleeding, scars and infections
  • Buccal fat removal can include a build-up of blood in the pocket where the fat has been removed along with injury to the ducts of  the spit gland that sits inside the cheeks
  • Neck liposuction risks include damage to deeper structures and over/under liposuction
  • Fat grafting from a site that is not sterile like the mouth can lead to a risk of infection so multiple precautions should be taken when performing the procedure

Consult with a Board-Certified Surgical Facial Contouring Doctor

Before patients make the final decision to undergo surgical facial contouring, they should schedule a consultation appointment with a board-certified doctor experienced in performing one or more of the surgical facial contouring procedures discussed above. The doctor will examine the patient to determine the current quality of the skin as well as the best technique(s) to achieve the desired results.