Buccal Fat Removal 4-Month Before & After Jawline
Before and after buccal fat removal results at 4 months in a 28-year-old female. See how cheek slimming surgery creates natural facial definition in Istanbul.
Patient Overview
Patient: Layla
Age: 28 years old
Gender: Female
Procedures: Buccal fat removal (cheek reduction)
After photos taken at: 4 months post-surgery
Location: Istanbul, Turkey
When Full Cheeks No Longer Match the Face You See
There is a particular frustration that comes with having a body that has matured while the face still carries the roundness of adolescence. Layla, a 28-year-old female patient, had well-defined features — a balanced nose, good bone structure, clear skin — yet her lower cheeks retained a fullness that softened everything else. No amount of weight management changed this, because the volume responsible was not subcutaneous fat that responds to diet and exercise. It was the buccal fat pad, a discrete encapsulated structure that sits deep between the cheek muscles and has its own genetic blueprint for size and persistence.
What Exactly Is the Buccal Fat Pad?
The buccal fat pad is an anatomical structure with a specific purpose in infancy — it aids in suckling by providing structural support to the cheek muscles. In adults, this functional role is no longer relevant, but the fat pad remains. Its size is largely determined by genetics, which is why some individuals maintain round, full lower cheeks regardless of their overall body composition. When this fullness creates a facial proportion that the patient finds unbalanced, buccal fat removal (bichectomy) offers a targeted correction that no other procedure can replicate.
The Procedure: Simple in Concept, Precise in Execution
Dr. Cem Berkay Sinaci, a European board-certified plastic surgeon (FEBOPRAS) and member of ISAPS and ASPS, performs buccal fat removal through a small incision inside the mouth, on the inner cheek wall. There is no external scar. The buccal fat pad is carefully identified, separated from surrounding structures, and removed in a controlled manner. The procedure takes approximately thirty minutes and is performed under local anaesthesia in most cases, meaning the patient is awake and comfortable throughout.
The precision lies in knowing how much to remove. Over-resection can lead to an excessively gaunt or hollow appearance that ages the face prematurely. Under-resection may leave the patient feeling the result is insufficient. Layla's anatomy called for a balanced removal that would reveal her underlying bone structure — particularly the zygomatic arch and mandibular angle — without creating hollowness.
Why Four Months Is the Right Time to Evaluate Results
Buccal fat removal is unusual among facial procedures because the result does not appear immediately. In the first weeks after surgery, internal swelling actually makes the cheeks look temporarily fuller than before. This can be unsettling for patients who expected instant change. The true result emerges gradually as the deep tissue swelling resolves, typically becoming visible around six to eight weeks and continuing to refine over three to six months.
Layla's before and after photos at four months capture this procedure at a point where the final contour is essentially established. The rounded fullness of her lower cheeks has been replaced by a more sculpted facial silhouette. Her cheekbones appear more prominent — not because anything was added, but because the masking volume below them has been reduced. The jawline reads as more defined for the same reason.
The Subtle Power of Subtractive Facial Surgery
In an era where facial aesthetics often revolves around adding volume — fillers, fat grafting, implants — buccal fat removal represents the opposite philosophy. Sometimes the most impactful change comes from removing what is obscuring the natural architecture beneath. Layla's case demonstrates this principle clearly. Her bone structure was always there; the buccal fat was simply hiding it. By removing this single structure, the entire balance of her midface and lower face shifted toward the defined, angular proportions she wanted.
Recovery After Buccal Fat Removal
The recovery from buccal fat removal is remarkably straightforward compared to most facial procedures. Because the incision is intraoral, there are no visible marks or bandaging. Swelling peaks around day two to three and gradually subsides over two to three weeks. Most patients return to social and professional activities within a few days. Dietary adjustments during the first week — favouring soft foods and avoiding anything too hot or spicy — help the intraoral incision heal cleanly. The stitches used inside the mouth are dissolvable and do not require removal.
Who Is a Good Candidate for Buccal Fat Removal?
The ideal candidate has genetically full lower cheeks that persist despite being at or near a healthy body weight. Age matters as well. The face naturally loses volume over the decades, particularly after the mid-thirties. In younger patients like Layla, the buccal fat pad is substantial and its removal creates a welcome refinement. In significantly older patients, removal may accelerate the appearance of facial volume loss. This is why a careful assessment by a board-certified plastic surgeon is essential before proceeding — the decision to remove buccal fat should account for the patient's current anatomy, ageing trajectory, and long-term aesthetic goals.
