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Can you target buccal fat without surgery? We find out

Familiar aesthetic treatments could provide an alternative to the face-slimming surgical procedure know as buccal fat removal popularised by Chrissy Teigen

While it may seem counterintuitive to those of us who regularly trust dermal fillers to help fill out our deflating faces, the removal of buccal fat to slim down a rounded visage is becoming more common in the UK. Already popular Stateside, it's recently become a talked about surgical procedure thanks to model Chrissy Teigen openly and enthusiastically speaking about her positive experience last year with cheek reduction surgery.
Speculation is rife too that both Kim and Khloe Kardasian have had their buccal fat removed. But given the permanence of the procedure, coupled with the natural ageing process that sees skin-plumping collagen depleted, it could be that the clever use of non-invasive options makes for a more cautious approach that can still deliver pleasing results.

Face fats 

Everybody has buccal fat around both cheeks, but it can appear slightly differently for each of us. "Buccal fat is found in the lower third of the face and below the apples of the cheeks," explains Surgeon Dr Jonquille Chantrey, EV Editorial Panellist and Founder of One Aesthetic Studio in Cheshire.

"It begins somewhere near the corner of the mouth and runs underneath the cheekbone. However, buccal fat is not the same in everybody as there can be genetic and ethnic differences, plus some people just have a propensity for more fat in that area."

In addition to those unique variations, buccal fat is also susceptible to change over time, in part because unlike muscle it's separated into smaller sections. "The fat in the face is not one continuous layer, it’s compartmentalised," adds Dr Chantrey.

"These discreet compartments can shift, change and age differently, so need to be considered as separate units. The buccal fat is one of these compartments. Of course any area can gain or lose fat or drop due to facial ageing from structural changes such as bone density changes and gravitational descent, which is part of the ageing process. Where buccal fat sits is the area that can drop as we get older, contributing to the heaviness of marionette folds."

She also underlines that buccal fat may not actually be the reason for a rounded face, adding, "It can be caused by many factors including dental problems and fat pads towards the back of the cheek or the outer cheek, while overdeveloped chewing muscles can also create a wider look to the face."

Slimming down

Identifying the correct issue and the removal of buccal fat therefore requires a highly specialised, skilled surgeon and should also be approached with serious thought about the long-term effects.

"Buccal fat is something that is very specific to each individual, because it can vary depending on a person's age, weight, ethnicity and habits," stresses Dr Ioannis Liakas, EV Expert and Medical Director at Vie Aesthetics. "This means that treatments for the specific area are unique and should be as a result of a consultation and examination by a medical practitioner. In addition, non-surgical procedures for buccal fat removal are not yet fully established."

It’s for these reasons that more moderate, aesthetic treatment options that offer ways to create the illusion of a slimmer face could be the best path forward for those eager to pursue a leaner look. As it’s not for everyone, doctors are seeing a particular type of patient who wants to achieve this aesthetic. "It tends to be people want to look slimmer in the lower portion of the face," reveals Dr Chantrey.

"From the corners of the mouth outwards they want to appear thinner and the cheekbone to look more defined, helping add to their perception of themselves as looking less full in the face," she continues. "So for those who have quite significant buccal fat pads, it’s about the dimensions of the face and what’s appropriate to help them achieve those goals, as well as not only looking at yourself front on, but from all angles."

The non-invasive options

A type of plastic surgery, the removal of buccal fat takes less than an hour under local anaesthetic with around seven days of immediate downtime. The full results make an impact after three to four weeks. Opting for non-invasive alternatives however, means little to no recovery time needed.

Dr Chantrey takes three approaches to a non-surgical solution, all tailored to the client and the proportions of their face. "I use dermal fillers to enhance the patient’s facial dimensions and then modify that if it’s appropriate," she explains. "Injecting it very specifically in micro amounts directly onto the cheekbone helps give some degree of lift and will increase dimension. I’m not talking about widening the face, or projecting it or making it look fuller – instead the filler adds a bit of extra height that can make the face look a little slimmer."

Another option that can be used alone or in conjunction with dermal fillers is high focus ultrasound. Once the dimensions of the face have been softly altered with filler if a combination is being used, Dr Chantrey uses the energy-based treatment to help tighten the deeper layers in the skin to give more support, which she says can also create the illusion of a slimmer face without reducing any fat.

Reviewed and topped up if necessary every three to six months, ultrasound can then tackle any laxity in the skin that needs to be addressed to re-establish this extra height. Finally, if the issue is overly active masseter muscles (the chewing ones) that are contributing to the face looking fuller, small doses of muscle-relaxing agents can help achieve a slimmer look over time by reducing their bulk.

The weigh up

Finances and downtime aside, when considering cheek reduction surgery, "Think about the mid and long term, plus how the face is going to age," suggests Dr Chantey. "It may look great in your 20’s and early 30’s after having buccal fat removed, but could make you look more gaunt and more tired as you get into your mid to late 40s."

Adopting the non-surgical approach by creating a slimmer looking face via some clever aesthetic trickery without actually taking any of the fat out, could instead be the smart way to temporarily get your cheek fat in check a la Teigen, while knowing it will still be there to cushion you in the future.

Ioannis Liakas, Medical Director

Dr Ioannis Liakas is a shining gem in the aesthetics world. Prior to becoming an industry leading practitioner, he worked...

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