Arcadia, CA plastic surgeon Arthur Y. Yu, MD has extensive experience giving people the face and body they want. He is passionate about providing his patients with specialized treatment plans and has an in-depth knowledge of human anatomy, which helps him perform meticulous procedures with minimal downtime. A popular procedure that Dr. Yu excels at is buccal fat removal. This is a treatment that many celebrities have undergone, including Chrissy Teigen and Bella Hadid, to reduce the appearance of baby fat for a smoother cheekbone. Dr. Yu gave us the scoop on the procedure.
What is the purpose of buccal fat removal?
“Buccal fat is anatomically designed to help glide the masseter muscle and move the buccal muscle. Before the age of 25, this fat is equivalent to the size of half a golf ball. It’s very stable, it stays there. However, after 30 years, the fat breaks off and protrudes forward. Thus, it somehow comes out of the boundary of the anterior edge of the masseter muscles, and as a result, the fat no longer works like a ball bearing. People can sometimes be seen with a small bulge in the center of the lower face where the vestibule is located.
So as you progress towards age 40 or 50 [the buccal fat] has become so obvious. In about 30% of the population, this fat becomes visible even without movement, usually when you smile. It’s almost a complete golf ball. Now every time I smile, my horizontal dimension is actually bigger than my vertical dimension, and most of that is actually due to prolapse, or sometimes we call it a pseudohernia or a hernia. So accordingly you would like to remove that fat, because firstly it no longer works like a ball bearing, and secondly it can make the face look a little ugly.
When do you know it’s time to get rid of buccal fat?
“Whenever we think the protrusion of fat destroys the proportion of the face, it’s time for you to have the fat removed.”
What is the procedure and recovery?
“I designed a minimally invasive surgery. Almost every surgeon in the world uses an almost inch-long incision in the mouth to remove fat. I only use a six millimeter size, small incision to tease the ball of fat. It is extremely important. Most doctors around the world would require patients to follow a liquid or semi-liquid diet for seven to 10 days to facilitate healing. My patients can chew a steak that night. He has no recovery time.
I am very easy with my anatomical knowledge. I don’t have to open my whole mouth because I know exactly where the fat is. I take my dissector out a few times and some of the fat will show up on its own. So I grab this little clip of the ball of fat, and then because it’s malleable, by teasing it with a little force, you can actually gradually push it out through that little hole that you’re making. So my patients just need a suture, a stitch, that’s all, and I can close it. Compared to my colleagues, usually we are talking about seven stitches to 10 stitches.
Is there any pain or swelling after the procedure?
“Out of 100 patients, maybe one patient will need a Tylenol, and the rest won’t need anything. You can’t see any bruises. You can’t even see any swelling. Of course, there is swelling. I always tell my patients after a week your face will get smaller and smaller. The reason is that the first seven days you are going to have some swelling. The swelling is actually offset by the loss of buccal fat volume, so it is essentially balanced accordingly. And there are no bruises because it’s deep. Even if there is bleeding, the blood will not show through the skin.
How much buccal fat do you remove during the procedure?
“There are concerns about how much buccal fat you need to remove, so we take into consideration the body mass of the patients, as well as the body mass of their parents, because when we get older, we usually follow the path of our parents.If their parents have more body mass, we usually remove more buccal fat, but if their parents are thin enough when they get older, we usually remove 50% or maybe 60% to make sure that as they get older , they didn’t really depress cheeks.”
Are there other ways to get rid of buccal fat?
“There’s another way to do oral fat removal, it’s actually more for people who are going to have a facelift. So when I do a facelift, I can actually remove the buccal fat through the facelift from the outside, but certainly not by making a cut in the center of the face, of course. This is
another very interesting phenomenon. I have done hundreds of these procedures. I don’t have a single complication, but I wrote an article recently, and there are about 2-3% complications, including hematoma and facial nerve damage, which is serious because it means your patient can’t even smile afterwards. There is also a risk of injury to surrounding muscle structures. I think it’s probably the result of people not really knowing the local anatomy.
Is there an ideal face shape that people are looking for?
“A lot of patients bring pictures of celebrities saying, ‘That’s what I want,’ and I ask them to smile. When I see those two balls coming out, I tell them, ‘Buccal fat removal is what you need”.
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