Facial plastic surgery · London
Buccal fat removal, honestly considered.
A day-case cosmetic operation to soften a round lower cheek and lift the cheekbone line, done by a BAAPS or BAPRAS surgeon who will decline you if your face is already slim. It is permanent. We say so before you sign.
Indicative pricing
What buccal fat removal costs in London.
Indicative ranges across UK private providers.
In short
Buccal fat removal, both sides, under LA plus sedation: £3,500 to £5,500, home the same day.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Consultation with a facial plastic surgeon | £180–£300 | 30–45 min | Same visit |
| Buccal fat removal, both sides, LA plus sedation | £3,500–£5,500 | 30–40 min | Day case |
| Buccal fat removal under general anaesthetic | £4,500–£6,500 | 45–60 min | Day case |
| Combined with rhinoplasty or facelift | £4,500–£7,500 | Add-on | Day case |
| Masseter Botox for jaw slimming (alternative) | £400–£700 | 15 min | Same visit |
| Second-opinion review of photos and prior plan | £150–£300 | 30 min | 48 hours |
Prices vary by surgeon, anaesthetic and whether the case is combined with rhinoplasty or a facelift. Buccal fat removal is cosmetic and is not covered by any UK health insurer.
The journey
From first photo to 12-month review, in order.
A slow, careful path with two chances to walk away: after our review, and after the consultation.
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Before
Consultation with the surgeon
Facial mapping, palpation of the buccal fat pad, a review of masseter bulk, skin quality and ageing trajectory. A firm quote and a written consent pack.
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On the day
Arrival at the day-case unit
Arrival, consent, marking and a chat with the anaesthetist. Local anaesthetic with sedation for most cases; a short general anaesthetic for combined procedures.
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On the day
The procedure itself
30 to 40 minutes. A 1 cm intra-oral incision inside the upper cheek, gentle dissection to the buccal fat pad, conservative removal of 2 to 3 grams a side, absorbable sutures.
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On the day
Home the same day
A short recovery, written aftercare and home within a few hours. Chlorhexidine mouthwash, soft diet for a week, and someone to collect you after sedation.
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After
Swelling settles over 4 to 6 weeks
The final shape is not visible for 4 to 6 weeks. A review at 2 weeks and 8 weeks, with photographs, and a longer-term check at 12 months.
When it helps
When buccal fat removal is the right step, and when it is not.
The patient we operate on, the patient we redirect to masseter Botox, and the patient we send away.
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A genetically round lower face
A stable, round mid to lower cheek since your teens or twenties, not weight-related fullness that would settle with a small change in body weight.
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Prominent lower cheek fat pad
A palpable buccal fat pad below the zygoma, visible as fullness under the malar eminence, not diffuse subcutaneous fat across the whole cheek.
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A goal of a sculpted cheekbone
A wish for a more defined submalar hollow and a stronger cheekbone line, in a face that is otherwise young, full and well-supported.
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A slim patient, already
If your face is already thin, buccal fat removal will hollow you prematurely. We decline these cases and often recommend filler or fat transfer instead.
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A square jaw from masseter bulk
A bothersome square lower face driven by masseter hypertrophy is a Botox problem, not a buccal fat problem. The fat pad sits above and in front of the masseter.
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Weight loss as the goal
Buccal fat removal is not a weight-loss procedure and will not slim your body. 2 to 3 grams a side is a cosmetic contour change, nothing more.
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Anti-ageing as the goal
The buccal fat pad protects against gaunt ageing. Removing it in a patient over 45, or with early jowling, will usually make the face look older, not younger.
Procedure options
The operation, and its non-surgical alternatives.
What each option involves and which patient it fits. Related pages: masseter Botox, chin augmentation, rhinoplasty, deep plane facelift, mid-face lift, lip fillers.
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Intra-oral buccal fat pad removal
The standard technique. A 1 cm incision inside the upper cheek, blunt dissection to Bichat's fat pad, gentle traction to deliver the fat, conservative removal and absorbable closure.
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Conservative resection (2 to 3 g a side)
A small, symmetric amount is removed. Over-resection is the single most feared complication and cannot be corrected except by fat transfer years later.
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Masseter Botox (a different problem)
For a square jaw driven by masseter hypertrophy, 25 to 50 units of Botox per side slims the lower face reversibly over 6 to 12 weeks. Repeated at 6 to 9 months.
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Chin augmentation (genioplasty)
A weak chin exaggerates cheek fullness. A chin implant or sliding genioplasty can restore lower-face balance without touching the buccal fat pad at all.
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Deep plane facelift (an older face)
In a patient over 45 with descent of the mid-face, a deep plane lift repositions tissue upward. Buccal fat removal in this group risks a hollow, aged result.
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Mid-face lift or filler
Malar filler or a mid-face lift can create the sculpted cheekbone look without removing the fat pad, and is reversible or maintainable.
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Combined with rhinoplasty
Buccal fat removal is often staged with preservation rhinoplasty in one anaesthetic, reducing recovery weeks and consultation visits.
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Second-opinion review
A specialist review of your photos and the surgeon's plan, before you commit to an operation you cannot reverse.
Safety and recovery
What to expect afterwards, honestly.
The risks worth planning for: over-resection, salivary duct injury, temporary smile asymmetry and premature gauntness in your 40s and 50s.
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Local anaesthetic with sedation
Most cases are done under LA and light sedation as a 30 to 40 minute day case. A short general anaesthetic is used for combined rhinoplasty or facelift work.
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Over-resection is permanent
The single most distressing complication. Once removed, buccal fat cannot be regrown. The only remedy is autologous fat transfer, years later, and the result is not identical.
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Parotid duct injury
Rare, in 1 to 2 per cent. A persistent salivary fistula or sialocele is a serious complication and needs specialist repair. Careful dissection is the prevention.
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Buccal branch of the facial nerve
Temporary weakness of the upper lip or an asymmetric smile is uncommon and usually resolves in weeks. Permanent injury is very rare in careful hands.
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Infection and haematoma
An intra-oral wound has a small infection risk. Chlorhexidine mouthwash for 7 days, soft diet, and a low threshold to call if pain or swelling worsens after day 3.
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Wound dehiscence and asymmetry
Small openings in the intra-oral suture line usually heal by themselves. Mild asymmetry is common early and settles as swelling resolves over 4 to 6 weeks.
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Transient trismus
Difficulty opening the mouth fully for the first week is normal. Gentle jaw exercises help. Persistent trismus beyond 2 weeks needs a review.
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Premature gauntness in your 40s to 50s
The face naturally loses fat with age. A buccal fat pad removed at 30 can look correct at 30 and hollow at 50. This is the risk consent conversation, at length.
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Red flags after discharge
Fever, spreading facial swelling, a bad taste of pus, a smile that has not returned to normal at 2 weeks, or clear fluid leaking from the mouth: call the clinic.
FAQs
The questions we get asked most.
Answered in one place.
Is buccal fat removal permanent?
Yes. The buccal fat pad, once removed, does not grow back. There is no way to reverse the operation in the true sense. If a patient later regrets the change, the only option is autologous fat transfer to add volume back, years later, and the result is never quite the same. This is why patient selection, photographs and honest consent matter more than the technical operation itself.
Will I look gaunt in 20 years?
Possibly, and this is the single most important conversation. The face naturally loses subcutaneous and deep fat with age. Removing the buccal fat pad in your late 20s or early 30s can look flattering at the time and hollow, tired or older-looking in your 40s and 50s.
What is the difference between buccal fat removal and masseter Botox?
They fix different problems. Buccal fat removal reduces fullness in the mid to lower cheek, above and in front of the jaw angle. Masseter Botox slims a square lower face caused by an enlarged chewing muscle at the jaw angle. If your concern is a square jawline rather than a round cheek, masseter Botox is almost always the right first step, and it is reversible.
Is buccal fat removal covered by insurance?
No. This is a purely cosmetic procedure and no UK insurer, Bupa, AXA Health, Vitality, Aviva or otherwise, will cover it. Expect a self-pay figure of £3,500 to £5,500 under local anaesthetic with sedation, or £4,500 to £6,500 under general anaesthetic. Combined cases with rhinoplasty or facelift run to £7,500.
Am I the right age for buccal fat removal?
The typical range is 25 to 40. Younger than that, the face is still maturing and the risk of premature gauntness is highest. Older than that, the mid-face has usually started to descend and the buccal fat pad is helping to hold a youthful shape, so removing it can accelerate an aged look. Age is a guide, though: the deciding factors are your baseline photographs, your facial fat pattern and your ageing trajectory.
Will buccal fat removal help me lose weight or slim my face?
No. Only 2 to 3 grams of fat is removed per side, and the operation is not designed to treat weight-related facial fullness. If your cheeks change with your body weight, the answer is a modest weight change and a review, not surgery. Buccal fat removal is a cosmetic contour operation for a specific fat pad in a specific patient phenotype.