“Buccal fat removal is perhaps the most misunderstood procedure in modern facial contouring. Done correctly — on the right patient, with conservative removal — it creates subtle, elegant midface refinement that looks completely natural. Done incorrectly — on the wrong patient, or with excessive removal — it can create a skeletonized, prematurely aged appearance in the 40s and 50s. Patient selection is everything. I decline to perform this procedure on patients who do not have sufficient buccal fat pad volume to support removal without creating a hollowed result over time.”
What buccal fat removal can do for you
Buccal fat removal refines the lower cheek in patients whose buccal fat pad is genuinely excessive. Dr. Truesdale evaluates every candidate conservatively — because over-resection ages the face prematurely and cannot be undone.
- Sculpted lower-cheek contour — the slight hollow beneath the cheekbone that defines a structured midface.
- Look great on camera and in photos — jawline reads sharper, cheekbones read higher, face reads more defined.
- No external scar — the incision sits entirely inside the mouth; no one can see where the work was done.
- Conservative reduction, by design — Dr. Truesdale only removes what still flatters you in your 50s and 60s — never more.
- One 30-minute procedure, permanent result — rapid recovery, back to work in under a week.
Ready to discuss your buccal fat removal goals?
Understanding buccal fat removal
What buccal fat removal is
Buccal fat removal refines the lower cheek in patients whose buccal fat pad is genuinely excessive. Conservative removal is the rule — because over-resection ages the face prematurely and cannot be undone.
Patient selection is the most important step. The buccal fat pad naturally diminishes with age, so patients with average or below-average cheek fullness who undergo buccal fat removal often appear gaunt by their 40s and 50s. The ideal candidate has genuinely excessive buccal fat creating persistent lower-cheek fullness regardless of weight — and enough underlying volume and bone structure to maintain a natural appearance after removal.
Dr. Truesdale takes a conservative approach and will decline to operate on patients he believes are at risk for an aged, hollow result. This reflects his commitment to a face that looks excellent not just immediately, but for a lifetime.
Who buccal fat removal is for
If any of the following describes you, buccal fat removal may be worth exploring:
What makes Dr. Truesdale’s approach different
Dr. Truesdale’s approach to every procedure reflects a consistent set of principles — the same standards that inform every consultation, every surgical plan, and every post-operative follow-up.
Restraint, Not Over-Correction
The most over-done procedures in facial aesthetics are over-done because someone kept going past the right stopping point. Dr. Truesdale's rule: when the result is right, stop — even if more could technically be done. Buccal fat removal is permanent. Dr. Truesdale’s rule is to remove only what still flatters the face at 60, not 30 — a discipline most surgeons abandon.
The Artist's Eye
Before becoming a surgeon, Dr. Truesdale was a trained portrait artist. That lens shapes every decision — proportion, light, shadow, the relationship between every feature — in a way purely clinical training alone does not. For buccal fat, that lens reads how facial fat will redistribute over the next two decades — selecting candidates with that future shape in mind.
Personal, Start to Finish
Every consultation, every surgical plan, every procedure — performed personally by Dr. Truesdale. No delegation to coordinators, PAs, or residents. Dr. Truesdale is personally involved every step of the way. Every buccal-fat resection is judged at the operating table by Dr. Truesdale — never by an assistant.
Natural Is Non-Negotiable
The only acceptable outcome is one that no one can identify as a procedure — a result that reads as a better version of you. No pulled look, no frozen expression, no obvious work. The buccal-fat goal: refined cheek architecture that reads as bone structure, not as removal.
“Once the buccal fat is gone, it's gone. Conservative sculpting is not a compromise — it's the standard.”
— Dr. Carl Truesdale, MD
From first consultation to final reveal
We always tell our patients to ‘trust the process.’ You are in good hands on every step of the journey to your unique masterpiece.
Consultation
Personal session with Dr. Truesdale — facial analysis, honest assessment of candidacy, and a clear plan for what the procedure can and cannot achieve.
Planning
Pre-operative instructions, medical clearance when you have sedation, and a personalized plan Dr. Truesdale reviews with you before the day of the procedure.
Procedure Day
Performed at True Surgical Center, under local anesthesia or with MAC and IV sedation, through a small incision inside the cheek. No external incisions or visible scars.
Healing
Regular diet as tolerated. Salt-water rinse after every meal for the first week. No straws. Brush only your front teeth; avoid touching the incision with your tongue. Day 6–7 follow-up. Mild swelling on the inside of the cheeks. No external bruising.
Cheek Hollowing
Swelling fully resolved. Lower-cheek refinement becomes visible.
Look and Feel Like a Masterpiece
Sculpted lower-cheek definition, fully revealed.
Individual timelines vary. Dr. Truesdale sets realistic, patient-specific expectations during your consultation — not exaggerated claims.
See if Buccal Fat Removal is right for you.
See the work in motion
Dr. Truesdale on technique, philosophy, and patient stories — from his self-produced Beyond the Surface docuseries and his educational content library.
Buccal fat removal in Beverly Hills: the essentials
- Your surgeon
- Dr. Truesdale personally. He judges how much to remove at the operating table himself.
- Where
- True Surgical Center, the AAAHC-accredited surgical center at 150 S. Rodeo Drive, Suite 220, Beverly Hills.
- Anesthesia
- Local anesthesia alone, or local anesthesia with MAC (monitored anesthesia care) and IV sedation, given and watched throughout by a board-certified anesthesiologist. Dr. Truesdale decides with you. When it is combined with other surgery, it is done under that surgery’s anesthesia.
- Time in surgery
- About 30 to 45 minutes on its own.
- The incision
- A small incision inside each cheek. No incision on the skin and no visible scar.
- Going home
- Back to your hotel or home the same day. With sedation, an adult takes you home and stays with you for the first 72 hours.
- Sutures
- Dissolvable sutures inside both cheeks. They dissolve on their own within about 2 weeks; nothing to remove. Your first follow-up is at 1 week.
- If you travel
- Arrive at least a day before surgery and plan on about a week. Most patients stay 7 to 9 days and fly home after their 1-week visit.
- Exercise
- Light cardio at 2 weeks; heavier exercise at about 3 weeks, once Dr. Truesdale clears you.
- Final result
- Cheek swelling settles over the first 1 to 3 months, when the lower-cheek refinement shows. Full healing can take up to 4 months.
The facts patients ask about first. Every plan is personal, so Dr. Truesdale confirms each of these for you at your consultation. Recovery, week by week
What happens on surgery day
Buccal fat removal reduces the fat pad in the lower cheek through the inside of the mouth. Conservative removal is the rule, because the result is permanent and the face thins with age. Here is what the day looks like for you.
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01Before you begin
Dr. Truesdale goes over the plan with you and confirms how much fullness to take away, judged on your face at rest and smiling. The inside of each cheek is then numbed.
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02A small incision inside each cheek
Through a small incision on the inside of each cheek, Dr. Truesdale reaches the buccal fat pad. Nothing is cut on the skin of your face, so there is no visible scar.
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03Conservative removal
Only part of the fat pad is removed: what still flatters your face in your 50s and 60s, never more. Dr. Truesdale judges this at the operating table himself.
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04Closing
Each incision is closed with dissolvable sutures, which dissolve on their own within about 2 weeks.
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05Going home
You go back to your hotel or home the same day; with sedation, an adult takes you home. You can eat a regular diet from the first day, rinsing with salt water after every meal.
Buccal fat removal: who is and isn’t a good candidate → · Adding chin augmentation · Facial fat transfer
Buccal fat removal recovery, week by week
This is the same protocol our patients receive in writing before surgery. The detailed instructions below come straight from it, so they change only when Dr. Truesdale changes them.
It may be hard to open your mouth at first; normal movement returns within a few days. Numbness, tingling, tightness and dull pain are normal, and swelling can increase on Days 3 and 4. Sleep on your back with your head raised on 2 to 3 pillows, and ice 20 minutes on and 20 off for 5 days to a week. Eat a regular diet, avoiding crunchy and hard foods, and rinse with salt water after every meal. Brush only your front teeth, and keep your tongue off the incisions. You may shower the day after surgery if no other procedures were done. Follow-up visit at 1 week.
No straws for 2 weeks. The sutures dissolve on their own within about 2 weeks. Keep your head raised when you sleep through the end of week 2. Light cardio from Day 14.
No bending, heavy lifting or straining until 3 weeks; heavier exercise then, once Dr. Truesdale clears you. SPF 50 and limited sun for 6 weeks.
Cheek swelling settles over the first 1 to 3 months. Tightness and numbness are normal and may last 2 to 3 months, and full healing can take up to 4 months. Follow-ups at 1 month and 3 months.
Your detailed instructions
Intraoral sutures on the inside of both cheeks. It may be difficult to open your mouth at first; normal movement returns within a few days. Numbness, tingling, tightness, and dull pain are normal. Ice 20 minutes on, 20 minutes off for 5 days to a week. Sleep on your back with head elevated on 2–3 pillows for the first 2 weeks.
Do not touch the incision with your tongue — this can separate the incisions. Brush only your front teeth. Do not brush your back teeth or touch your toothbrush to the inside of your mouth.
Regular diet as tolerated; rinse with salt water after every meal. You may bathe or shower the day after surgery if no other procedures were performed.
Regular diet as tolerated; avoid crunchy or hard foods. Salt-water rinse after every meal. Brush teeth gently. Days 3–4 may bring increased swelling. Day 6–7 follow-up appointment.
Straws, for two weeks. Straining or bending. Crunchy or hard foods.
Sutures are dissolvable and dissolve on their own within 2 weeks. Cheek swelling persists for the first 1–3 months.
Tightness and numbness are normal and may last 2–3 months. Full healing may take up to 4 months.
Full post-operative care guide · Preparing for surgery · Traveling for surgery
Buccal fat removal risks, and how we keep you safe
Every operation carries risk. Dr. Truesdale goes through the risks that apply to your plan at your consultation, and each one is written in the consent you read and sign. For buccal fat removal, the consent lists:
- Hollowing. Hollowing of the cheeks that becomes more pronounced with age is possible.
- Nerve or Duct Injury. Injury to the salivary (parotid) duct or a branch of the facial nerve is possible; weakness may be temporary or permanent.
- Asymmetry and Irregularities. Asymmetry, puckering, depressions or lumps are possible.
- Opening the Mouth. Temporary difficulty opening the mouth or eating is possible.
- Bleeding into the Cheek. Bleeding into the cheek is possible.
- Prolonged Swelling. Swelling that lasts longer than expected is possible.
- Infection Inside the Mouth. Infection inside the mouth is possible.
Risks of any operation
- Bleeding. Bleeding during or after surgery is possible. A collection of blood under the skin (hematoma) may need drainage or a return to the operating room, and severe bleeding may need emergency treatment or a blood transfusion.
- Infection. Infection is possible and may need antibiotics, drainage or further surgery.
- Bruising and Swelling. Bruising and swelling are expected. They may last several weeks, and swelling or discoloration may persist longer.
- Scarring. Every incision or entry point leaves a permanent scar. A scar may be raised, widened, darker, lighter or more visible than expected, and takes at least 3 months to mature.
- Keloid or Raised Scar. Itching, thickening, pain or a growth along any incision can be the first sign of a keloid (a thick, raised scar). Let us know right away so it can be injected with a steroid to stop the keloid from forming. A keloid is more likely if you have had one before and may need further injections or treatment.
- Change in Skin Sensation. Numbness, tingling or a change in skin sensation around the treated areas is possible; it may be temporary or permanent.
- Delayed Healing. Delayed healing or separation of an incision is possible and much more likely with nicotine in any form.
- Allergic Reactions. Allergic reactions to tape, sutures, skin cleansers, latex or medications are possible.
- Blood Clots. Blood clots in the legs or lungs (deep vein thrombosis or pulmonary embolism) are possible and more likely with longer surgery; your surgical team uses the clot-prevention plan chosen for you.
- Anesthesia. Risks of anesthesia and sedation are possible; the anesthesia provider reviews them with you separately.
- Pain. Pain after surgery is expected and should settle over several days; pain that lasts longer is possible.
- Result and Revision. A result that does not meet your expectations is possible: healing differs between people, no result is guaranteed, and a revision may be advised, with the fees described in your patient policy.
- Serious Complications. Serious complications, including death, are possible with any surgery or anesthesia.
- Heart and Lung Problems. Heart or lung problems, such as pneumonia or an irregular heartbeat, are possible after surgery and anesthesia.
- Medication Side Effects. Side effects of the medications used during and after surgery, such as nausea, vomiting, constipation, dizziness or trouble urinating, are possible.
- Injury to Deeper Structures. Injury to deeper structures, such as nerves, blood vessels, muscles or glands, is possible.
- Persistent Sutures. A deeper stitch may work its way to the surface and need to be removed.
How we keep you safe
- Careful selection: Dr. Truesdale declines buccal fat removal when he believes it would leave your face hollow as you age.
- Medical clearance, and blood-clot risk screening, before surgery with sedation. Under local anesthesia alone, no labs or clearance are needed.
- No nicotine in any form for 3 weeks before surgery and 3 months after.
- Salt-water rinses after every meal, brushing only your front teeth, and no straws for 2 weeks, to protect the incisions inside your cheeks.
- If an incision inside your cheek feels like it is opening, call us. A follow-up at 1 week, and a direct line to the team the whole time.
When to call us right away · Before & after gallery · Who is a good candidate · Request a consultation
Buccal Fat Removal FAQs
Bring your own questions to consultation — Dr. Truesdale personally answers every one. Below are the questions patients ask most often about buccal fat removal.
The strongest candidates have genuine fullness in the lower cheek that is out of proportion to the rest of the face and will not respond to weight loss or RF tightening. Dr. Truesdale evaluates you personally in consultation and only recommends the procedure when it will genuinely help. If a different approach would serve you better, he’ll tell you that too.
This is the critical question. Buccal fat removal cannot be undone. If your face is already on the leaner side, removing buccal fat will accelerate the hollow appearance of aging. Dr. Truesdale evaluates facial fullness at rest, smiling, and at 40+ years projected age before recommending the procedure. Most candidates are in their 20s to early 40s with round or heart-shaped faces.
Most patients describe the discomfort as mild to moderate. Dr. Truesdale’s team is available throughout recovery — you are not managing discomfort on your own. See “What kind of anesthesia is used?” for details on intra-operative comfort. Dr. Truesdale’s team is available throughout recovery — you are not managing discomfort on your own.
Buccal fat removal can be done under local anesthesia alone, or under local anesthesia with MAC and IV sedation; Dr. Truesdale decides with you. When sedation is used, our surgical procedures utilize a patient-focused anesthesia technique known as MAC (Monitored Anesthesia Care) and IV Sedation, ensuring your maximum comfort and safety. This method provides a level of gentle, deep sedation comparable to the comfortable experience many patients have during a colonoscopy, which we have found helps make patients less fearful. The anesthesia is administered intravenously and meticulously monitored by a hand-picked group of board-certified anesthesiologists, who are dedicated to your well-being throughout your entire procedure.
Plan on 5–7 days of social downtime. Expect mild facial swelling and tightness inside the mouth that resolves over 2 weeks. Light activity may resume at Day 7; full activity (heavy cardio, lifting, bending) at 3 weeks. Your follow-up appointments along the way are conducted by Dr. Truesdale and our physician assistant, with Dr. Truesdale seeing you personally at the key milestones.
That’s the entire standard Dr. Truesdale designs for. Conservative is always right. Over-resection ages the face prematurely — and cannot be reversed. Every patient is evaluated in a seated, relaxed state beforehand so the target is based on your real anatomy — never on an idealized template.
Permanent. Buccal fat, once removed, does not regrow.
Yes. A significant portion of Dr. Truesdale’s patients travel from across the United States and internationally. The process begins with a virtual consultation with Dr. Truesdale himself (not a coordinator), followed by in-person pre-procedure evaluation. Our patient-care coordinators help arrange travel, accommodations, and local transportation, and Dr. Truesdale’s team conducts virtual follow-ups after you return home.
Request a consultation through the form at the bottom of this page, email contact@doctortruesdale.com, or call (424) 363-4112. Our team responds within one business day to schedule either an in-person consultation at 150 S. Rodeo Drive, Suite 360, Beverly Hills, or a virtual consultation worldwide. Every consultation is conducted personally by Dr. Truesdale.
Buccal fat removal is most commonly performed between 20 and 40. The procedure permanently contours the lower cheek, so Dr. Truesdale is thoughtful about timing — facial fat changes meaningfully through your 40s and 50s, and what reads as fullness at 25 can look “right” at 55. He only recommends buccal fat removal when the result will still flatter you two decades from now.
The cost of buccal fat removal can vary based on the patient’s situation, including if it is a revision surgery and if this surgery will be combined with other surgeries or treatments. The total cost may include the surgeon’s fee, operating room fees, and anesthesia fees. At Truesdale Facial Plastic Surgery, we believe the surgeon’s philosophy and experience, and your comfort with him, are just as important as the final cost of the surgery. We can provide an approximate range for this procedure over the phone, and your patient care coordinator (PCC) will confirm the pricing for you after your consultation with Dr. Truesdale.
A regular diet from the first day, as you tolerate it. Avoid crunchy and hard foods, rinse with salt water after every meal, and don’t use straws for 2 weeks. Brush only your front teeth, and don’t touch the incisions with your tongue or your toothbrush, because that can separate them.
No. The sutures inside your cheeks are dissolvable and dissolve on their own within about 2 weeks. You still come in for a follow-up at 1 week, and again at 1 month and 3 months.
Swelling can increase on Days 3 and 4; that is normal. Cheek swelling then settles over the first 1 to 3 months, which is when the lower-cheek refinement shows. Tightness and numbness may last 2 to 3 months, and full healing can take up to 4 months. Sleeping with your head raised for 2 weeks and icing 20 minutes on and 20 off for the first week help.
Arrive at least a day before surgery and plan on about a week. Most patients stay 7 to 9 days so we can see them at their post-op visits, and fly home after their 1-week visit. See traveling for surgery for hotels and aftercare.
The consent you sign lists these possible complications: hollowing of the cheeks that becomes more pronounced with age; injury to the salivary (parotid) duct or a branch of the facial nerve, with weakness that may be temporary or permanent; asymmetry, puckering, depressions or lumps; temporary difficulty opening the mouth or eating; bleeding into the cheek; swelling that lasts longer than expected; and infection inside the mouth. It also lists the risks of any operation, including bleeding, infection, blood clots and the risks of anesthesia. Dr. Truesdale reviews each one with you. See buccal fat removal risks and safety.
Schedule your buccal fat consultation
Dr. Truesdale will give you an honest assessment of whether this procedure is right for your anatomy — and your future self. We respond same-day, Monday-Friday.
Book a Surgical Discovery Call online
After clicking the booking link, select “new patient” under Schedule Your Appointment and fill out the form to see our current availability for a Surgical Discovery Call with a Patient Care Coordinator and book immediately. Call us (424) 363-4112 for additional appointment times and information.All times are based on Los Angeles, Pacific Time (PT).
Book Discovery Call →Prefer to share details first? Submit the form and a Patient Care Coordinator will reach out the same business day (Monday–Friday).