Facial Liposuction & Buccal Fat Removal
Buccal fat removal, double chin liposuction, and platysmaplasty (double chin muscle tightening)
Facial liposuction is surgery in which small openings are made in areas with a lot of subcutaneous fat, such as the cheeks, jawline, and double chin, and fat is suctioned out with a thin tube (cannula), mainly to define the jawline and slim the lower face.
It may be considered when full cheeks make the face look large, or when the jawline is rounded and a double chin stands out.
Facial Liposuction at a glance
- Surgery time
- About 1 hour
- Anesthesia
- IV sedation
- Compression band
- 24 hours a day for 7 days
- Stitch removal
- 7 days after surgery (only with buccal fat removal or platysmaplasty)
- Swelling & bruising
- 1–2 weeks
- Return to daily life
- 1 week
These may vary depending on the treated areas, the extent of liposuction, and any combined procedures.
Quick answer
When is facial liposuction recommended?
Facial liposuction may be considered when full cheeks make the face look large, or when the jawline is rounded and a double chin stands out. If a lot of deep buccal fat makes the cheeks look chubby, the buccal fat may also be removed through the inside of the mouth, and if a double chin is caused by subcutaneous fat under the chin, liposuction often improves it.
What is facial liposuction?
Facial liposuction is surgery in which small openings are made in areas with a lot of subcutaneous fat, such as the cheeks, jawline, and double chin, and fat is suctioned out with a thin tube (cannula), mainly to define the jawline and slim the lower face. It removes the subcutaneous fat just beneath the skin; the buccal fat deep in the cheek is removed separately through an incision inside the mouth, and when the cheeks are full overall, both may be done together.
In a study of 32 Asian patients, 29 reported being satisfied and 3 somewhat satisfied (Gu et al., 2023).
When facial liposuction may be needed
- Full cheeks make the face look large
- The jawline is rounded and a double chin stands out
- A lot of deep buccal fat makes the cheeks look chubby and the jowls stand out
- The weight of the fat makes the cheeks and jawline look saggy
- Sagging fat under the chin causes a double chin, or the front of the neck looks loose
- Uneven facial fat distribution, and you want smoother contours
Facial liposuction, buccal fat removal, and platysmaplasty
Facial liposuction
Fat in areas with a lot of subcutaneous fat, such as the cheeks, jawline, and double chin, is suctioned out through small openings below the earlobe and under the chin to refine the facial contour.
Buccal fat removal
Buccal fat is a pad of fat that sits deep inside the cheek, between the muscles. Because it is not the fat just beneath the skin, it does not shrink much with facial liposuction or dieting. It is removed through an incision inside the mouth, and because it is fat that naturally decreases with age, it is important to remove only an appropriate amount and only when there is a lot of it. The inside of the mouth is closed with dissolvable stitches, but they are removed 7 days after surgery to check healing.
Double chin liposuction
If a double chin is caused by subcutaneous fat under the chin, liposuction often improves it. Fat is suctioned out through a small opening under the chin to refine the border between the jawline and neck.
Platysmaplasty (double chin muscle tightening)
This surgery pulls together and ties the loosened, separated platysma muscle under the chin to refine the border between the chin and neck. It is considered for a double chin caused by loose muscle or when the front of the neck looks loose, and it is often done together with liposuction under the chin. It requires an incision of about 2–3 cm under the chin, and the stitches are removed 7 days after surgery.
Learn more about the facial fat graft →Learn more about the thread lift →
How facial liposuction is performed
- 1
Design
Areas with a lot of fat and the area to be treated are planned and marked.
- 2
IV sedation
The surgery is performed under IV sedation.
- 3
Liposuction
Small openings are made below the earlobe and under the chin, and fat is suctioned out with a thin cannula.
- 4
Buccal fat removal (if needed)
When there is a lot of buccal fat, it is removed through an incision inside the mouth, which is closed with dissolvable stitches.
- 5
Compression band
A compression band is worn to reduce swelling and help the skin settle to the new contour.
What we check during a facial liposuction consultation
- Height and weight
- Whether there is a lot of buccal fat
- Skin thickness and elasticity
- Fat thickness
- Length of the lower jaw
- Whether the skin under the chin and on the neck has loosened
- Shape under the chin when you lower or raise your head
Facial liposuction recovery and swelling
After facial liposuction, swelling and bruising are most noticeable on days 2–3 after surgery and gradually decrease, and face washing and makeup (except on the treated areas) are allowed from 2 days after surgery. The face may temporarily feel tight or numb, but this gradually improves after about 1–2 months.
Day of surgery
- If buccal fat was removed, eat soft liquid foods such as porridge or soup for 1 day
Next day
- Light strolls and walking allowed
2 days
- Face washing and showering allowed (do not rub the treated areas hard)
- Makeup allowed except on the wounds
2–3 days
- Swelling and bruising at their peak
First 3–5 days
- Raise your pillow to keep your head above your heart
First 7 days
- Wear the compression band 24 hours a day (remove only for meals and showers)
- Cold compresses
- Keep the healing tape on, changing it every 1–2 days
- If buccal fat was removed, rinse your mouth after meals and avoid chewy or spicy foods
7 days
- Stitch removal if buccal fat removal or platysmaplasty was done
First 2 weeks
- Avoid opening your mouth wide, exaggerated facial expressions, and facial or deep massage
2 weeks – 2 months
- Wear the compression band only while sleeping
- Warm compresses and neck stretches (help soften firm areas)
First 4 weeks
- Avoid smoking, alcohol, strenuous exercise, swimming, baths, saunas, and heated spas
1–2 months
- Tightness and numbness in the face gradually improve
Facial liposuction side effects and precautions
What are the possible side effects of facial liposuction?
After facial liposuction, besides temporary swelling, bruising, tightness, and reduced sensation, there may rarely be unevenness, left–right asymmetry, skin sagging, or hollowing from excessive fat removal. If buccal fat removal was done as well, the wound inside the mouth may become inflamed, so if you notice a bad smell in your mouth or yellow pus, contact the clinic.
Is it normal for the area to feel firm or lumpy after facial liposuction?
Firmness or lumpiness in the treated area after facial liposuction is common during healing. It happens as the tissue where fat was removed heals and temporarily becomes firm, and warm compresses and neck stretches from 2 weeks to 2 months after surgery can help it soften. If pain or redness is severe, it is best to visit the clinic to have it checked.
Does the skin sag after facial liposuction?
Whether the skin sags after facial liposuction depends on skin elasticity and the amount of fat removed. When skin elasticity is good, the skin often contracts and settles as the fat is removed, but when elasticity is reduced or a large amount is removed, it may look saggy. If there is already skin sagging, lifting is considered as well.
Does facial liposuction leave scars?
Facial liposuction is performed through small openings below the earlobe and under the chin, so in many cases the scars are not easily noticeable after healing. Buccal fat removal is done through an incision inside the mouth, so there is no visible external scar, and the inside of the mouth is closed with dissolvable stitches. How visible the scars become depends on skin type and constitution.
Contact the clinic if you have these symptoms
Contact the clinic if you have severe pain not controlled by pain medication, continuous bleeding, a feeling of heat, significant swelling on one side only, or a bad smell or yellow pus in your mouth.
Facial Liposuction FAQ
Do I need to wear a compression band after facial liposuction?
Wearing a compression band after facial liposuction is recommended, because it helps reduce swelling and helps the skin settle to the new contour. For 7 days after surgery, wear it 24 hours a day except during meals and showers, and from 2 weeks until 2 months after surgery, wear it only while sleeping.
For a double chin, do I need liposuction or platysmaplasty (muscle tightening)?
If a double chin is mainly due to subcutaneous fat under the chin, liposuction is usually the option; if loose muscle under the chin is the cause, platysmaplasty (double chin muscle tightening) is considered. The two causes often occur together, so liposuction and muscle tightening are sometimes done together, and the cause is identified by looking at the shape under the chin when you lower or raise your head and the fat thickness.
Will my cheeks look hollow or saggy later after buccal fat removal?
Buccal fat naturally decreases with age, so removing too much can make the cheeks look hollow or older over time. That is why, in buccal fat removal, it is important to remove only an appropriate amount and only when there is a lot of buccal fat, and it is not recommended when the cheeks are thin or already hollow. If sagging is the main concern, lifting is considered rather than removal.
How long do recovery and swelling take after facial liposuction?
After facial liposuction, swelling and bruising are most noticeable on days 2–3 after surgery and gradually decrease, and if there are no stitches, face washing and makeup (except on the treated areas) are allowed from 2 days after surgery. The face may temporarily feel tight or numb, but this gradually improves after about 1–2 months. It is best to avoid alcohol, smoking, saunas, and strenuous exercise for 4 weeks.
How is the cost of facial liposuction determined?
The cost of facial liposuction depends on the extent of the treated areas and whether it is combined with procedures such as buccal fat removal, platysmaplasty (double chin muscle tightening), or a fat graft. Because the extent of surgery varies with your face, an exact cost can be given after consultation.
Your doctor
Dr. Dahan Kim
Board-Certified Plastic Surgeon Medical Director, Steady Plastic Surgery
Steady Plastic Surgery is an eye-focused plastic surgery clinic in Gangnam (Sinnonhyeon), Seoul. Board-certified plastic surgeon Dr. Dahan Kim personally sees every patient from consultation to surgery and follow-up, focusing on double eyelid surgery, double eyelid revision, under-eye fat repositioning, lower blepharoplasty and middle-aged eye surgery.
- M.D. and master's degree, CHA University School of Medicine
- Plastic surgeon, CHA Bundang Medical Center
- Member, Korean Society of Plastic and Reconstructive Surgeons · Korean Society for Aesthetic Plastic Surgery · Korean Association of Plastic Surgeons
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References
- Gu T, Zhang X, Yu P, et al. "Subzone-Counting" Method in Asian Facial Liposuction: A Retrospective Study. J Craniofac Surg. 2023;34(8):2514-2517. doi:10.1097/SCS.0000000000009622 PMID 37589969