Buccal Fat Excision and Repositioning in Beverly Hills: Why the Smarter Approach Is Not Just Removal
There is a particular kind of frustration that brings patients to this page. They exercise consistently. Their weight is stable. Their bone structure is good. And yet something in the lower face rounds out the overall picture in a way that feels incongruent with everything else. The cheeks sit full. The cheekbones are less prominent than they could be. The jawline, which should be clean and defined, softens into the lower face instead of announcing itself.
The cause, in most cases, is the buccal fat pad. And the solution, when performed with genuine surgical judgment, is buccal fat excision and repositioning in Beverly Hills with Dr. Daniel Golshani.
What separates Dr. Golshani’s approach from a standard buccal fat removal is a single, important word: repositioning. Blanket removal of the buccal fat pad is a procedure that has produced a generation of patients who looked sculpted at twenty-eight and gaunt at forty-two. The fat, once taken, cannot be returned. The hollows that develop with age in the lateral midface become permanent and accelerated. Dr. Golshani does not simply remove. He evaluates each patient’s anatomy, removes what is genuinely excess, and in many cases strategically repositions a portion of the fat to areas that benefit from added volume, preserving long-term facial harmony while delivering the definition the patient came for.
Understanding the Buccal Fat Pad: What It Is and What It Does
The face contains two primary fat compartments in the cheek region. The malar fat pad sits above the cheekbone and contributes to the fullness and lift of the upper cheek. Below it, sitting between the cheekbone and the jaw, is the buccal fat pad, a discrete, encapsulated mass of fat that varies considerably in volume from one person to the next.
For patients with naturally larger buccal fat pads, the effect on facial appearance is specific and consistent. The lower face appears round. The transition between the cheekbone and the jawline lacks the concavity that creates the impression of definition. The face can read as soft or youthful in the wrong direction, appearing less angular than the patient’s underlying bone structure would otherwise allow.
This is not a weight problem. It is an anatomical one. And it is entirely correctable through surgery.
The Limitation of Simple Removal: Why Repositioning Changes the Conversation
When buccal fat removal first entered mainstream cosmetic surgery practice, the procedure was straightforward: access the fat pad through an incision inside the mouth and remove it. For many patients in their twenties and early thirties, the results looked excellent. Defined cheeks. Cleaner jawlines. More prominent cheekbones.
But the face continues to age. And one of the consistent features of facial aging is the loss of volume in the lateral midface, the zone directly below the cheekbone. This is the area that gives a mature face its lifted, supported appearance. When the buccal fat pad has been removed in its entirety from a patient who later loses volume with age, the result is a face that appears prematurely hollowed. The cheeks deflate. The midface drops. The areas beneath the cheekbone become concave rather than gently contoured.
The solution is not to avoid surgery altogether. It is to perform surgery with the long term in mind.
Dr. Golshani’s approach to buccal fat excision and repositioning is built on this principle. Rather than treating the buccal fat pad as simply an excess to be discarded, he evaluates whether a portion of it can be repositioned to an area of the midface that will benefit from added volume, an approach sometimes referred to as buccal fat pexy. In doing so, he sculpts the lower face, reduces the rounded fullness the patient is bothered by, and at the same time preserves or enhances volume in the lateral cheek to protect the face against premature aging.
This is the procedure as it should be performed: not a trend, but a measured surgical decision tailored to the individual anatomy and the long-term appearance of the person sitting across from you in the consultation room.
Who Actually Benefits From Buccal Fat Excision and Repositioning
Not every patient with full cheeks is a good candidate for buccal fat excision, and one of the most important things Dr. Golshani does during a consultation is make that determination honestly.
The patients who benefit most share a specific profile. They have a full, rounded contour in the lower cheek that persists regardless of their weight and fitness level. Their skin quality is good. Their face has reached its final adult proportions. And critically, their lateral midface has enough volume that selective reduction of the buccal fat pad will produce definition without creating hollows.
Patients who are older, who already show signs of midface volume loss, or who have thinner facial bone structure may not be appropriate candidates for excision alone. For these patients, Dr. Golshani may recommend repositioning the fat rather than removing it, combining it with facial fat grafting, or redirecting the consultation toward a procedure better suited to their anatomy.
This honesty is not a limitation of the practice. It is the practice.
The Relationship Between Buccal Fat, the Cheekbones, and Long-Term Facial Harmony
The cheekbone is the structural anchor of the midface. Its projection, its height, and the way the soft tissue drapes over it determine the overall impression of youthfulness and definition in the middle third of the face.
When the buccal fat pad is reduced or repositioned, the cheekbone becomes more architecturally visible. The shadow that develops between the cheekbone above and the jawline below creates a sculpted, athletic quality in the face that no amount of contouring makeup reliably replicates. This effect is permanent and proportional, provided the reduction is calibrated appropriately.
For patients whose primary goal is greater cheekbone prominence and a more angular lower face, buccal fat excision and repositioning is frequently the most direct and effective path to that outcome. And unlike facial implants or filler stacking, it works with the patient’s own anatomy rather than adding to it.
Combining Buccal Fat Excision with Other Procedures
Buccal fat excision and repositioning is often performed as a standalone procedure, particularly in younger patients with isolated lower cheek fullness. But it is also frequently combined with adjunctive procedures to address the face comprehensively:
- Facial Fat Grafting with G-Stem to restore or enhance volume in the temples, periorbital area, or lateral midface in patients where volume preservation is a component of the plan
- Deep Plane Facelift in patients whose lower face and neck have aged together and who want a comprehensive structural rejuvenation
- Blepharoplasty to address periorbital aging when the eyelids are also a concern
- Rhinoplasty in patients who want to address both the midface contour and the profile simultaneously
- Chin Augmentation to balance the lower face and create a stronger jaw-to-chin relationship that complements the sculpting effect of buccal fat reduction
The goal, as always, is a result that looks harmonious across every zone of the face. A well-defined lower face sitting beneath an upper face that remains unchanged does not constitute a complete result. Dr. Golshani plans each procedure in the context of the whole.
What Is a Buccal Fat Removal?
Each cheek has two fat pads: the malar fat pad, which lies on top of the cheekbones, and the buccal fat pad, positioned between the cheekbone and the jaw. People with naturally thin buccal fat pads have flat or hollowed contours between the cheekbones and the jawline. Those with larger buccal fat pads have rounder, fuller contours in the lower portion of the face, which can create a chubby-cheeked, cherubic, or babyish look. There’s nothing wrong with that. It can be attractive. However, if that’s not the look you want for yourself, buccal fat removal is cosmetic surgery to remove or reduce the buccal fat pads to pull in the lower part of your cheeks and make your cheekbones more prominent.
Buccal Fat Removal Vs. Liposuction of the Cheeks
Liposuction removes excess fat from the layer just below the skin rather than the deeper fat pads. It accomplishes this by breaking up and extracting the fat through a surgical tube, or cannula, inserted through small incisions just behind the hairline. Buccal fat removal uses incisions inside the mouth to surgically remove or reduce the buccal fat pad, which lies in a layer that cannot be reached via liposuction. Both techniques have their uses and benefits, but they correct different cosmetic issues. While liposuction is effective for reducing overall fat volume, buccal fat removal has a sculpting effect precisely in the lower cheeks.
Why Beverly Hills Patients Choose Dr. Golshani for Buccal Fat Excision and Repositioning
The patients who come to Dr. Golshani’s Wilshire Boulevard practice for buccal fat excision and repositioning have typically already done their research. They have seen the results that come from removal without judgment, and they are looking for a surgeon who understands that the face they are treating today will continue to age for decades after they leave the operating room.
Dr. Daniel Golshani, MD, FACS is a double-board-certified plastic and reconstructive surgeon with advanced fellowship training in cosmetic surgery and a subspecialty focus on the face. He has spent his career developing and refining facial procedures that produce results which are both immediately satisfying and structurally sound over time. His buccal fat excision and repositioning technique is built on that same philosophy: define the face now, protect it for the future.
His practice at 9301 Wilshire Blvd., Suite 410 in Beverly Hills serves patients from Beverly Hills, Bel Air, Brentwood, West Hollywood, Pacific Palisades, Santa Monica, and internationally. When patients travel specifically for this procedure, they are arriving with a standard in mind. Dr. Golshani’s results are built to meet it.
Your Buccal Fat Excision and Repositioning Journey: Step-by-Step
Step 1 — The Consultation
Your consultation begins with a detailed conversation about what you want to change and why. Dr. Golshani examines your facial bone structure, the volume and position of your buccal fat pads, your skin quality and resilience, and the overall architecture of your mid and lower face. He determines not only whether you are a candidate for the procedure, but which approach, excision, repositioning, or a combination of both, is appropriate for your specific anatomy and long-term facial goals. A patient coordinator attends every consultation to record everything discussed, so nothing is lost between your visit and your surgery date.
Step 2 — Preparation
In the weeks before surgery, Dr. Golshani walks you through specific preparation: stopping smoking for at least six weeks before and after the procedure, discontinuing medications and supplements that increase bleeding risk, and arranging a soft and liquid diet for the days immediately following surgery. His team ensures you have everything you need before you arrive.
Step 3 — The Procedure
Buccal fat excision and repositioning is performed on an outpatient basis, typically under local anesthesia, sometimes with sedation. When combined with another procedure, general anesthesia is used. The surgery takes place at the Rexford Surgical Institute, an accredited surgical center on the same floor as Dr. Golshani’s Beverly Hills office. Two small incisions are made on the inside of each cheek, through which Dr. Golshani accesses the buccal fat pads, removes what is excess, and repositions what can serve the face better elsewhere. Incisions are closed with dissolvable sutures. There are no external scars. The procedure typically takes between thirty minutes and one hour as a standalone, longer when combined.
Step 4 — Recovery
Plan to rest at home for the first few days. A liquid diet for the first day or two, followed by soft foods, protects the internal incisions while they heal. Swelling, bruising, and mild numbness in the cheeks are normal and expected. Keeping the head elevated and using ice packs helps manage swelling in the early days. Most patients return to work and light activity within five to seven days. The first signs of improved definition are visible within one week as initial swelling resolves. Final results, with all swelling gone and the cheeks fully settled, are typically visible at the six to eight week mark.
Schedule Your Buccal Fat Removal Consultation in Beverly Hills
Contact us today to schedule a private consultation with Dr. Golshani to learn more about how buccal fat removal can bring out the natural beauty of your face.
Buccal Fat Excision & Repositioning FAQs -Beverly Hills, CA
What is buccal fat excision and repositioning in Beverly Hills?
Buccal fat excision and repositioning is a surgical procedure that reduces lower cheek fullness by removing or strategically relocating the buccal fat pad, a discrete encapsulated mass of fat sitting between the cheekbone and the jaw. Dr. Daniel Golshani performs this procedure in Beverly Hills to sculpt the lower face, highlight the cheekbones, define the jawline, and in many cases reposition a portion of the fat to preserve long-term facial volume and prevent premature hollowing.
What is the difference between buccal fat excision and buccal fat repositioning?
Buccal fat excision removes some or all of the buccal fat pad to reduce lower cheek fullness and create definition. Buccal fat repositioning, also called buccal fat pexy, takes a portion of that same fat pad and relocates it to an adjacent area of the midface that benefits from added volume. Dr. Golshani frequently combines both in a single procedure, calibrating how much is removed and how much is repositioned based on each patient’s anatomy and long-term facial goals.
How much does buccal fat excision and repositioning cost in Beverly Hills?
The cost varies depending on whether the procedure is performed as a standalone or combined with other surgeries, the anesthesia approach, and surgical facility fees. Dr. Golshani’s team provides personalized, itemized cost estimates during the consultation.
Am I a good candidate for buccal fat excision and repositioning?
You are likely a good candidate if you are bothered by persistent lower cheek fullness that is unrelated to your weight, you are at least eighteen to twenty years old and your face has reached its adult proportions, your skin quality is good, and you are in overall good health. Older patients or those with existing midface volume loss may be better served by repositioning rather than pure excision. Dr. Golshani determines the right approach during consultation.
What is the recovery time for buccal fat excision and repositioning?
Most patients return to light activity and non-strenuous work within five to seven days. A liquid and soft food diet is required for the first several days to protect the internal incisions. Visible swelling resolves within one to two weeks. Final results, with the cheeks fully settled into their new contour, are typically visible at six to eight weeks.
Are the results of buccal fat excision permanent?
The fat that is removed does not return. The results are therefore permanent in that sense. However, the surrounding facial fat, which lies in a different compartment just beneath the skin, can fluctuate with weight changes. Maintaining a stable weight is the most reliable way to preserve the definition achieved. It is also worth noting that the face continues to age, which is precisely why Dr. Golshani’s approach to repositioning is designed to protect long-term facial harmony alongside the immediate sculpting result.
What are the risks of buccal fat excision and repositioning?
As with any surgical procedure, risks include bleeding, infection, asymmetry, scarring, and anesthesia-related complications. Because the incisions are made inside the mouth, infection risk is managed through a specific post-operative mouthwash protocol provided by Dr. Golshani’s team. In the hands of an experienced, board-certified facial surgeon, serious complications are uncommon.
How long do buccal fat excision results last?
Results from buccal fat excision are permanent in terms of the removed fat, but the broader appearance of the face is influenced by natural aging, skin quality, and weight fluctuations over time. Maintaining a stable weight, following a consistent skincare routine, and avoiding excessive sun exposure all help preserve the sculpted result long-term.
When preparing for a facelift consultation, it’s essential to gather I nformation about your medical history, current medications, and desired outcomes. Additionally, bring along any questions and photos of your ideal to discuss with Dr. Golshani and his surgical coordinators. Additionally, its always important to be open about your expectations and concerns.
Before your facelift surgery, follow Dr. Golshani’s pre-operative instructions carefully, which will include fasting before the procedure, avoiding certain medications that can increase bleeding risk, and arranging for transportation to and from the surgical facility. It is also important to make sure that you have a comfortable recovery area at home with necessary supplies following your facelift procedure.
The improvements made with a facelift last for years. Your face will continue to age naturally, but you’ll always look younger than you would have without the surgery. You can extend the results and slow the effects of aging by maintaining a stable weight and taking good care of your skin, especially by protecting it from excessive exposure to the sun. If, after a few years, you’re bothered by the effects of aging, you might choose to have a refresher facelift. Nonsurgical treatments can also complement the improvements made with a facelift.
There is no right age for facelift surgery. Timing depends on the changes to your face over time and your readiness for surgery. The surgery is simpler and results last longer for younger patients (in their early 40s, for example) because of the elasticity and resilience of younger skin. But we have had facelift patients in their 70s and 80s who have been delighted with their results. A one-on-one consultation is the best way to determine if you are a good candidate.
Only a surgical facelift can make the comprehensive and long-lasting enhancements to an aging face you see in the before and after pictures on this site. That’s not to say that everyone who’s bothered by the signs of aging needs a facelift. Positive improvements can be made with non-surgical and minimally invasive treatment. Options include chemical peels, microdermabrasion, laser skin resurfacing, dermal fillers, Botox®, and endoscopic procedures. We can combine a customized series of non-surgical treatments to give you a personalized minimally invasive facelift.
The duration of a facelift procedure can vary depending on the extent of the surgery and the particular techniques used by Dr. Golshani. On average, a traditional facelift may take several hours, while a mini-facelift may have shorter operating times.
Typically, a traditional facelift is a more comprehensive procedure that addresses sagging skin, muscle laxity, and excess fat in the face and neck area. In contrast, a mini-facelift, also known as a limited incision facelift, focuses on targeting specific signs of aging in a more limited area with a shorter recovery time and less dramatic results.
A non-surgical facelift typically involves minimally invasive treatments like injectables, laser therapy, or skin tightening procedures to improve facial contours and reduce signs of aging without surgery. In comparison, a traditional facelift is a surgical procedure that involves lifting and repositioning facial tissues for more significant and long-lasting results.
To prolong facelift results, maintain a healthy lifestyle with a balanced diet, regular exercise, and proper skincare routine. Protect your skin from sun exposure, avoid smoking, and follow Dr. Golshani’s post-operative instructions for optimal healing and long-term outcomes.
Swelling, bruising, and initial healing after a facelift may vary, but most of our patients feel comfortable going out in public within 1-2 weeks after surgery. Additionally, makeup can help conceal any residual bruising or redness during the early stages of recovery.
Strenuous exercise and activities should be avoided for several weeks after a facelift to allow for proper healing and minimize the risk of complications. Dr. Golshani and his surgical team will provide guidelines on when you can gradually resume physical activities based on your individual recovery progress.
Generally speaking, the timing of returning to work after a facelift depends on the extent of the surgery, individual healing process, and the nature of your job. Most patients can expect to return to work within 1-2 weeks, but it may vary for each person.
Smoking can have detrimental effects on the healing process and outcomes of a facelift. It is advisable to quit smoking before undergoing a facelift to reduce the risk of complications, improve circulation, and promote optimal wound healing. If you are a smoker, being transparent with Dr. Golshani is incredibly important so that, together, you can come up with the best course of action prior to your facelilft surgery.
A deep plane facelift is a surgical technique that involves lifting and repositioning deeper facial tissues, specifically the SMAS (superficial musculoaponeurotic system). This technique can provide more significant and longer-lasting results compared to a traditional facelift by addressing sagging tissues in a more comprehensive manner. Dr. Golshani is incredibly skilled and experienced with performing deep plan facelifts and uses this technique very often.
On the other hand, a hybrid facelift combines surgical and non-surgical techniques to address facial rejuvenation tailored to each patient. This approach may involve a combination of facelift surgery with injectables, laser treatments, or other minimally invasive procedures to enhance facial contours and address multiple signs of aging. Consulting with a board-certified plastic surgeon, such as Dr. Golshani, can help you determine the most suitable facelift approach based on your goals and anatomy.
