Some faces carry fullness in the lower cheeks that never seems to change, no matter how disciplined you are with diet or exercise. It can soften the definition of your cheekbones and jawline and leave you looking rounder than you feel. Buccal fat removal is a refined, minimally invasive procedure that addresses this specific kind of fullness by reducing the fat pad that sits deep in the mid to lower cheek.

At FacesFirst in Denver, Dr. Nicolette Picerno and Dr. Christopher Cote approach this procedure with restraint and precision, sculpting contour that looks like you, only more defined. Patients travel to us from Denver, Lone Tree, Highlands Ranch, Centennial, Parker, Castle Rock, and Aurora for facial surgery performed by specialists who do nothing but faces.

What Is Buccal Fat Removal?

The buccal fat pad is a distinct pocket of fat that sits between the cheekbone and the jaw muscles, deeper than the fat just beneath the skin. Everyone has one, but the size varies considerably from person to person, and it is largely determined by genetics rather than by weight. When the pad is naturally large or sits low in the face, it creates rounded, full lower cheeks that resist every other kind of effort.

Buccal fat removal, sometimes called a buccal lipectomy or cheek reduction, is the surgical removal of a measured portion of that fat pad. The incisions are made inside the mouth, along the inner cheek, so nothing is visible on the outside of the face and there is no external scarring. The result is a narrower lower face with more visible cheekbone definition and a cleaner transition into the jawline.

Because the buccal fat pad also plays a role in facial volume as you age, the amount removed matters enormously. Our surgeons take a conservative approach on purpose. The goal is definition now that still looks natural in ten and twenty years.

Benefits of Buccal Fat Removal

• A slimmer, more sculpted lower face
• Greater definition along the cheekbones
• A cleaner, more distinct jawline contour
• Correction of fullness that does not respond to diet or exercise
• No visible scarring, since incisions are placed inside the mouth
• A short procedure, typically performed under local anesthesia
• Permanent results, as the removed fat does not return
• Recovery measured in days rather than weeks

Are You a Candidate for Buccal Fat Removal?

The best candidates are healthy adults with genuine buccal fat prominence, meaning fullness that sits low in the cheek and is not simply a reflection of overall body weight or of youthful facial fat that will redistribute naturally with time. If your face has always been round in the lower cheeks and stays that way even at your leanest, you may be an excellent candidate.

Good candidates are nonsmokers or are willing to stop for a period before and after surgery, are in stable general health, and have realistic expectations about what a subtle contour change can accomplish. Age is worth discussing openly. Younger patients in their late teens and early twenties often still have facial fullness that will resolve on its own, and removing fat too early can contribute to a gaunt or hollow appearance later in life. Patients who are already thin in the midface may be better served by a different approach entirely.

This is exactly why an in-person evaluation matters. Our surgeons will tell you honestly if buccal fat removal is not the right procedure for your face, and they will explain what would serve you better, whether that is facial contouring with fillers, a chin or jawline procedure, or simply waiting.

Preparing for Your Procedure

Once you and your surgeon have decided to move forward, our team will walk you through everything you need to do in the weeks leading up to your procedure. You will be asked to stop taking blood-thinning medications, certain anti-inflammatories, and supplements such as fish oil and vitamin E, since these can increase bruising and bleeding. If you smoke or use nicotine in any form, you will need to stop well in advance, as nicotine interferes with healing of the tissues inside the mouth. We will also review your full medical history, current medications, and any prior facial surgery so there are no surprises on the day of your procedure.

Practical preparation is straightforward. Fill any prescriptions ahead of time so they are waiting for you at home, stock your kitchen with soft foods and cool liquids, and pick up an antibacterial mouth rinse if we have recommended one. Arrange for someone to drive you home if you are receiving sedation. Plan to take a few days away from work and social commitments, and avoid scheduling your procedure immediately before a wedding, presentation, or vacation. Our staff in Denver is available throughout this period, and we encourage patients from Lone Tree, Highlands Ranch, and the surrounding communities to call with any question, however small it seems.

The Buccal Fat Removal Procedure

Buccal fat removal is performed in our Denver surgical suite and usually takes about thirty to forty-five minutes. Most patients are comfortable with local anesthesia, though light sedation is available if you prefer it, and the procedure is frequently combined with other facial surgery when that is part of your overall plan.

Your surgeon begins by making a small incision inside each cheek, near the back of the mouth. Working through that opening, they gently release and identify the buccal fat pad, which presents itself once the surrounding tissue is opened. A carefully judged portion of the pad is then removed, and the rest is left in place to preserve natural facial volume. The incisions are closed with dissolvable sutures that do not require removal.

Because everything happens through the inside of the mouth, there is no external incision, no visible scar, and no change to the skin of your cheeks. Both Dr. Cote and Dr. Picerno work with the same principle here: remove only what needs to be removed, verify symmetry before closing, and err on the side of conservative. Fat that is taken out cannot be put back, and precision at this stage is what separates a sculpted result from an overdone one.

Recovery

• Expect swelling and mild soreness in the cheeks for the first several days, with the peak around day two or three
• Cold compresses and your prescribed medications keep discomfort manageable
• A soft or liquid diet is recommended for the first few days, and you will rinse with a prescribed or saltwater solution after eating to keep the incisions clean
• Most patients feel comfortable returning to work and normal daily activity within three to seven days
• Strenuous exercise should be paused for roughly two weeks
• Visible swelling typically resolves within two to three weeks
• Final contour continues to refine over three to six months as tissues fully settle
• We will see you for follow-up visits at our Denver office to confirm you are healing as expected

Why Choose FacesFirst?

FacesFirst has served Denver for over forty years, and in that time we have built the practice around a single idea: the face deserves a specialist. Dr. Nicolette Picerno and Dr. Christopher Cote are both double board-certified and fellowship-trained in facial plastic surgery, with over thirty years of combined experience devoted exclusively to the care and enhancement of the face. That focus matters for a procedure like buccal fat removal, where the difference between elegant definition and a hollowed look comes down to millimeters of judgment.

You will also notice the atmosphere. FacesFirst is a judgment-free place where you can say out loud what bothers you about your appearance and be met with understanding. Patients from Denver, Lone Tree, Highlands Ranch, Centennial, Parker, Castle Rock, and Aurora choose us because they want confidence in their surgeon, their care, and, above all, their results.

What to Expect During Your Consultation

Your consultation is a conversation before it is anything else. Your surgeon will begin by asking what brought you in and what you hope to change, and they will listen carefully to how you describe it, because the words patients use tell them a great deal about the result that will actually make you happy. From there, they will examine your face in detail, assessing the position and size of your buccal fat pads, your cheekbone structure, your skin quality and elasticity, and the overall balance of your midface and jawline.

You will then hear an honest assessment. If buccal fat removal gives you the definition you are looking for, your surgeon will explain how much fat they would remove and what that will and will not accomplish. If your fullness stems from something else, or if you are young enough that your face is still changing, they will say so and outline better alternatives.

We will review your medical history, discuss anesthesia options, walk through recovery in practical terms, and go over cost and financing so you leave with a clear picture. Bring your questions and bring photos if you have images that capture the look you are drawn to. Nobody will pressure you toward a decision, and many patients from across the Denver area take time to think it over before scheduling.

What Is the Cost of Buccal Fat Removal?

The cost of buccal fat removal at FacesFirst depends on several factors, including whether the procedure is performed on its own or combined with other facial surgery, the type of anesthesia used, and the specifics of your surgical plan. Because buccal fat removal is a cosmetic procedure, insurance generally does not cover it.

You will receive a detailed, itemized quote at your consultation with no obligation attached, so you know exactly what is included. We offer financing options to help make treatment more manageable, and our team is glad to walk you through them. If you are comparing options across Denver and the south metro area, we encourage you to weigh training and experience alongside price.

Schedule a Consultation

If full lower cheeks have bothered you for years and nothing has changed them, buccal fat removal may be the refinement you have been looking for. Dr. Nicolette Picerno and Dr. Christopher Cote would be glad to meet you, evaluate your face, and tell you honestly what is possible.

Contact FacesFirst in Denver today to schedule your consultation. We welcome patients from Denver, Lone Tree, Highlands Ranch, Centennial, Parker, Castle Rock, Aurora, and communities throughout Colorado.

Nicolette Picerno, M.D.

Board Certified Facial Plastic Surgeon at FacesFirst | Website

Dr. Nicolette Picerno is a double-board-certified facial cosmetic surgeon certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology. She received her medical degree from Hahnemann University, School of Medicine in Philadelphia, and completed her fellowship for the American Academy of Facial Plastic and Reconstructive Surgery at the Beeson Aesthetic Surgery Institute in Carmel, IN. She also completed the Cenegenics Physician Training and Certification in Age Management Medicine program in 2012 and became a certified BioTE provider in 2014. When not in the office, Dr. Picerno enjoys spending time with her family, hiking, skiing, playing tennis, and running her doggie daycare with her husband.