Buccal fat removal surgery involves making a small incision inside the mouth to remove fat tissue, thereby making the lower cheek appear contoured and slimmer. Representation Pic

The surgery, also called Bichat’s procedure after French anatomist Xavier Bichat who described the buccal fat pad in detail in 1802, involves making a small incision inside the mouth for removal of fat tissue, done under local anaesthesia. “Patients need not worry about visible scarring on the outside of their cheek since the procedure is performed on the inside,” says plastic and cosmetic surgeon Dr Kogadu, adding, “The surgery can be done alone or in conjunction with another procedure like a facelift, rhinoplasty, chin implant, lip augmentation, etc.” It typically costs Rs 40,000 to Rs 70,000, is short and easy to recover from. The only prerequisites: eat soft foods for two days and maintain good oral hygiene. “There may be a bit of swelling of the cheeks for three to five days, but this is not obvious to others. The final result may take one or two months to appear,” says Dr Prakash, adding that the results  are long lasting because buccal fat is unlikely to reappear.

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Rashmi Shetty, Karishma Kogadu, Siddharth Prakash and Tanu Puri

Just like online discussions, our doctors are also divided on the topic. Indian board-certified dermatologist and founder of Ra Skin and Aesthetics in Mumbai, Dr Rashmi Shetty has reservations. “Just because people are engaging in a conversation, doesn’t mean everybody is running to a plastic surgeon to yank out their buccal fat,” she says, adding that the surgery can make the face appear unusual and artificially gaunt. “Fat in the face, is stored in two areas—deep fat pads and superficial pads. While the superficial pads move downwards and become a sort of excess as we grow old, the deep fat pad in fact, regresses and reduces over time in with ageing. Why would you want to remove the fat and lose the support on your lower face while you are still young?” she wonders, adding that some patients return after a few years to fill in the area using micro-fat grafting.

Wadala-based counsellor and psychotherapist Tanu Puri says, “Low self-esteem, distorted self-image, and emotional insecurity can lead to cosmetic enhancement of oneself.” She adds,  “This makes us ignore the long-term side effects. And because our identity is so tightly linked to how we look, when the side effects of surgeries begin to show, our psychological health takes another beating.”