Who should not have buccal fat removal

Absolute and strong contraindications

Already-narrow or thin facial structure. If your face is oval-narrow, long, or already showing some natural cheek hollowing, removing buccal fat will accentuate skeletal angularity. This is the most common reason we decline.

Significant aging-related fat loss already visible. Patients 45+ with visible mid-face volume loss are usually better served by volume-restoring procedures (fat grafting, fillers) than by buccal fat removal.

Active eating disorder or significant weight instability. Until weight is stable and a healthy relationship with body image is established, this surgery is contraindicated.

Body dysmorphic disorder. Buccal fat removal will not resolve the underlying dissatisfaction and may worsen it. Clinical psychological support is the appropriate first step.

Unrealistic expectations. Patients expecting dramatic transformation — "Hollywood cheek surgery" — will be disappointed by what is a refined, subtle procedure.

Common scenarios we decline

To make this concrete, here are anonymised composite scenarios where we typically advise against surgery:

"35-year-old woman, oval face, 56 kg at 168 cm, already has subtle hollowing under cheekbones, requesting buccal fat removal because a friend had it." — Decline. The face is already proportioned; surgery would create hollowness she would notice within 5 years.

"22-year-old woman, round face, 78 kg at 165 cm, planning aggressive weight loss, wants surgery before honeymoon in 6 weeks." — Defer. Reach goal weight first, reassess in 6 months.

"42-year-old woman, formerly round face but now mid-face is starting to flatten, requests removal of "remaining buccal fullness." — Decline. The fullness she's noting may be the last anchor of youthful cheek shape; removing it would age her face by years.

If you've been declined elsewhere — or here

Some surgeons will perform this surgery on anyone who pays. We don't. If you've been declined, that's a meaningful signal — it usually means the surgeon assessed long-term aging trajectory and concluded the procedure wasn't in your best interest.

If you've been declined by Doç. Dr. Erdal but feel certain you want some kind of facial slimming, we're happy to discuss alternatives that may genuinely suit you:

• Masseter Botox (if jaw width is the concern)
• Chin augmentation (if the chin is short or weak, making the cheeks look fuller by contrast)
• FaceTite or radiofrequency skin tightening (if mild jowling is the issue)
• Dietary and lifestyle work (for weight-related facial fullness)

Frequently asked questions

Will any surgeon honestly tell me not to have this?

A good one will. Ethical practice requires the surgeon to advise against procedures that wouldn't serve you long-term, even at the cost of the booking. About 30% of patients who send photos for assessment to our clinic receive a 'not the right procedure for you' response.

If I had buccal fat removal already and regret it, what can be done?

Partial volume restoration is possible through fat grafting — your own fat is harvested from another body area, processed, and injected into the cheek to restore some of the lost contour. However, fat grafting cannot fully recreate the original anatomical fat pad. See our revision page for details.