When patients come for revision
Most revision consultations follow one of three patterns:
- Over-resection. Visible hollowing of the mid-cheek, often more pronounced in three-quarter view. The patient appears prematurely aged or "skeletal". Onset is typically 1–3 years post-op, as natural fat loss compounds the surgical loss.
- Asymmetry. One cheek visibly thinner than the other, usually due to asymmetric removal during the original surgery.
- Regret with an acceptable result. Some patients dislike the change even when it is objectively well-performed. This is a psychological consideration as much as a surgical one and is approached differently.
What revision can and cannot do
Revision can:
- Restore volume to the cheek using the patient's own fat (autologous fat grafting), harvested from the abdomen or thigh
- Rebalance asymmetry by either further removing fat from the fuller side, or adding volume to the thinner side
- Soften a harsh or hollow appearance over a series of sessions
Revision cannot:
- Restore the original buccal fat pad anatomy. The encapsulated pad with its three extensions is gone. Grafted fat is grafted into the soft tissue spaces but does not recreate the original pad.
- Guarantee that grafted fat will take long-term. Fat graft "take" rates are 50–70% in the face — meaning multiple sessions may be needed.
- Make the cheek behave as it would have without the original surgery. The result is a reasonable approximation, not a reset.
Fat grafting technique
Autologous fat grafting for buccal area volume restoration involves:
- Donor harvest. Fat is harvested from the abdomen or inner thigh via small liposuction cannulas. 30–60 ml is typically harvested for facial use.
- Processing. The harvested fat is processed (washing, centrifugation, or both) to isolate the live adipocytes.
- Injection. Fat is injected in small parcels (~0.1 ml each) into the soft tissue planes of the cheek, using a fine cannula introduced through a small puncture point near the cheek.
- Recovery. Swelling in the donor area for 1 week; some bruising on the face for 5–10 days. Final result visible at 3–6 months.
Typically 1 ml is injected per cheek per session, repeated 1–2 times at 6-month intervals to build durable volume.
Honest assessment for revision patients
Dr. Erdal sees revision consultations from patients who had original surgery elsewhere. The conversation is honest:
- The original surgery cannot be undone.
- Fat grafting offers volume restoration but not anatomy restoration.
- Multiple sessions are usually needed for durable volume.
- Results are generally good but not equal to never having had the original surgery.
- For some patients, accepting and adapting (with makeup techniques, dermal fillers, or lifestyle changes) is a more realistic path than surgical revision.
Revision patients are encouraged to spend significant time in consultation before booking — these decisions are emotionally loaded and the right answer is sometimes "do nothing more".
Frequently asked questions
How soon after my original surgery can I have revision?
Wait at least 12 months. Swelling fully settles by 6 months; the additional 6 months gives time to confirm that what you see is the true settled result and not a transitional appearance.
Will fat grafting last forever?
Approximately 50–70% of grafted fat survives long-term. The surviving fat is permanent. Multiple grafting sessions are common to achieve and maintain the desired volume.
Can I have revision under local anaesthesia?
Often yes — depending on the volume of fat being harvested and grafted. Many revision cases are performed under local with sedation.
Not sure if you're a candidate?
Buccal fat pad removal is the right choice only for the right face. Send 3 facial photos (front, profile, three-quarter) and Doç. Dr. Erdal will give you an honest, no-pressure suitability assessment before you decide anything.
Ready to discuss buccal fat removal?
Schedule a free WhatsApp consultation with Doç. Dr. Erdal. Send a few facial photos and your questions — typical response within 2 hours during business hours.