Introduction to Cheek Fat Removal
When we are born we all have large fat pads in our cheeks that create the round, chubby “baby faces” that look so adorable in photographs. As we grow up, these chubby faces usually transform into the more sculpted appearance of the adult face with cheekbone highlights and a distinct jawline. However, this is not the case for everyone and in some people the round, chubby cheeks of childhood do not dissipate and instead remain into adulthood. In fact, due to heredity, some people may never lose the childhood “chubby” look in their cheeks which can make them appear “overweight” and less attractive in adulthood. Buccal fat pad removal is an elegant but simple procedure that is designed to help patients that have full, round or “chubby” cheeks achieve a more sculpted, athletic facial appearance.
The buccal fat pads are located in the lower portion of the face and when they are large they can give a person the appearance of “chubby” or “chipmunk” cheeks. During buccal fat pad extraction, these oversized buccal fat pads are removed in order to give the patient a more elegant, sculpted facial appearance with improved contour of the lower face and enhancement of the cheek hollow. The overall look is one of a patient that appears to have lost weight as well as a more chiseled face with higher appearing cheek bones. The change afterwards is a subtle, beautiful thinning of the cheeks and not a drastic or unnatural change in appearance. Most people will simply ask if you have “lost weight.” The procedure itself is non-invasive, scarless and quick to heal in experienced hands.
During your consultation, Dr Motykie will address your desires from buccal fat pad removal and he will give you a clearer understanding of how the surgery may best be able to meet your own needs and expectations. Dr Motykie will also give you an opportunity to ask him any question you may have about buccal fat pad removal as well as its possible benefits in your particular case. When going into your consultation, it is wise to come with questions written down and have a general understanding of the overall procedure so you can be prepared to learn as much as possible during your visit with Dr Motykie. Sometime during your consultation Dr Motykie may have you look through a photography book that contains numerous photographs of different results from surgery in order to help you determine what type of “look” you personally find attractive as well as which surgical technique may best help you to achieve your desired outcome from surgery. You are also encouraged to bring in photographs you may have obtained on your own from magazines or various internet websites which show the desired “look” you would like to achieve from surgery. Dr Motykie has found that looking through these types of photographs as well as reviewing his personal surgery portfolio.
You should leave your consultation with a preliminary game plan for your surgery. Cost is always a consideration in elective surgery. At the conclusion of your consultation you will have the opportunity to meet with Dr Motykie’s surgical consultant who will be able to explain to you the possible cost and timing of your surgery. Cost may include surgeon’s fee, surgical facility costs, anesthesia fees, prescription medications, post-surgery garments, and medical screening tests. Dr Motykie’s consultant will also be able to explain to you all of your possible financing options. Remember, a surgeon’s price for surgery will vary based on their experience, the type of procedure being performed as well as the geographic location of their office. Please do not bargain shop for your plastic surgery but also make sure that you are not overpaying for your procedure by doing your homework, online research and obtaining several opinions from different board certified plastic surgeons before making your final decision about having your own breast lift procedure.
For your own personal and confidential consultation, contact Dr. Motykie’s office today. Dr Motykie will answer all of your questions and together you can determine which procedure best fits your desires and needs. Remember, it is impossible for a surgeon to tell you the best approach for you without first listening to your desires and concerns and then performing a physical examination of your breasts and surrounding tissue. Out of town patients may send photographs in order to have a virtual consultation performed by Dr Motykie.
Dr. Motykie will meet with you during your pre-operative appointment and he will take the time to answer any questions you may have about your surgery as well as to discuss your personal surgical plan in detail. Several different photographic views of your face will be taken during this visit for inclusion in your medical record. These photographs will also be used for reference during actual surgery as well as to show you the difference in your face before and after surgery.
Your pre-operative examination will include assessment of your overall health and facial features. This assessment is critical in order to plan a surgery that can successfully produce naturally appearing results. “Safety first” is Dr Motykie’s motto so you will be required to give a thorough medical history, undergo a complete physical examination and obtain certain laboratory tests in order to evaluate your general, overall health prior to any surgery. If you are on a weight-loss plan, it is best to be close to your target weight prior to having your surgery. Some patients ask if it is better to start and exercise and diet program before or after surgery; Dr. Motykie’s answer is always both. If you start your wellness program prior to your surgery your body will be in better health for surgery and if you have already begun a health and wellness program prior to surgery, it will be easier for you to resume that same lifestyle program after surgery.
You will also receive all of your post-operative instructions and prescriptions for medications to be taken during your post-operative course. It is advised that you fill these prescriptions prior to your surgical date and bring them with you on the day of your surgery. In this way you will have all of the medications you need prior to your surgery and any questions and/or concerns you may have can be addressed prior to your actual procedure. Included in these medications are pain medication and antibiotics. You will be instructed to avoid taking drugs containing aspirin, ibuprofen, blood thinning medication, anti-inflammatory drugs and any herbal supplements that are associated with an increased risk of bleeding during surgery. A complete list of medications, vitamins and herbs to avoid prior to your surgery will be given to you at you pre-operative appointment and it can also be downloaded by following this link(Medications to Avoid List).Depending on your health, you may be asked to take certain medications or adjust your current medications. Be prepared to discuss your use of any current medications, vitamins, herbal supplements, alcohol, tobacco and/or drugs.
If you smoke cigarettes, you absolutely must stop smoking well in advance of surgery. If you are a smoker, plan to quit at least two weeks prior to your surgery and not to resume smoking for at least two weeks after your surgery in order to avoid the increased risks of complications associated with smoking. It is absolutely imperative for smokers to follow these guidelines if they do not want to risk any healing complications after surgery. The nicotine in the cigarette smoke can causes the blood vessels necessary for proper healing to shrink which can lead to healing problems after surgery. It is also important to avoid sunlight exposure before and after your surgery because sunlight exposure can cause permanent darkening of post-operative bruising.
Guidelines on eating and drinking the night prior to surgery as well as everything you need to prepare and/or bring with you the day of surgery will also be explained and given to you in your pre-operative packet (Link to Pre-operative packet). Do not go on a stringent diet before or after surgery, as this can inhibit your ability to heal. If you develop a cold or infection of any kind prior to surgery, let Dr Motykie’s office know as soon as possible because your surgery may need to be postponed for safety reasons. Lastly, the consumption of alcohol prior to surgery can lead to an increased risk of bleeding during your surgery and you are therefore advised to limit your alcohol intake for the week prior to surgery. In addition, alcohol can interfere with your post-operative medications and should therefore be avoided as long as you are taking prescription medications (usually the first week after surgery).
During your recovery period, be sure to arrange for someone to drive you home after surgery and to take care of you for at least the first day or two after your surgery. (You may also need to have someone drive you back and forth for your first few follow-up visits). You will also be given several post-operative visit dates and specific times that you will need to follow-up with Dr Motykie during your recovery process.
Day of Surgery
Pre-Operative Marking – Prior to your surgery, you will have the opportunity to speak with Dr Motykie about any part of your surgical procedure and/or recovery process. You will be asked to change into a surgical gown and Dr Motykie will place surgical markings on your face. Lastly, wear loose fitting clothing the day of your surgery that is easy to get in and out of such as sweat pants and a shirt that zippers in the front.
Anesthesia and Operating Facility – For almost all facial procedures you most likely receive general anesthesia (you are asleep) for your own personal comfort, safety and surgical ease. It is Dr Motykie’s opinion that the safest and most effective way to perform surgery is under general anesthesia.
Dr. Motykie uses only Board Certified Anesthesiologists to administer anesthesia and monitor your safety during your surgery. You may be given medication before reaching the operating room so you will feel relaxed before surgery. The surgery takes approximately thirty minutes to perform in its entirety. Every surgery is performed in a state of the art fully accredited, state of the art (AAAASF) surgical facility where your safety, comfort and privacy are of the utmost importance. Deep vein thrombosis (blood clots) precautions are taken with every patient and include a minimum of anti-embolic stockings and sequential compression devices (SCDs) on the lower extremities during the entire length of your procedure.
Surgical – After general anesthesia is administered (you are put to sleep), a very small incision is made inside of your mouth opposite the upper molar teeth on both sides. The buccal fat pads are then simply and quickly removed from inside of the mouth and the tiny incision used to remove the fat pads is closed with a single dissolvable suture. Because the entire procedure is performed inside of the mouth there is no resulting facial scarring and there is no need for bandages following the procedure.
Recovery Room – After surgery you will be brought to the recovery area where you will be allowed to rest and completely recover from anesthesia. Nurses will be on staff by your bedside to make sure you are recovering properly as well as being able to provide you with pain medications and small amounts of water and/or ice chips while you are becoming more awake and alert. After you have fully recovered from anesthesia, you may be released to home with a responsible adult or you may choose to stay overnight in an outpatient recovery retreat where there are nurses on staff 24hrs to assist you with post-operative care and medications.
The most comfortable position to recover in after surgery is a reclining chair with your head elevated. You will return to Dr Motykie’s office the next morning to receive further instruction for the rest of the week. The night following your surgery, you may experience some discomfort that can be controlled with your prescribed pain medication. Temporary bruising and swelling are common the first night after surgery. You may need to go to the bathroom frequently during the night because of the IV fluids you were given during your surgery.
One Day After Surgery
The next morning following your surgery, you will return to Dr Motykie’s office for your first post-operative. Upon arrival to the office you will be escorted to a private examination room where your operative sites will be evaluated. After your examination, you will be allowed to return back to your home. All of your questions will be answered and you will be given instructions for the following week. You may feel tired and sore for several days following the surgery. Your face may be swollen and tender. You will most likely be able to return to work within a few days depending on your job.
- Diet: Mostly patients start with a liquid diet the night after surgery. Usually by the next day most patients are back to a normal diet.
- Medications: Some swelling, bruising and discomfort are normal immediately following surgery and it is typically controlled with your prescription pain medication. Do not take any other pain medication including Tylenol, aspirin or ibuprofen in combination with your pain medications unless you are given permission by Dr Motykie. A combination of Arnica Montana and Bromelain are encouraged after surgery in order to promote your healing process.
- Bathing: Showering and bathing are permitted the very next day after surgery.
- Activity: Light activity is allowed and encouraged including moving about your house and going for walks outside in order to aid the circulation in your lower extremities. However, no heavy lifting or strenuous activity should be attempted during the first 72 hours after surgery. Aerobic and impact cardio exercise should be avoided for one week post-operatively. The resumption of and amount of physical /athletic activity should be guided by the level of your discomfort with “pain” being the ultimate guide.
Once Week After Surgery
Although the recovery process after a buccal lipectomy is relatively quick, your results will typically be obscured by swelling and bruising for the first week after surgery. In fact, you may even notice during the first week or two after your surgery that your face appears slightly “rounder” Do not be alarmed, this is completely normal and is due to swelling from the surgery. Any discomfort you do feel can be relieved with your prescribed medications but most patients say that a buccal lipectomy is almost “painless.” Most patients return to work and can drive their vehicles within a few days after surgery but still plan on having someone drive you to your first few post-operative visits anyway.
- Medications: Some continued swelling, bruising and discomfort are normal and they are typically controlled with your prescription pain medication and muscle relaxants. You should also be finishing your prescription antibiotics at this time. Arnica Montana and Bromelain may be continued for another week in order to promote your healing process.
- Bathing: You may bath and shower freely during the second week after surgery.
- Activity: The majority of patients are allowed to return to light, low impact cardiovascular exercise during the first week of recovery. Exercise of some sort is very important, even if it is just walking around your house. Having said this, rest is also important to the healing process and heavy lifting and strenuous activity are still restricted during the first month after surgery. You will be able to return to more strenuous exercise/heavy lifting at 3-4 weeks after surgery.
One Month After Surgery
At this point in time, you should already be back into your normal rhythm at work. Exercise and workout routines should also be back to normal by this point in your recovery process. During this time, many of the benefits of your surgery will begin to materialize and you will begin notice a beautiful, subtle thinning of your cheeks.
Long Terms Results
All patients vary in their ability and speed to recovery after surgery but most commonly you can expect the final result to be evident by a few months after surgery. Friends and family may begin to ask if you have “lost weight” but the change should not be drastic or unnatural. Since the entire procedure is performed from inside of your mouth there are no detectable signs or scars from this type of surgery. The results of this surgery are very elegant and beautiful and it is very commonly performed in actresses and models from all over the world.
Many different procedures can be combined with a buccal lipectomy since it is very non-invasive and quick to perform. Patients complaining of “chubby cheeks” also commonly complain of a “bottom heavy” face or a heavy neck. In these patients it is also common to perform such facial reshaping procedures as liposuction of the neck and facial fat grafting to the upper face. The combination of these procedures can create a more noticeable change in the overall facial shape which Dr Motykie describes as “facial reshaping.” The results from this sort of combined approach can be impressive and beautiful when performed by an experienced surgeon that possess both a strong aesthetic sense and experienced hands.