DIY way to tell if buccal fat pad removal surgery is right for you by Dr. Zelken

To make the concept of buccal fat pad removal less ambiguous, Dr. Zelken introduces his concept of framing the face. In addition, he offers advice on how to make your own DIY BUCC-O-METER assessment tool to educate you and guide expectations for buccal fat pad removal surgery. The concept is rather simple. In previous videos, you may have gathered that ideal candidates for buccal fat pad removal surgery have strong jawbones (mandibles) and strong cheekbones (malar mound/positive vector). Also, a well-developed masseter muscle comes in handy to frame the buccal space (think Jennifer Garner). If you think of the buccal space as a window or a picture within a frame, you can understand not only where the buccal space lives, but whether or not you would benefit, and what to expect from buccal fat pad removal surgery.
Let us start with the "4 Ms" of buccal fat pad anatomy and framing. The first M stands for masseter (chewing muscle), and this is the posterior wall of the frame. The second M is mandible (jawbone, jawline), which can be thought of as the floor of the frame. The third M, the front wall, is the mouth (technically, the deep nasolabial fat compartment). Finally, the fourth M, the ceiling, is the malar eminence- better known as her cheekbone. Within the context of these 4 walls the ideal shape is very subjective. I think we can all agree that convexity or bulging from this space is not attractive. Whether or not you think a smooth versus concave contour is attractive is subjective and addressed on an individual basis. For example, many thin young patients in the modeling industry come to me for removal of the buccal fat pad to create a more sculpted look even though they may not "objectively" benefit from it.
Finally, in this video, Dr. Zelken will show you how to make your own BUCC-O-METER. This inexpensive and simple device is designed to really help you determine not only where your buccal fat pad lies, but whether or not you may benefit from this operation. Of course, nothing beats an in-person examination to better guide your expectations and to assess your candidacy for the procedure. To make an in person or virtual consultation, please call [phone].
LINK for DIY BUCC-O-METER pending
How to make your own BUCC-O-METER in 10 easy steps:
Supplies needed: cardboard or construction paper, scissors or x-acto knife, marker, ruler, post-it-note.
To conform to the LEFT cheek (for right, flip it over)
1. Mark and cut out a 9 cm (3.5 in) square.
2. On the bottom edge, mark 2 cm from the left.
3. On the right edge mark 3 cm up from the bottom.
4. Connect the dots and cut out 2 triangles.
5. Cut out the center leaving about 2 cm of borders.
6. On the bottom write "mandible" (jaw)
7. On the top write "malar" (cheek)
8. On the left write "mouth" (deep nasolabial fat compartment)
9. On the right write "masseter" (jaw muscle)
10. Then place a piece of leftover material inside and move it to line up with the front edge of your masseter muscle. (Optional: take a post it note and line the adhesive up with the front edge of the masseter)
To find your masseter, clench your jaw and look for an angled shadow from your cheek to the angle of your jaw OR feel for it with your thumb.
The remaining space is where the buccal fat can herniate.

[@CrystalCupcake86]

I am definitely one of those people who have been wondering if it’s my buccal fat or jowls that causes my issue or just loss of volume in my cheeks . Thank you so so much for addressing this !!

[@jonathanzelkenmd]

Of course. Glad to be of help!

[@rosiepetals8488]

This is extremely helpful, thank you for sharing this information. This also gives me realistic expectations of what to expect.

[@HimeGirl15]

You’re such a cool doctor!

[@jonathanzelkenmd]

Why thank you HimeGirl

[@everg14]

Brilliant doc

[@fabmack1961]

I guess if one just smiles whilst using this method, the fat would push through the space. I contacted a random Plastic Surgeon the other day, primarily because they are close to where i live. He sent me text, stating that he doesn't do this procedure what so ever and he is against it! With no explanation. I personally have never heard anything negative about it! Any idea why he was so against this procedure.

[@jonathanzelkenmd]

There are a handful of plastic surgeons who feel this way. It’s a bit novel as a popular procedure and the more that you do, the more you become aware of the subtlety of the results. I would encourage you to find a plastic surgeon who is not opposed to the procedure and have him or her determine your candidacy.

[@mkryu]

I recently saw this video on why this surgeon stopped performing buccal fat removal surgeries. Maybe this would be good for you to watch to get one perspective kzbin.info/www/bejne/ipSkfXqhdslkkMU&feature=share

[@ap6252004]

@@mkryu Yes! I watched this video and feel that the removal of buccal fat is very unnecessary! Why not just do a mini face lift?

[@mkryu]

@@ap6252004 I could never see any difference when I looked at before and after photos so I never considered buccal fat removal. Maybe it’s good to save that fat for our later years to transfer to other areas of the face for volume?

[@ap6252004]

@@mkryu Agreed!

[@freyja484]

Thank you for sharing this very very helpful!

[@ManyFacesOfChicago]

I love this. Bravo!

[@jonathanzelkenmd]

Thank you

[@decekfrokfr3mdx]

Would you recommend buccal removal in the case of a slim person who still has chubby chipmunk cheeks, but who does not have a strong jawline and cheekbones? I understand to be accurate in specific cases you would need to see the person, but as a general principle, does buccal removal still improve the appearance of someone with chipmunk cheeks but who also has a so-so facial bone structure? Thanks!

[@jonathanzelkenmd]

My instinct is to say yes.

[@didonavo4254]

Omg Same my face is exactly like urs chubby cheeks with weak bone structure and i have the same question

[@tinybrit3225]

I had this question as well, thank you!

[@anettefrieser6963]

Hello Dr. Zelken, is the BMM procedure a good way to tighten loose muscle/tissue at older women? I am 59 and had a facelift 1 year ago but the perioral mounds were not addressed, so still there are these downward mouthcorners...

[@jonathanzelkenmd]

Hi Anette I’d really need to examine you to better answer your question. My guess, without seeing you, is that a corner lip lift may be a more effective solution.

[@anettefrieser6963]

Thank you very much for your reply!

[@juliaalyssandra373]

finally! someone who explains it soo well and actually makes sense! thanks doc!

[@jonathanzelkenmd]

Finally :)

[@Pirake123]

Hi Doctor, what percentage removal do you normally take out? 80% or 100%?

[@jonathanzelkenmd]

100% of the body which is about 70-80% of the entire pad.

[@spanishjohn420]

Hello. I had a cyst on the right side buccal pad which, once healed, took a lot of mass out of that area. But its also lop sided due to facial asymmetry. Should i get buccal fat pad removal on the other side to compensate?

[@jonathanzelkenmd]

Sounds like a good idea

[@potentnaturals188]

Hi Doctor! After buccal fat removal, will the skin on that area shrink and follow the facial contour result later on to reveal a firmer jawline? Im afraid to get loose skin after the procedure. Thanks for great info!

[@jonathanzelkenmd]

In my experience I have not seen loose or baggy skin result from this procedure.

[@potentnaturals188]

@@jonathanzelkenmd Thank you for your helpful info!

[@DemureDarlings]

Thank you

[@bumba8154]

Hey doc, I understand that you can answer to the best of your ability by in person consult. Just wanted to know if you would recommend bucal fat removal if someone has hypertrophied masetters and a square bone structure which is my case.. thanks in advance! Keep the videos coming doc!

[@jonathanzelkenmd]

Id probably recommend masseteric botox

[@bumba8154]

@@jonathanzelkenmd oh no, I like them how they are. I just mean from your perspective.. would buccal removal be a good idea with big masseters. I have slight hollow cheeks but only under the zygo arch

[@tiffanyt7121]

But what about lower sagging side jowls? I am 38 and have visible sagging chin jowls, will buccal fat removal help this?

[@jonathanzelkenmd]

I’d really need to see you, but the jowls would likely need to be treated as well. Think of the two as mutually exclusive entities.

[@potentnaturals188]

@@jonathanzelkenmd How do you treat this issue?

[@njbhcolio]

Thnk u..u shud hv made a template and post it for ur to print it out..

[@jonathanzelkenmd]

On my website:)

[@mostlyharuno9923]

I dont even need this fram , i can tell without checking that i have much amount of buccal fat 😟

[@jonathanzelkenmd]

There’s a procedure for that :)

[@throwaway7899]

Why am I watching this I already had it done 😅 thanks for the info though

[@orhanmo1250]

How was it?

[@throwaway7899]

@@orhanmo1250 I'm very happy with it but it's a subtle change

[@orhanmo1250]

@@throwaway7899 u mean that it was not so lifchanging procedure?

[@throwaway7899]

@@orhanmo1250 nope

[@potentnaturals188]

@@throwaway7899 was your buccal fat completely removed or partial?

[@sayitshay]

Hello, I contacted your office. I want to know the average cost of buccal fat removal and if I have to be awake or not

[@jonathanzelkenmd]

Hi there, we'd really need to see you for an accurate quote (feel free to make a virtual consultation if you'd prefer), but you do not need to be awake for the surgery.

[@ece5612]

Hey doc this video is really helpful for me first of all thank you so much for your wise recommendations. Then I want to ask something. I’m very slim and I have round face but it’s like really round with small chin everyone tries to squeeze my cheeks and I hate that I want to get done this surgery may I ask if am good or bad candidate for this procedure?

[@jonathanzelkenmd]

Thanks so much. Of course I would need to examine you to answer your question.

[@ece5612]

@@jonathanzelkenmd thanks for your reply Dr. Zelken 🥲 unfortunately I live in Turkey so I don’t have opportunity to come and see you… i would like to I watched all video of yours. I just wanted to know if a person who has very roundish face in thin body as me is suitable for this procedure?

[@vishnusuresh4773]

Nice

[@lalalalaland84]

What about cheek fat though?! I dont even need the buccalmeter to see that i have a lot of flesh on my lower frontal face. Ive no idea if itll be fixed through buccal fat removal or not

[@jonathanzelkenmd]

Thats why an in-person examination is so important

[@odettg9106]

Thank you doc do you have before & after 3 mths of your patients with similar faces like your nurses one like one with thinner face and other with more candidate for buccal fat removal ..

[@jonathanzelkenmd]

We do. We are preparing a video now of a fuller face candidate and can show you thinner faces too.

[@cbb8129]

Eres un genioooo

[@LYlmaz]

Hi Doc! I couldn't get that: I do have extra issue. How do I know if it's my buccal fat or jowls?

[@jonathanzelkenmd]

Typically jowls fall below the mandible border.

[@matchachachoco8948]

I really want to have buccal fat removel because I always bite the side of face when I talk, yes the inside of my face!

[@yolandazhanay3480]

Where are you located ?

[@jonathanzelkenmd]

Newport Beach California

[@danar4584]

Is there a surgeon you recommend in NYC for buccal fat removal?

[@jonathanzelkenmd]

My friend Richard Reish is a talented surgeon.

[@jonathanzelkenmd]

Of Alan Matarasso

[@danar4584]

@@jonathanzelkenmd Thank you so much!!

[@harkamalkaur3040]

@@jonathanzelkenmd do they specialize in buccal fat removal as much as you do? If not, do you know anyone that does here in NYC?

[@firuzayildirim8917]

I have done it 8 months ago together with other procedure and doctor hasn’t showed me what he has removed from my cheeks so couldn’t see any results and wherever ago surgeons still suggest me to do buccal removal since Istill have the same chubby chins :((

[@jonathanzelkenmd]

Sorry Angel- you should always ask for a picture at the time of surgery or take the pic yourself. Also, buccal fat and the chin are separate structures, so removal shouldn’t influence chin shape.

[@firuzayildirim8917]

@@jonathanzelkenmd sorry for inconvenience I meant to say cheeks ! Of course I took a picture of myself before the surgery but It was done under general anesthesia together with other procedure so I was sleeping during the operation, When I woke up I had a small incision inside my mouth but the thing is that surgeon hasn’t showed me my buccal fat saying that he forgot to take a picture and that he trew it away . As a result I haven’t seen my buccal fats and still there is no difference between pre operation and post operation unfortunately... Also recently I have seen another surgeon for brow lift where he suggested me to have my buccal fat removed

[@hannahdivic28]

Do you have a website or information on how to book a procedure with your office?

[@jonathanzelkenmd]

Yes www.zelkeninstitute.com, and our number is [phone]

[@be_luna]

I think in the end I would be too scared cz what if when I’m older my face looks hollow. So in the end I’d rather not

[@c-lexis8747]

always look at your parents to see if they’re lost fullness in their cheeks yet or not. that’s a good way to predict how you’ll age if you get the procedure

[@plumpy_space_princess]

@@c-lexis8747 exactly! I thought of getting this procedure but not anymore. I have my mom's cheeks and she's lost some fullness as she's aged, so I won't be getting it anymore! 😊

[@michaeljuarez3355]

Hey doc....I'm looking into getting this procedure done....does the fat come back in the area or surrounding areas?...and what does a consultation cost... thanks

[@jonathanzelkenmd]

The fat pad never comes back and the surrounding areas do not redistribute. Please call 949-432-4730 during PST business hours to discuss fees, etc.

[@edwardhisse2687]

I feel like a have way more fat in my cheeks than that little piece of cartboard is suggesting, maybe i should just lose weight and water weight. The more I watch tgese the more I realise theres just too much to try and fix😕

[@blindship5792]

amusingly enough, she DID have a buccal fat removal in one of his other videos

[@jonathanzelkenmd]

Yes you are correct!

[@Laura-lh7xg]

This is great, I'm gonna get some carton and scissors now! 😃

[@milliedragon4418]

Why I am here?

[@jonathanzelkenmd]

So many answers to that wonderful question.

[@plumpy_space_princess]

@@jonathanzelkenmd 💀

[@xristinarose2409]

But... i like my chubby cheeks 😲 they make me look younger. I m 30 and they often think that i'm around 22 and that s because of the chubby cheeks

[@jonathanzelkenmd]

The operation is not for everyone and remember it’s elective surgery.

[@uzairlol]

Having chubby cheeks is death sentence for me, it hides my wide mandible and give me a rounder jaw shape😕

[@Lala-gn4pj]

I had buccal fat removal and now one of my cheeks is flat and has no shape. One of my cheeks was flatter to begin with, I don't know why he removed it on that side. Stupid idiot doctor! I hate it!

[@jonathanzelkenmd]

Oh no! It sounds like there was not enough communication between you and your doctor. There may be ways to address the asymmetric cheeks.

[@Lala-gn4pj]

I said " I don't like sunken-in cheeks". I didn't know one side of my face had less bone and would sink. He should have known that. He did not do tests to see my tissue underneath, like they do in Korea. To address the flatness I pay $ 1000 for filler. Now I'm going to waste more money for the rest of my life. Buccal fat removal is a horrific idea!

[@jonathanzelkenmd]

@@Lala-gn4pj sorry you feel this way but its really good for the community to hear all angles, so thank you!

[@chou-4737fjswi]

STOP!! No one needs any kind of surgery!!

[@jonathanzelkenmd]

This is true. Nobody needs aesthetic surgery. The title should not say “need”. I’ll change it.

[@plumpy_space_princess]

@@jonathanzelkenmd 🥰

[@everylittlebreeze]

Why would you do a KZbin video with a mask on!? Utterly ridiculous. I don’t know what a narrative. You’re trying to push. But it’s not appreciated.

[@jonathanzelkenmd]

There was a mask mandate in the past and I was interacting with patients. I do not routinely wear a mask these days. I appreciate your honesty and concern.

[@tsrocketqueen]

Can you get buccal fat removal after a facelift? will there be any possibility it could cause jowling