Should You Have Buccal Fat Removal With a Facelift?

Short answer: Korean surgeons are mostly cautious about it. Buccal fat (심부볼, medically 협부지방) doesn't grow back, and as facial fat thins with age the hollow it leaves can get more noticeable. At facelift age, surgeons more often lift or reposition sagging cheek fat than cut it out.

Buccal fat removal is a 20s-and-30s trend in Korea. On Gangnam Unni, one Sinsa clinic listed it at ₩550,000 (about $390) after a 45% discount in October 2026.

Facelift patients are usually in their late 40s or older. That age gap is the whole question.

What is buccal fat, exactly?

It's a separate pocket of fat deep in the cheek, under the cheekbone. Dr. Seo Jae-won of 365mc in Daegu described the removal to Newsis: an incision inside the mouth, then part of the fat mass is taken out.

Is the bulge you want gone actually buccal fat?

Often not. Dr. Park Jun-gyu of Surs Plastic Surgery wrote in a September 2026 column that he feels at least 95% of people asking for the surgery point to the wrong place, usually the bulge just below the corners of the mouth.

That bulge, he wrote, can come from soft tissue around the mouth or from bone that doesn't support it well. Remove the buccal fat and the bulge stays. The area under the cheekbone hollows out instead.

For facelift patients, the bulge beside the mouth is usually the jowl (불독살). A facelift lifts it. Our post on jowls and the neck explains how.

Why are Korean surgeons wary of it at facelift age?

Because aging takes fat out of the face on its own. Dr. Park wrote that once facial fat shrinks with the years, the hollow can bother you more. He added that in Korean faces with prominent cheekbones, removing that volume can make the cheekbones stand out further and the cheeks look sunken.

Dr. Seo gave a similar warning: take out too much and the face looks hollow and older.

This is the opposite of what most facelift patients want. Many end up having fat added back. See facelift with fat grafting.

Can it make sense with a facelift?

Sometimes, in a narrow case: a full, heavy lower face where the buccal fat itself has dropped. Dr. Seo said removal can be considered when the cheeks alone bulge on an otherwise lean person, or when there's so much buccal fat that it's likely to sag.

A 2022 study from a Tokyo surgeon followed 30 patients with an average age of 54 after buccal fat excision alone. Lower-face volume fell by about 4 to 5 mL per side at 12 months, and one patient needed filler for a small dent in the upper cheek. The author called his sample small and short-term.

Some surgeons outside Korea reposition the buccal fat during a deep plane lift rather than removing it. If a clinic proposes removal, ask why removal and not repositioning.

What should you ask before saying yes?

• Is the fullness I'm pointing at buccal fat, jowl, or something else?
• How much will you take out, and how will my cheeks look at 60?
• Could the facelift alone fix this?
• If I hollow later, what's the fix, and what does it cost?
• Is the removal priced separately on the quote?

A ₩550,000 add-on is easy to accept without thinking. Our questions for a Korean facelift surgeon has the rest of the list.

How do we help?

• Send the short form with your email and a few photos, and we get free, itemized quotes from 2–3 specialist clinics, with any buccal fat add-on shown as its own line.
• An interpreter in the consultation room, so you can ask the surgeon to point to exactly what they plan to remove.
• Airport pickup and scheduling, if you want a second surgeon's opinion before committing.

Ask for free quotes from the form below.

Frequently asked questions

What is 심부볼?

It's the Korean name for buccal fat, the deep fat pad in the cheek below the cheekbone. The medical term is 협부지방.

Does buccal fat grow back?

No. That's why Korean surgeons warn against taking out too much.

Is buccal fat removal a good idea with a facelift?

It's rarely the default. Korean surgeons warn it can leave the face hollow and older-looking, and a facelift often lifts the same fullness instead.

Where is buccal fat located?

Under the cheekbone, above the middle of the cheek. One Korean surgeon estimates at least 95% of patients point lower, beside the mouth.

How much does buccal fat removal cost in Korea?

One Sinsa clinic's Gangnam Unni listing showed ₩550,000 (about $390) after discount in October 2026. Ask whether anesthesia and aftercare are included.