Facial Slimming Through Buccal Fat Removal, Liposuction, or Masseter Botox®?

A slim, well-defined face with a sharp jawline—the so-called “V-shape”—is one of the most common aesthetic goals among our patients. The term “facial slimming” encompasses various treatments designed to refine facial contours and create a more harmonious appearance. Depending on individual anatomical characteristics, different procedures may be appropriate.

In this post, we explain the three most important methods for slimming the face:

• bichectomy (buccal fat removal),
• liposuction of the face and chin,
• The treatment of masseter hyperplasia with botulinum toxin.

Buccal Fat Removal & More: Why Does a Face Look Wide or Round?

Face shape is essentially determined by four factors:

1. Bony structures —the zygomatic bone and the mandibular angle—define the framework.

2. Muscles— particularly the masseter muscle (chewing muscle).

In cases of masseter hyperplasia, often exacerbated by teeth grinding (bruxism), the mandibular angle appears angular and broad.

3. Adipose tissue —the Bichat fat pad (corpus adiposum buccae) in the center of the cheek, as well as fat deposits on the chin and along the jawline.

4. Skin quality and tissue tone —as we age, the distribution of tissue changes.

A thorough analysis during a personal consultation is crucial: Only when the cause is correctly identified can the appropriate method for facial slimming be selected.

Buccal Fat Removal: Bichectomy for Slimmer Cheeks

In a Bichectomy, part of the Bichat fat pad is removed through a small incision in the oral mucosa. There are no visible scars on the outside. The goal is a subtle slimming of the lower cheek area and a more pronounced definition of the cheekbones (“hollow cheeks” effect).

Who Is a Good Candidate for Buccal Fat Removal?

Bichectomy is suitable for patients with:

• pronounced, round cheeks (“baby face”) despite having a normal body weight
• the desire for more defined cheekbones
• stable weight and good skin elasticity

Important: This procedure should be performed with caution. Since the face naturally loses volume with age, removing too much cheek fat can lead to a gaunt appearance in the long term. Careful patient selection by an FMH-certified specialist in plastic, reconstructive, and aesthetic surgery is therefore essential.

The Bichectomy Procedure

• Anesthesia: usually local anesthesia, with twilight sleep available upon request
• Duration: about 30–45 minutes
• Access: small incision (approx. 1–2 cm) in the buccal mucosa; closed with absorbable sutures
• Outpatient: You can leave the office the same day

Recovery and Aftercare

Swelling is normal during the first few days and usually subsides for the most part within 1–2 weeks. The final result will be visible after about 3–6 months, once the tissue has fully settled. During the first few days, we recommend eating soft foods, maintaining good oral hygiene, and avoiding exercise.

Risks of Buccal Fat Removal

Like any surgical procedure, a parotidectomy carries risks, including swelling, bruising, infection, asymmetry, and—rarely—injury to the parotid duct or branches of the facial nerve. In the hands of an experienced surgeon and when performed using an anatomically appropriate technique, these complications are rare.

Liposuction to slim the face in the lower jaw, chin, and neck areas

Localized fat deposits beneath the chin (double chin, submental fat) and along the jawline can be treated with targeted liposuction performed under local anesthesia. Unlike a buccal fat pad removal, liposuction does not target the center of the cheeks, but rather the lower face and the transition to the neck—with the goal of achieving a more clearly defined jawline.

The Liposuction Procedure

• Anesthesia: Tumescent local anesthesia, outpatient
• Technique: Fine cannulas inserted through small incisions measuring just a few millimeters, which are barely visible afterward
• Duration: approx. 45–60 minutes
• Aftercare: Wear a compression bandage for a few days; mild swelling and bruising may occur

Combinability of Liposuction

Chin/neck liposuction can be easily combined with a buccal fat pad removal if both the cheeks and the jawline are to be treated. If skin elasticity has diminished, a skin-tightening treatment (e.g., radiofrequency microneedling) may be a useful addition—we’ll discuss this on an individual basis during your consultation.

Botulinum Toxin for Masseter Hyperplasia (Masseter Botox®)

The masseter muscle is one of the strongest masticatory muscles. In some people, it is significantly enlarged due to genetic predisposition or chronic teeth grinding and clenching (bruxism). The result: a broad, angular-looking mandibular angle.

How does botulinum toxin work on the masseter muscle?

Botulinum toxin is injected directly into the masseter muscle, reducing its activity. As a result, the muscle becomes slimmer over the course of several weeks (atrophy due to reduced use)—the lower face appears narrower and softer. At the same time, the treatment can alleviate symptoms caused by bruxism, such as jaw pain, tension, or tension headaches.

How Botox® Works and Its Effects on Facial Slimming

• Treatment: a few targeted injections per side, duration approx. 15 minutes, no downtime
• Onset of action: initial relief for the muscle after about 1–2 weeks; visible slimming usually after 4–8 weeks
• Duration of effect: approx. 4–6 months; repeat treatments are necessary for lasting results
• Advantage: non-surgical, no incisions, and no anesthesia

Who is a good candidate for Botox® to slim the face?

This Botox® treatment is ideal for patients whose facial width is primarily caused by muscle tension—as evidenced by the fact that the angle of the lower jaw becomes noticeably stiff and protrudes when the patient clenches their teeth tightly. During the consultation, we assess this through palpation and analysis of facial proportions.