Awake face surgery
Awake Buccal Fat Removal in Ottawa
Buccal fat removal reduces fullness in the lower cheeks to create a more contoured face. It is a short procedure that can often be performed awake under local anesthesia.
Buccal Fat Removal at a glance
| Typical operating time | About 30 to 60 minutes |
|---|---|
| Awake suitability | Often a good candidate for awake surgery |
| Typical return to desk work | Often within 2 to 4 days |
| Anesthesia | Local anesthesia with or without sedation. General anesthesia arranged if needed |
| Setting | Outpatient, with an anesthesiologist present throughout |
Times are typical ranges for planning, not promises. Your plan is individualized.
What is buccal fat removal?
Through a small incision inside the mouth, a portion of the buccal fat pad is removed. There is no external scar. Not everyone is a good candidate, because removing too much fat can make the face look hollow with age.
Who may be a good candidate
- People with round or full lower cheeks
- Those who want a slimmer facial contour
- Patients with realistic expectations who understand future aging effects
Why awake buccal fat removal may work
The operation is brief, the mouth and cheek can be numbed with local anesthetic, and it avoids a general anesthetic. Procedure-specific published evidence is limited, so we present this as a reasonable option for suitable patients and not as an established standard. Patients stay relaxed and can talk with the team.
When awake may not be the right choice
If buccal fat removal is combined with other major procedures, the overall anesthetic plan may change.
Your awake buccal fat removal journey
1. Before surgery (pre-op)
We examine facial structure and discuss the risk of over-resection. Not everyone is suitable.
- A consultation to review your goals, health history, medications and previous surgeries, and a physical examination
- An anesthesia assessment to decide whether an awake plan is appropriate and safe for you
- Photographs, with your consent, and a written plan, quote and consent form
- Medication guidance, including when to stop blood thinners, certain supplements, and smoking or vaping
- Fasting instructions from the anesthesia team. Follow them exactly
- A ride home and an adult to stay with you after surgery
2. Day of surgery (intra-op)
The cheeks and mouth are numbed, a small incision is made inside the mouth, and fat is removed.
- You arrive, change, and meet the surgeon and anesthesiologist, and your markings and plan are confirmed
- An IV and monitors are placed. The anesthesiologist stays with you from start to finish
- Local anesthetic is given. Expect brief stinging, then numbness, and light sedation if planned
- You can listen to music, talk with the team, and tell us at any time if you feel discomfort
- Afterward you rest in recovery, receive written instructions and go home with your driver
3. Recovery (post-op)
You are observed in recovery, given written instructions and pain-control guidance, and scheduled for follow-up. Call us or seek urgent care for fever, spreading redness, severe or worsening pain, heavy bleeding, chest pain, shortness of breath, or leg pain or swelling.
| When | What is typical |
|---|---|
| Days 1 to 3 | Swelling of the cheeks. Soft diet and mouth rinses. |
| Week 1 | Swelling settles. Most return to normal activities. |
| Weeks 2 to 6 | Contour emerges gradually. |
| 3 to 6 months | Final contour is seen. |
Timelines are general and vary. Your surgeon gives you instructions specific to you.
Anesthesia options
Anesthesia options range from local anesthesia, with or without sedation, to general anesthesia. An anesthesiologist is present throughout your procedure and recommends an approach after reviewing your health, the extent of surgery and your preferences. If an awake approach is not suitable, general anesthesia is arranged. Plans can change during surgery if comfort or safety requires it, including deepening sedation or converting to general anesthesia.
Learn more: anesthesia options, levels of anesthesia, fear of intubation, and pain perception and music.
Alternatives
Non-surgical contouring, weight management, or no treatment.
Risks
Over-resection leading to a hollow look as you age, asymmetry, infection, bleeding, injury to nerves or the salivary duct, and anesthesia-related risks.
Anesthetic risks include reactions to medications, breathing or airway events, the need to deepen sedation or convert to general anesthesia, and, rarely, transfer for further care. All surgery carries risk, and results are not guaranteed.
Frequently asked questions about awake buccal fat removal
Will I look hollow when I'm older?
That is a real concern. We assess whether the procedure is appropriate for you.
Can it be done awake?
Often yes.
Is there a scar?
Incisions are inside the mouth.
Is the result permanent?
Removed fat does not return.
Related procedures
Starting from $5,000 (CAD, before 13% HST), including surgeon, anesthesia and facility fees. Your written quote follows your consultation. See pricing and financing.
Explore your options at a consultation
Evidence note: published studies specific to this procedure under awake or local anesthesia are limited. The approach described here follows general principles of local anesthesia and is individualized to each patient. General references on local anesthetic safety are listed below.
References
- Conroy PH, O'Rourke J. Tumescent anaesthesia. Surgeon. 2013;11(4):210-221. PMID 23375489
- Dillane D, Finucane BT. Local anesthetic systemic toxicity. Can J Anaesth. 2010;57(4):368-380. PMID 20151342