Buccal fat removal with "special" buccinator muscle tightening technique - is this legit for making sure skin stays tight post surgery?

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BUCCAL FAT REMOVAL

Buccal fat removal is a minimally invasive procedure that reduce chubby cheek. Dr.Joe is an expert with experience more than 10,000 cases.

www.hersclinic.com

I'm considering going here for buccal fat removal. They do what is describeas:

"Cheek muscles tightening technique : This technique can tighten you cheek muscle and facial skin at the lower part of your cheeks."

Then in their chat with me they said:

"The main difference is Dr. Joe’s Buccinator Lift (B-Lift) technique. In addition to buccal fat removal, he performs suturing to lift and tighten the buccinator muscle, aiming to provide better cheek support and contour. This additional step is not typically performed in standard buccal fat removal procedures."

I'm just not understanding what tightening the muscle would have to do with making sure the skin doesn't sag. I'm a bit older so it does concern me.

 

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Claude's response:

Your confusion is correct — the mechanism doesn't connect the way the marketing implies. Let me draw the actual anatomy and you'll see where the gap is:

The layers of your cheek, outside-in: skin → subcutaneous fat → the SMAS/superficial muscle layer → the buccal space where the fat pad lives → the buccinator muscle → the inside of your mouth. The buccinator is the deepest layer — it's the flat muscle you use to compress your cheeks (blowing, sucking through a straw, keeping food on your teeth). It is several layers away from your skin, with fat and fascia in between, and it has essentially no mechanical connection to whether your surface skin drapes or sags. Skin sag after buccal removal is driven by the outer layers: skin elasticity, the superficial fat compartments, and the retaining ligaments. Tightening the deepest muscle to prevent surface sag is like tightening your mattress springs to stop the bedsheet wrinkling.

What the B-Lift suturing plausibly does do — the steelman: after the pad comes out, there's a dead-space pocket. Suturing that region closed (and plicating the buccinator a bit) collapses the pocket in a controlled way, may reduce fluid collection, and gives the deep cheek a firmer "packed" feel instead of a loose cavity. That's real, modestly useful surgical housekeeping — many careful surgeons do some version of dead-space management without branding it. What it cannot do is substitute for skin elasticity or hold up the superficial layers, because it isn't attached to them. So the honest translation of their pitch: "we close the pocket neatly" (true, minor benefit) marketed as "your skin won't sag" (not something any deep suture can promise).

And here's why your instinct matters more than the technique debate: "I'm a bit older" changes the whole buccal calculation. The sag-and-hollowing risk from buccal removal isn't mainly about surgical technique at all — it's about the fact that your face will naturally lose fat every year from here, and the pad you remove is support you never get back. The older you are at removal, the less spare volume you have and the sooner the withdrawn support shows. That's precisely why the field swung conservative, why "remove all of it" is the red-flag version, and why no suture — B-Lift or otherwise — cancels the math. A deep stitch doesn't refill volume in 2036.

So the practical read: your question ("what does muscle tightening have to do with skin not sagging?") is one you should ask them directly, verbatim, and grade the answer. A great answer sounds like: "you're right, it doesn't tighten skin — it closes the dead space and supports the deep contour; your skin outcome depends on your elasticity and on us removing conservatively, which for your age means partial removal only." A bad answer re-asserts that the technique prevents sagging. And regardless of their answer, the decision framework we built stands, now reinforced by your age concern: partial removal or none, decided by what the majority of your seven exams said about your cheeks — with "none, and let leanness do the slimming" being a genuinely respectable option for an older face that will want that volume later. The B-Lift is fine housekeeping if you proceed; it is not a reason to proceed, and it is definitely not a license for total removal.