Submalar fat pad removal for esthetic purposes has been performed as a routine in the last decades. However, several factors have not been properly analyzed and studied. In order to address this problem, the purpose of this study is to describe clinical parameters to be taken into account when analyzing potential patients as well as a systematic approach during the pre, intra and postoperative stages.

Patients complaining of cheek fullness were evaluated to determine if they were good candidates for the procedure. Eligible patients underwent the same patient selection criteria and pre, intra and post-surgical protocol.

A total of 44 patients were selected. 40 females and 4 males, with a mean age of 25.4 years. The bilaterally excised buccal fat pads had an average weight of 4.3 gs. There was only 1 complication (unilateral emphysema), during the immediate postoperative phase.

Submalar fat pad removal is an effective technique for refining the facial silhouette that should be reserved only for patients with increased buccal fat pad volume or its pseudoherniation. Performing the surgery following the protocol established in our study can allow the surgeon to achieve more reliable intra and postoperative outcomes.