Rhinoplasty and buccal fat removal in Switzerland: a harmonious nose and more defined cheeks

A face is appreciated first by its proportions. A wide nose, a hump on the bridge or a drooping tip draw the eye to the centre; round, full cheeks, even in a slim person, widen the lower face and give a youthful or baby-faced look that is not always wanted. When these two features coexist, correcting only the nose can leave a face that is still round, and slimming only the cheeks can make the nose look more prominent. Combining rhinoplasty with buccal fat removal, that is, partial removal of the fat pads in the hollow of the cheeks, treats both areas at the same time to reshape the middle third of the face. This page explains what the buccal fat pad is, for whom removing it makes sense and for whom it is not advised, how the two procedures fit together, how the procedure and recovery unfold, the risks specific to each, how the result changes over the years and how provision and fees vary in Switzerland.

Under general anaesthesia, the surgeon reshapes the nose, through an incision inside the nostrils or a small incision on the columella, working on the bone, cartilage and sometimes the septum. They then remove part of the buccal fat pad on each side, through an incision of one to two centimetres inside the mouth, with no visible scar. Allow two and a half to four hours in theatre, often without an overnight stay or with one night. A splint is worn on the nose for about a week, and a soft diet is advised for a few days. Swelling masks the result for several weeks; slimming of the cheeks emerges within two to four months, refinement of the nose within a year. Only functional correction of the septum may be covered by insurance. Budget guidelines are on the page on rhinoplasty with buccal fat removal prices in Switzerland.

Rhinoplasty changes the shape of the nose: it can reduce a hump, refine a tip, shorten a long nose, narrow a wide base, straighten a deviation or correct an asymmetry. Buccal fat removal removes part of the fatty body of the cheek, called the buccal fat pad (Bichat's fat pad), an encapsulated mass of fat located deep between the cheek muscles. Both procedures act on the middle third of the face, which extends from the eyes to the mouth, and their effects combine: a refined nose and less rounded cheeks reshape the oval and structure of the face.

Our page on rhinoplasty in Switzerland details the techniques of nose surgery; this page focuses on what the combination with buccal fat removal changes.

Rhinoplasty is one of the oldest procedures in plastic surgery; its modern techniques developed throughout the twentieth century, with the rise of the open approach, cartilage grafts and, more recently, preservation approaches and ultrasonic instruments. Buccal fat removal, on the other hand, only recently became popular in cosmetic surgery, driven in particular by the quest for a face with prominent cheekbones. This rapid popularity has sometimes led to overly broad indications; surgeons now stress the need to select patients carefully.

Before being used in cosmetic surgery, the buccal fat pad was mainly known to maxillofacial and reconstructive surgeons, who use it as a flap to repair defects inside the mouth, thanks to its good blood supply. Its cosmetic use, to slim the cheeks, developed later. This dual use is a reminder that this fat has an anatomical role, and that it should be removed with restraint.

The buccal fat pad, also called Bichat's fat pad, is named after the French anatomist who described it in the eighteenth century. It is made of a particular type of fat, surrounded by a thin capsule, lying between the buccinator muscle, which forms the wall of the cheek, and the masseter muscle, used for chewing. It has a main body and several extensions that reach towards the temple, backwards and downwards. In infants, it is very well developed and helps with sucking; in adults, its volume varies greatly from person to person, regardless of weight.

The buccal fat pad comprises a central body, located below the cheekbone and in front of the masseter muscle, and several extensions: one rises towards the temple, another extends backwards, another descends towards the jaw. During cosmetic buccal fat removal, the surgeon mainly removes part of the central body and the extension that protrudes into the cheek, without reaching for the deep extensions. This caution limits the risks to neighbouring structures and preserves some of the volume.

Its exact role in adults is still debated. It is thought to act as a cushion and a gliding surface between the chewing muscles, and it contributes to the volume and support of the cheek. With age, like the rest of the facial fat, it tends to diminish and descend slightly. This is an essential point: removing too much of this fat in a young person can, years later, accentuate a hollow-cheeked appearance. Buccal fat removal must therefore never be a routine procedure.

When smiling, the buccal fat pad is pushed forwards and can accentuate the roundness of the cheeks. After buccal fat removal, the cheeks often look less puffy when smiling. The smile itself, controlled by the muscles, is not changed, except in the rare event of nerve damage. Many patients appreciate a smile that better highlights the cheekbones.

Full cheeks are particularly noticeable in front-facing photos when smiling, as the buccal fat pad is then pushed forwards. After well-indicated buccal fat removal, photos often show a more defined face, with more visible cheekbones and a smile that no longer puffs out the cheeks as much. To judge this effect, it is useful to compare photos taken under the same conditions, smiling and at rest, before the procedure and four to six months afterwards. Selfies, which distort the face, should be avoided for this comparison; photos taken from a few metres away, with identical lighting and a comparable expression, are better. This simple method gives a faithful picture of the progress made, at rest and smiling, from the front and at three-quarters, under natural, consistent lighting.

By reducing volume below the cheekbone, buccal fat removal creates a slight hollow that highlights the cheekbone, giving a more sculpted face. In people whose cheekbones are not very prominent, this effect is limited; adding volume to the cheekbone itself, with fat or filler, can then be discussed.

By slightly reducing the volume of the cheeks, buccal fat removal can refine the oval of the face, especially seen from three-quarters. It does not change the jawline itself, but can make it more visible by removing excess volume above it. This effect is clearer in young faces with firm skin.

A round face can have several causes: excess subcutaneous fat in the cheeks, a large buccal fat pad, developed masseter muscles, a wide jaw, or a combination of these factors. Only an excess of buccal fat is corrected by buccal fat removal. A large masseter calls rather for botulinum toxin injections; significant subcutaneous fat, for facial liposuction; a wide jaw, for a bony procedure. Identifying the cause is the first step towards a successful plan.

Facial liposuction removes fat located under the skin, for example on the lower cheeks, the jawline or the double chin. Buccal fat removal removes deep fat, located under the cheek muscles. The two procedures do not treat the same area or the same type of fat. A round face can sometimes benefit from one, the other or both, depending on how the fat is distributed.

When the width of the lower face is due to developed masseters, botulinum toxin injections gradually reduce their volume over a few weeks. The effect lasts several months and must be repeated. This treatment can complement a combination of rhinoplasty and buccal fat removal when several causes coexist, but it is generally done separately.

The nose and cheeks respond to each other in the perception of the face. A wide nose looks more imposing in a narrow face, and a face with full cheeks makes a fine nose look even smaller. By treating both areas at the same time, the surgeon can balance the proportions: refining the nose without it looking out of proportion, and slightly hollowing the cheeks to highlight the cheekbones and the structure of the face. The combination also means a single anaesthetic and a single period of swelling, which is welcome for social and professional life.

When the nose is refined, the cheeks look proportionally more prominent; when the cheeks are slimmed, the nose seems more marked. That is why the combination requires thinking about both procedures together, adjusting the intensity of each. A slightly reduced nose and moderately slimmed cheeks often give a more balanced result than a single procedure taken to the extreme. The surgeon explains this balance at the consultation, using photographs and, if needed, a simulation. This overall approach is one of the main benefits of treating both areas in the same procedure, and one of the keys to a face that looks naturally harmonious, from the front and in profile, today and in years to come.

Buccal fat removal does not slim the face as a whole and changes neither the chin nor the jaw. Rhinoplasty does not change the position of the cheekbones or the width of the face. If the chin is receding, genioplasty, that is, chin surgery, may be more useful to balance the profile; our page on rhinoplasty combined with genioplasty presents this other combination.

The combination of rhinoplasty and buccal fat removal can sometimes be supplemented by other procedures: genioplasty for a receding chin, neck liposuction for a double chin, fat transfer to the cheekbones. Each additional procedure lengthens the operation and recovery. The surgeon helps set priorities and choose what will contribute most to facial harmony, sometimes scheduling certain procedures for a later stage. Our page on profileplasty with rhinoplasty, genioplasty and double chin treatment presents an overall approach to the profile.

A receding chin makes the nose look bigger and the lower face less defined. Before significantly reducing a nose, the surgeon looks at the chin: sometimes, slightly advancing the chin improves the balance of the profile more than a major reduction of the nose. A genioplasty, using bone or an implant, can be combined in this case.

In some people, the desired effect — a face with prominent cheekbones — is better achieved by adding a little volume to the cheekbones than by removing fat from the cheeks. Fat transfer or hyaluronic acid injections can then be offered, alone or in addition. The surgeon explains the advantages of each option.

A double chin, due to fat under the chin, can contribute to the round appearance of the face. Neck liposuction or other techniques can reduce it. This procedure is different from buccal fat removal and is discussed separately.

When several areas of the face bother you, it is useful to rank them in order of importance. The nose is often the priority. The cheeks come next, provided buccal fat removal is indicated. The chin, neck or cheekbones can complete the picture, at the same time or later. A gradual plan is sometimes safer and more satisfying than an overly extensive procedure.

The ideal candidate is an adult, often between twenty-five and forty, who wants to correct the shape of their nose and whose cheeks look full because of a large buccal fat pad, while their face is otherwise slim or of normal weight. They have realistic expectations: a more defined face, not a transformed one. They do not smoke or agree to stop, and their weight is stable.

• Faces that are already slim or have hollow cheeks, in whom removal would accentuate a gaunt appearance.
• People over forty-five to fifty, in whom the natural loss of facial fat has begun.
• Faces that are round mainly because of weight or the masseters.
• Very athletic people with low body fat, whose face will become thinner over time.
• People who want a very hollow face, fashionable on social media, which risks ageing badly.

In these situations, rhinoplasty can be performed alone, and other solutions considered for the cheeks.

Certain situations require the procedure to be postponed: an infection of the sinuses, nose or teeth, a cold, a poorly controlled chronic disease, clotting disorders, pregnancy. Smoking is not an absolute contraindication, but it increases the risks and must be stopped. The anaesthetist assesses all these factors before the procedure.

Mention all your treatments, including food supplements and herbal products. Some, such as aspirin, anti-inflammatories, high-dose omega-3s or ginkgo, encourage bleeding and must be suspended before the procedure, on medical advice. Acne treatments based on vitamin A derivatives can also affect healing and must be discussed.

With age, the face loses volume: fat diminishes, tissues descend, cheeks hollow. Removing a buccal fat pad in a twenty-five-year-old with a round face can give a very good result at the time, but the effect of this natural loss must be anticipated. In a fifty-year-old, buccal fat removal risks accentuating a tired, aged appearance. That is why cautious surgeons reserve it for young adults with genuinely full cheeks, and remove a moderate amount.

Many requests come from young adults between eighteen and twenty-five. For rhinoplasty, facial growth must be complete, generally at around sixteen or seventeen in girls and a little later in boys. For buccal fat removal, caution is needed: a young adult's cheeks may still slim naturally in the following years. Many surgeons prefer to wait until the face has matured, often at around twenty-five, before removing fat.

When a young adult is considering a procedure, their parents sometimes accompany them to the consultation. Their presence can help with asking questions and taking a step back. The decision must nevertheless come from the person concerned, not from outside pressure. The surgeon makes sure the request is personal and well considered.

After buccal fat removal, the cheek skin must retract slightly onto a reduced volume. In young adults, it does so without difficulty. In older people or those with lax skin, removing volume can instead accentuate laxity. This is another reason to reserve buccal fat removal for young faces.

The skin of the cheeks also plays a role in the result of buccal fat removal. Thick, firm skin masks a small hollow and ages better; thin skin reveals a hollow under the cheekbone more quickly. The surgeon takes this into account in the amount removed.

One question to ask before buccal fat removal is: what will my face look like in twenty years? If too much cheek fat is removed, the face risks looking hollow sooner than expected, and fat or fillers may need to be reinjected. Partial, measured removal preserves some of the volume for the future. The surgeon should address this question frankly.

Even with measured removal, the face will lose volume with age. Years later, you may want volume added to the cheeks or cheekbones, with fat or filler. This is not a failure of the buccal fat removal, but the natural ageing of the face. The surgeon can mention it from the first consultation.

The nose consists of a bony upper part, formed by the two nasal bones, and a cartilaginous lower part, with the upper lateral cartilages and the tip cartilages, called the alar cartilages. In the middle, the septum, made of cartilage and bone, separates the two nasal passages. The whole is covered by skin that is thinner at the top and thicker at the tip. Each element can be modified by rhinoplasty: lowering the bony and cartilaginous hump, reshaping the tip cartilages, straightening the septum.

The skin of the nose plays a decisive role in the result. Thin skin reveals the details of the structure, which gives a precise result but also reveals the slightest irregularity. Thick skin, rich in glands, masks details and loses its swelling slowly; the tip stays rounder for longer. The surgeon adapts their technique to the skin thickness and explains what it means for the result.

In people whose nasal skin is thick and oily, which is common in certain backgrounds and in men, the tip loses its swelling slowly and the details of the structure are less sharply defined. The surgeon adapts their technique: they strengthen the tip structure so that it projects through the skin, avoid over-reducing the cartilages and may suggest skin care, or even medical treatment, after the procedure. The result remains satisfactory, but it emerges more gradually and with softer contours.

Thin skin reveals every detail: this is an advantage for precision, but the slightest irregularity of bone or cartilage can become visible over time. The surgeon carefully smooths the surfaces and may place thin tissue grafts to camouflage contours. These noses lose their swelling faster, and the result appears sooner.

A hump on the bridge is one of the most common requests. It is formed partly of bone, at the top, and partly of cartilage, lower down. The surgeon lowers it, then closes the vault of the nose to avoid an overly wide or open appearance, often by bringing the bones together with an osteotomy. The profile becomes straighter, without necessarily being scooped: many patients prefer a slightly straight bridge to an overly upturned nose, which quickly looks artificial.

A wide, bulbous or poorly defined tip is linked to the shape and spacing of the alar cartilages and to skin thickness. The surgeon reshapes the cartilages with sutures, sometimes removes a small part of them, and may add a graft to support the tip. The result emerges slowly, as the tip is the last area to lose its swelling, especially in people with thick skin.

A drooping tip, especially when smiling, gives a longer nose and a tired look. The surgeon lifts and supports the tip, sometimes reducing a muscle that pulls it down when smiling. The angle between the nose and the lip opens slightly. Lifting the tip too much should be avoided, as it would expose the nostrils excessively.

A nose can be wide at several levels: the bone at the top, the tip in the middle or the nostril base at the bottom. Each level is corrected differently: osteotomies for the bone, cartilage reshaping for the tip, alar reduction for the base, with small scars hidden in the nostril crease. The refinement must remain in proportion with the rest of the face.

A deviated nose often results from an old injury or a deviated septum. It sometimes hinders breathing. Correction combines straightening the bones, the septum and sometimes the cartilages, often with a functional component. A perfectly straight nose is difficult to achieve when the deviation is significant, but the improvement is generally clear.

A nose with a scooped bridge, sometimes called a saddle nose, often results from an injury, previous surgery or a weak septum. Correction generally requires cartilage to rebuild the bridge. This is a more complex rhinoplasty, which calls for an experienced surgeon.

In men, the goal is usually a straight, strong nose with a straight bridge and a defined tip that is not too refined or upturned. An over-feminised nose quickly looks artificial on a male face. The skin, often thicker, requires an adapted technique.

In women, expectations vary, but often tend towards a slightly lower bridge, a fine tip and a slightly more open angle with the lip. Here again, the key is proportion with the face: a very small nose in a wide face can look unbalanced.

Many people who consult about the appearance of their nose also have breathing difficulty, linked to a deviated septum or enlarged turbinates. Rhinoplasty can correct these problems at the same time, with septoplasty. This functional component, if documented, may be covered by insurance. Our page on septoplasty covers this in detail.

Many people get used to breathing poorly through their nose without realising it: snoring, a dry mouth on waking, a nose blocked on one side, difficulty during sport. At the consultation, the surgeon asks about these signs and examines the inside of the nose, sometimes with a small camera. If a deviated septum, enlarged turbinates or weak nasal valves are found, they can be corrected during rhinoplasty. Improving breathing is a significant benefit, often underestimated by patients who consult first about appearance.

The nasal valves are the narrowest areas of the airway in the nose. When they are too narrow or collapse on inhalation, breathing is impaired, especially during exertion. A rhinoplasty that refines the nose too much can worsen this problem. The surgeon takes care to preserve or even widen these valves, sometimes with cartilage grafts. This is one of the reasons why an aesthetically successful nose must also remain functional.

The turbinates are structures inside the nose that warm and humidify the air. When they are too large, they can hinder breathing. A careful reduction of their volume can be performed during rhinoplasty. This functional procedure can be part of the request for coverage.

Allergic or chronic rhinitis impairs breathing regardless of the shape of the nose. It must be treated medically before and after the procedure, otherwise breathing difficulty may persist despite surgical correction. Your GP or an ENT specialist can help control it.

When breathing is impaired, the surgeon can submit a request for coverage to the insurer for the functional part of the procedure, documenting the symptoms and examination findings. If the request is accepted, part of the costs of the septoplasty or turbinate surgery is reimbursed; the cosmetic part and the buccal fat removal remain at the patient's expense. The invoice then separates the two parts.

Some people hope that rhinoplasty will make their snoring disappear. Improvement is possible if snoring is linked to nasal obstruction, but it often has other causes, such as laxity of the soft palate or the tongue. The surgeon can refer you for specific tests if snoring is significant.

For athletes troubled by nasal obstruction, functional rhinoplasty often improves breathing during exertion. The improvement is felt once the swelling has resolved, generally after a few weeks to a few months.

Expectations and features vary between backgrounds: thicker skin, softer cartilages, a wider base, a wider or rounder face. Rhinoplasty must respect the identity of the face rather than impose a single model. Likewise, buccal fat removal must take the overall structure of the face into account. Our page on ethnic rhinoplasty develops these aspects.

Men also request this combination, with different goals: a straight, strong nose rather than a very refined one, and cheeks that reveal a more defined jaw. Buccal fat removal must be particularly measured, as an overly hollowed male face quickly looks gaunt. The surgeon adapts the plan to these expectations.

A male face is often characterised by a stronger jaw and less hollow cheeks. Excessive buccal fat removal can give a gaunt, tired or unwell appearance. In men, the surgeon favours very moderate removal, or even advises against the procedure if the roundness of the face is mainly due to the masseters or superficial fat.

In very athletic people, particularly endurance athletes, body fat is low and the face often becomes thinner naturally over time. Buccal fat removal can then accentuate a hollow appearance. The surgeon takes this into account and may advise waiting or forgoing the procedure on the cheeks.

The consultation begins with your expectations: what bothers you about your nose and cheeks, and the image you want to project. The surgeon examines the nose from the front, in profile and from below, feels the bone and cartilages, assesses skin thickness and looks inside the nostrils to judge breathing. They then examine the cheeks: they assess fat distribution, pinch the cheek, ask you to clench your teeth to assess the masseters, and observe the face at rest and when smiling. They take standardised photographs and may offer a simulation for the nose.

A first consultation for rhinoplasty combined with buccal fat removal often lasts forty-five minutes to an hour. It includes listening to your expectations, examining the nose and cheeks, assessing breathing, photographs, sometimes a simulation, and discussing the plan. It is useful to prepare your questions in writing so as not to forget anything.

The surgeon gives you written information about rhinoplasty, buccal fat removal, their risks, recovery, how the face changes with age and the alternatives. Take time to read it and ask your questions before signing, after a period of reflection.

Informed consent sets out the risks specific to each procedure: bleeding, infection, irregularities and breathing difficulty for the nose; haematoma, damage to the salivary duct or a nerve branch and cheeks that are too hollow for buccal fat removal. It also mentions how the face changes with age and the possibility of a touch-up. Reading it carefully, asking your questions and taking time to think before signing are part of a calm approach.

For a facial procedure, a reflection period of several weeks is recommended. It allows you to review the simulations, compare opinions, think about the effect of buccal fat removal with age and choose the right time.

A second consultation allows you to review the simulation calmly, ask questions that have come up in the meantime and confirm, in particular, whether buccal fat removal is worthwhile. For a procedure that changes the face, this extra time is often invaluable.

To judge whether buccal fat removal is worthwhile, the surgeon looks at the face from the front and at three-quarters, at rest and smiling. A sign suggestive of a large buccal fat pad is fullness of the cheek below the cheekbone that persists even in a slim person and becomes more marked when smiling. They also feel the cheek from inside the mouth. They compare with the thickness of the skin and superficial fat. If the roundness comes mainly from elsewhere, they say so and propose another approach.

For the nose, a photo simulation can help visualise the result and agree on the desired shape. It remains indicative, as the actual result depends on skin thickness, healing and the structure of the nose. For the cheeks, simulation is more difficult: the effect of buccal fat removal is subtle and emerges gradually. The surgeon can show photographs of patients who have had the same combination.

Before the procedure, the surgeon takes a series of standardised photographs: from the front, in profile on both sides, at three-quarters and from below for the base of the nose. On these images, they analyse proportions, the hump, the tip, symmetry, cheek volume and the position of the cheekbones. They use them to explain what they propose and, sometimes, to produce a simulation. These photographs also serve as a reference for judging the result objectively, often better than memory, which quickly forgets what the face looked like before.

The simulation shows an intention, not a promise. It allows agreement on the direction: a straighter bridge, a finer tip, more defined cheeks. The actual result depends on the skin, healing and the structure of the nose. Good practice is to treat the simulation as a reference point for discussion, knowing that the final result may differ slightly, for better or worse.

The surgeon reasons in proportions: nose width relative to the distance between the eyes, nose height relative to face length, the relationship between forehead, nose and chin in profile, cheek volume relative to the cheekbones and jaw. A change that seems ideal in isolation can unbalance the whole. The combination allows these proportions to be adjusted coherently.

These reference points help analyse a face, but they are not norms to be imposed: every face has its own harmony.

The face is divided into three thirds: from the forehead to the eyebrows, from the eyebrows to the base of the nose, and from the base of the nose to the chin. The nose occupies the middle third; the cheeks span the middle and lower thirds. A middle third dominated by an imposing nose and full cheeks can overwhelm the rest of the face. The combination rebalances this third. If the lower third looks short or the chin receding, genioplasty can complete the result.

From the front, the eye mainly assesses the width of the nose, symmetry and the oval of the face, where the cheeks play an important role. In profile, it assesses the hump, the tip, the angle with the lip and the projection of the chin. Rhinoplasty acts on both views; buccal fat removal mainly on the frontal and three-quarter views. The surgeon analyses the face from these different angles before proposing a plan.

Photographs taken close up with a phone, such as selfies, distort the face: the nose looks bigger and the face rounder than in reality, because of the short distance. Many people judge their face from these images. The surgeon works from standardised photographs taken at a distance, which better reflect actual appearance. It is useful to know this so as not to base a request on a distorted image.

Many people judge themselves through the mirror, which reverses the image, and photos taken close up with a phone, which enlarge the nose. They know their profile poorly, as they rarely see it. At the consultation, the surgeon shows the face from every angle, using photos taken at a good distance. This step often helps clarify what really bothers you and what is an impression linked to how you look at yourself.

Whether for the nose or the cheeks, the guiding principle of the combination is harmony. An experienced surgeon does not try to reproduce a fashionable nose or cheeks, but to create a balance between the different parts of the face, respecting its natural proportions, its identity and how it will change in the future. It is this approach that achieves a result you remain happy with for many years, and that ages with the face rather than against it.

It is useful to arrive with a precise idea of what you want, illustrated if possible by photographs of noses and faces you like, of people with a similar build. Also say what you do not want: a nose that is too upturned, a face that is too hollow. Be wary of retouched images on social media, which create unrealistic expectations.

It is useful to ask yourself why you want this procedure: a long-standing perceived flaw, breathing difficulty, remarks from those around you, the influence of online images. A personal, long-standing motivation is often associated with greater satisfaction. A recent motivation, linked to a trend or a difficult period, calls for taking more time.

The shape of the nose and the volume of the buccal fat pads are largely hereditary. It is not unusual for several members of the same family to have full cheeks or a nose with a hump. This family dimension can make the decision delicate, as changing an inherited feature sometimes touches on identity. Many patients choose to keep the character of their nose while softening what bothers them. The surgeon can propose this approach, which harmonises without erasing family features. Likewise, inherited full cheeks only justify buccal fat removal if they are genuinely due to a large buccal fat pad and the face will remain harmonious with age.

Those around you, a partner or family, sometimes express opinions about the procedure, sometimes encouraging, sometimes reserved. These opinions can help you think things through, but the decision must remain personal. A result you appreciate is first and foremost one that matches what you wanted for yourself, not the expectations of others. If in doubt, taking more time and talking to the surgeon is always a good idea.

The nose and face are at the heart of self-image. In some people, preoccupation with a flaw of the nose or the roundness of the face becomes overwhelming, takes up a lot of time and thought, and persists despite previous procedures. This is called body dysmorphic disorder. In these situations, further surgery rarely brings the hoped-for relief. An attentive surgeon recognises these signs and may suggest psychological support before any decision. This is not a refusal, but a way of protecting the person.

Social media promotes very sculpted faces, with hollow cheeks and a fine, upturned nose, often retouched with filters. These images create expectations that are difficult to meet and sometimes poorly suited to a real face. Buccal fat removal was popularised partly by these trends. A good surgeon helps distinguish what will suit your face from a fashion that could age badly.

The goal of well-performed rhinoplasty and buccal fat removal is not to change your face, but to harmonise the one you have. A nose too different from the rest of the face, or cheeks that are too hollow, can make the face lose its character. The most satisfied patients are often those whose friends and family say they look rested or well, without knowing exactly what has changed.

The preceding weeks are used to stop smoking, which harms healing of the nasal skin and the lining of the mouth, to suspend products that encourage bleeding on medical advice, and to treat any dental or sinus infection. A dental check-up is useful, as buccal fat removal is performed through the mouth. Plan soft foods for the first few days, cold compresses and one to two weeks away from social life.

Before the procedure, prepare what you need to spend the first few days comfortably: several pillows to keep your head raised, cold compresses or small ice packs wrapped in a cloth, saline solution for nasal rinses, soft tissues, and a supply of soft, lukewarm foods such as soups, stewed fruit, purées or yoghurts. Also plan ways to keep yourself occupied without effort: reading, series, music. In the first few days, you breathe through your mouth, which dries the lips; a moisturising balm is useful.

Someone close to you present in the first few days helps prepare soft meals, watch for a nosebleed and reassure you about the swelling. It is useful to explain to them in advance what to expect: a swollen face, bruising, a splint, breathing through the mouth.

Some people prefer to tell those close to them before the procedure, so that they know what to expect and can support them. Others prefer to say nothing. There is no right answer; what matters is feeling comfortable with your choice, and having at least one trusted person for the first few days.

• Pillows to sleep with your head raised.
• Cold compresses.
• Saline solution and gauze for the nose.
• The prescribed antiseptic mouthwash.
• Soft, lukewarm foods.
• A lip balm.
• The prescribed painkillers and the team's number.

Smoking reduces circulation in the skin and mucous membranes. It delays healing of the nasal skin, the nasal lining and the incisions in the mouth, and increases the risk of infection. Stopping completely, several weeks before and after the procedure, is strongly recommended. It is also good for breathing in the long term.

Good oral hygiene reduces the risk of infection of the small incision inside the cheek. Scaling in the preceding weeks may be advised. The surgeon often prescribes an antiseptic mouthwash to use before and after the procedure.

The combination is generally performed under general anaesthesia, which is more comfortable for a procedure of this length and for rhinoplasty, which requires perfect stillness and airway protection. Buccal fat removal alone could be done under local anaesthesia, but when it accompanies rhinoplasty, it benefits from the same anaesthetic.

• What type of anaesthesia is planned?
• How will pain be relieved when I wake up?
• Do my usual treatments need adjusting?
• What if I had nausea after a previous anaesthetic?
• Will I be able to go home the same day?

Most surgeons perform the rhinoplasty first, as it requires the greatest precision, then the buccal fat removal, which is shorter. Others start with the cheeks so as not to handle the nose once the dressing is in place. What matters is that the mouth and nose are prepared under sterile conditions and that the instruments are suited to each area.

Rhinoplasty can be performed through a closed approach, with incisions only inside the nostrils, or an open approach, with an additional small incision on the columella, the strip of skin between the nostrils, which leaves a very discreet scar. The surgeon lifts the skin, reshapes the bone and cartilages, and may straighten the septum. The bone can be worked with conventional instruments or an ultrasonic device, which is more precise; our page on ultrasonic rhinoplasty presents this technique. At the end, a splint is placed on the nose and sometimes packing or internal splints in the nostrils.

At the start of the rhinoplasty, the surgeon injects into the nose a solution containing a local anaesthetic and a product that constricts the blood vessels. It reduces bleeding during the procedure, improves visibility of the structures and prolongs comfort on waking. Gauze soaked in this solution may also be placed in the nostrils for a few minutes. These precautions help reduce bruising and swelling.

The choice depends on the complexity of the correction and the surgeon's experience. Both approaches can give excellent results.

With an ultrasonic device, the surgeon sculpts the nasal bone using inserts that vibrate at very high frequency. These inserts act on the bone while sparing the neighbouring soft tissues more. The procedure is more precise than with a mallet and chisels, and can reduce bruising and swelling. This technique requires an open approach to access the bone, and specific equipment; it is not essential for every nose.

To support a tip, straighten a bridge or fill a hollow, the surgeon sometimes uses cartilage taken from the nasal septum, more rarely from the ear or a rib. These grafts strengthen the structure of the nose and improve the stability of the result over time. They are common in revision rhinoplasty or noses with weak structure.

When the bony bridge is wide or a hump has been lowered, the surgeon can cut and bring together the nasal bones to close the vault and refine the nose. This procedure, called an osteotomy, is responsible for much of the bruising around the eyes. Performed with ultrasonic instruments, it can be more precise and less traumatic.

Some recent techniques seek to preserve the structures of the nose as much as possible, particularly the bridge, by lowering the hump without removing it. They often give a very natural appearance and faster recovery, but do not suit every nose. The surgeon chooses the approach according to the anatomy and the desired result.

When a nose has already been operated on, a new rhinoplasty is more complex: scar tissue, sometimes missing cartilage, altered skin. Cartilage grafts are often needed. Combining buccal fat removal remains possible, but the procedure becomes longer. These revision rhinoplasties are a matter for experienced surgeons.

The surgeon makes a small incision of one to two centimetres inside the cheek, opposite the second upper molar, staying away from the opening of the parotid gland duct, which emerges at this point. They separate the fibres of the buccinator muscle, carefully open the capsule of the buccal fat pad and ease the fat out with light external pressure on the cheek. They remove part of the main body, in a measured amount, without pulling on the deep extensions. They control bleeding and close the lining of the mouth with a few absorbable stitches. The procedure takes about twenty to thirty minutes for both sides.

When performed on its own, buccal fat removal is often done under local anaesthesia, in a practice or day clinic. The procedure takes about twenty minutes for both sides. The patient goes home the same day, with a few days of swelling and a soft diet. When combined with rhinoplasty, it benefits from the general anaesthetic and adds little time to the procedure.

The amount removed is modest, of the order of a few millilitres on each side, and varies according to the volume of the buccal fat pad and the desired result. The surgeon compares both sides to remove balanced amounts, taking any facial asymmetry into account. They generally favour partial removal over complete excision, to preserve some of the cheek volume for the future.

The current trend is towards partial removal. Removing the entire buccal fat pad carries a greater risk of complications and of a hollow face over time. Measured removal, adapted to the initial volume, slims the cheek while preserving support. The surgeon compares the amounts removed on each side to respect symmetry.

The amount removed depends on the volume of the buccal fat pad seen during the procedure, the shape of the face, age and the goal discussed at the consultation. The surgeon removes part of the fatty body that presents spontaneously, applying light pressure to the cheek, without pulling. They compare both sides to balance them. This cautious approach aims for natural slimming rather than a marked hollow.

Near the buccal fat pad run the duct that carries saliva from the parotid gland to the mouth, as well as fine branches of the facial nerve that control certain muscles of the cheek and upper lip. A gentle technique, without excessive traction on the fat, and good knowledge of the anatomy allow them to be preserved. Injuries are rare but possible; they are among the risks to be aware of.

A rigid or thermoformed splint is placed on the nose, sometimes with packing or splints in the nostrils. In the mouth, the small incisions are closed with absorbable stitches. Cold compresses are applied to the face to limit swelling.

After rhinoplasty, some surgeons place packing in the nostrils to limit bleeding and support the septum. Others prefer silicone internal splints, which leave an airway and are more comfortable. These devices are removed after a few days to a week. Removal is quick and not very painful.

During the procedure, the patient lies on their back, with the head slightly raised to reduce bleeding. The mouth is protected during the rhinoplasty. For the buccal fat removal, a retractor gives access to the inside of the cheek. The surgeon changes the surgical drapes between the two procedures, as the mouth and nose do not have the same sterility requirements.

The buccal fat removal incision is closed with a few absorbable stitches, which fall out on their own within one to two weeks. Some surgeons leave a small opening to allow any bleeding to drain. Gentle compression of the cheek from outside during the first few hours helps prevent a haematoma.

The surgeon may prescribe a short course of antibiotics, mainly because of the incision made in the mouth, a naturally bacteria-rich environment. Antiseptic mouthwashes after meals complete infection prevention. It is important to follow these prescriptions and report any sign of infection.

On waking, the nose is blocked, especially if packing has been placed, and you breathe through your mouth. The cheeks are swollen and slightly tender. A feeling of tightness in the face is common. Pain is generally moderate and well relieved by painkillers. Keeping your head raised and applying cold compresses limit swelling.

After the procedure, you leave with a prescription for painkillers, possibly antibiotics, saline solution and mouthwash, written instructions and the team's number. You go home accompanied. At home, keep your head raised, apply cold compresses and rest.

During the first week, favour clothes that open at the front or have wide necks, so as not to pull a tight garment over your face and the splint. This detail avoids accidentally knocking the nose.

Fatigue is common for a few days, linked to the anaesthesia and mouth breathing, which disturbs sleep. It decreases markedly after the first week. Naps and good hydration help you recover.

Seeing your face swollen, with bruising and a splint, can be disconcerting. When the splint is removed, the nose often looks wider or bigger than expected because of the swelling. This stage is normal. It helps not to judge yourself too quickly and to remember that the result emerges over several months. If your mood stays low for a long time, talking to your doctor helps.

For forty-eight to seventy-two hours, the face swells more, then begins to go down. Bruising may appear around the eyes, especially if the nasal bone has been worked on; it disappears within ten to fifteen days. The cheeks also swell, which may seem paradoxical after buccal fat removal: this is swelling, which masks the result. Sleep with your head raised, avoid blowing your nose hard, sneeze with your mouth open and avoid exertion.

Cold compresses applied to the cheeks and around the eyes, for a few minutes at a time, reduce swelling and bruising during the first forty-eight hours. Do not apply ice directly to the skin or press on the nose. After a few days, cold becomes less useful.

During the first few weeks, blowing your nose hard can cause bleeding or move structures that are healing. Wipe the nostrils gently and use saline rinses to clear secretions. When sneezing, it is advisable to keep your mouth open to reduce pressure in the nose.

Bruising appears mainly around the eyes when the nasal bone has been worked on. It turns from purple to yellow and disappears within ten to fifteen days. The cheeks may also show some bruising after buccal fat removal. Concealer can hide it after a few days. Avoiding aspirin and blood-thinning products before the procedure limits its extent.

In the first few days, a soft, lukewarm diet is advised: purées, soups, yoghurts, foods that are easy to chew. Avoid hard, crunchy, very hot or spicy foods, which could irritate the incisions in the mouth. After each meal, rinsing with the prescribed mouthwash or clean water keeps the mouth clean. A normal diet resumes gradually after about a week.

In the first few days, favour soft, lukewarm, low-salt foods: soups, purées, scrambled eggs, fish, stewed fruit, yoghurts. Salt encourages swelling. Avoid hard or crunchy foods, which require chewing and may irritate the incisions in the mouth, as well as very hot or spicy foods. Drink enough, preferably water. Gradually reintroduce a normal diet after about a week.

After buccal fat removal, chewing may be slightly uncomfortable for a few days. Gradually reintroduce firmer foods, starting with tender textures, then return to a normal diet towards the end of the first week. Very hard foods, such as nuts or thick bread crusts, can wait one to two weeks.

Brushing your teeth remains possible, with a soft brush, avoiding rubbing directly on the incisions. The prescribed mouthwashes are used several times a day for a week. The absorbable stitches fall out on their own within one to two weeks. Redness, increasing swelling or a persistent unpleasant taste must be reported.

Even after healing, good dental hygiene remains important. It has no direct effect on the result of the buccal fat removal, but it protects the mouth and prevents infections that could, rarely, affect the tissues of the cheek. Regular dental check-ups are part of a healthy lifestyle.

The splint protects the nose and holds the new shape during the first few days. It is generally removed after a week, at the first check-up, together with any internal splints. The nose then looks swollen, sometimes wider than before: this is normal. The surgeon may apply adhesive strips for a few more days.

Splint removal, at around the seventh day, is an eagerly awaited moment. The nose appears for the first time, often swollen, sometimes wider or more upturned than hoped, with slightly oily skin. Do not draw conclusions: the shape will refine over months. The surgeon explains what you see and what will change, and may apply adhesive strips for a few days.

After splint removal, the nose remains fragile. Adhesive strips may be applied for a few days to support the skin and limit swelling. Continue to avoid knocks, glasses resting on the nose and blowing hard. The skin of the nose may peel slightly or be a little oily; gentle cleansing is enough. This is often when social life resumes, with a face that is still a little swollen but already transformed. Many patients find that those around them mainly notice a rested face, without guessing that they have had surgery.

With an open approach, the small scar on the columella is slightly pink at first, then fades within a few months. It generally becomes very discreet. Protecting it from the sun in the first year helps it mature.

The small incision inside each cheek heals quickly, within one to two weeks, without leaving any visible trace. You can sometimes feel a small firmer area with your tongue for a few weeks.

In the first few weeks, nasal breathing is often obstructed by swelling of the lining and crusts. Saline rinses prescribed by the surgeon help clean the nose. Breathing improves gradually over a few weeks. If septoplasty was combined, the improvement in breathing is felt once the swelling has resolved.

In the first few days, the nose is often blocked by swelling, internal splints or packing, and you breathe through your mouth. This dries the mouth and lips and can disturb sleep. Drinking regularly, using lip balm and, if needed, a humidifier in the bedroom help you through this period. Nasal breathing returns gradually.

Saline rinses several times a day for a few weeks remove crusts and secretions, improve breathing and promote healing of the lining. The surgeon explains the technique: gentle, without excessive pressure. They quickly become a simple daily routine.

Crusts form inside the nose during the first few weeks. Do not pull them off; soften them with rinses and wait for them to come away on their own. The surgeon can remove them at check-ups.

For several weeks, the nose may feel stiff, numb or slightly tender to the touch. These sensations are linked to swelling and tissue healing. They gradually disappear. Avoid handling, massaging or squeezing the nose unless the surgeon instructs otherwise.

As for pain, patients mainly describe pressure in the nose, tender cheeks and discomfort when chewing in the first few days. Simple painkillers are usually enough. Pain that increases instead of decreasing, or painful asymmetric swelling of one cheek, requires medical attention.

Sleep on your back, with your head raised on two pillows, for at least one to two weeks, to limit swelling and avoid pressing on the nose. Sleeping on your side would press on the cheek and could increase swelling.

Sleeping with your head raised for one to two weeks clearly reduces facial swelling. Two pillows, or a wedge-shaped cushion, help keep this position. Pillows placed at the sides stop you turning over in your sleep and pressing on your nose or cheeks. Sleep may be disturbed in the first few days by mouth breathing; it improves afterwards.

Glasses must not rest on the bridge of the nose for several weeks, especially if the bone has been modified. Contact lenses can be used if you are used to them. If glasses are essential, the surgeon can suggest a way of holding them without resting on the nose.

Like prescription glasses, sunglasses must not rest on the bridge of the nose for several weeks. A wide-brimmed hat protects the face from the sun without pressing on the nose.

Most people return to social life after a week to ten days, once the splint has been removed and the bruising has faded. Concealer can hide it. Residual swelling is often barely visible to those around you, even if it is to you.

Intimacy can resume when you feel ready, avoiding any firm contact with the nose and cheeks for a few weeks.

Driving is possible once strong painkillers are no longer needed and vision is not impaired by eyelid swelling, often after a few days to a week.

Short trips are possible after a few days. For a longer trip, particularly at altitude or with pressure changes, it is better to ask the surgeon's advice, as the nose remains congested for the first few weeks. It is advisable not to travel far before the first check-up.

Periods without strong sunshine are often preferred: the sun encourages swelling and pigmentation of bruises. Winter, on the other hand, brings colds, which hinder breathing and healing of the nose; avoid having surgery during a respiratory infection.

Summer brings sun, which encourages swelling and pigmentation, and heat, which increases swelling. Winter brings colds and respiratory infections, which hinder healing of the nose. Spring and autumn are often considered the most favourable. What matters is avoiding surgery during an infection and protecting the face from the sun.

If an important event is planned, such as a wedding or a professional photo shoot, it is better to schedule the procedure at least three to six months beforehand, or even a year for the nasal tip to be final. The face will then have had time to lose its swelling and stabilise.

For people whose job relies on their image or voice, such as actors, presenters or singers, it is useful to discuss this with the surgeon. The voice may be slightly altered for a few weeks, until nasal swelling has resolved. Recovery arrangements and the timetable must be adapted to professional constraints.

For a self-employed person, time off for a cosmetic procedure is generally not compensated, except for any covered functional part. Work without public contact can often resume after a few days.

If you have young children, make sure they do not knock your nose during the first few weeks: a child jumping into your arms can cause a knock. Arrange help for the first few days and favour cuddles sitting down, protecting your face.

During the first few weeks, exertion increases blood pressure in the face and can encourage bleeding and swelling. Walking is encouraged from the first few days, but intense exertion waits about a month. Sports that expose the face to knocks, such as ball, combat or racket sports, wait two to three months, as the nasal bone needs this time to consolidate. Sports that require a mask or goggles pressing on the nose, such as diving or skiing with goggles, also wait. A gradual return, listening to your body, clearly limits the risks.

During the first two to three months, the nasal bone consolidates in its new position. A knock during this period can displace the bridge or the tip. Risky situations should therefore be avoided: contact sports, play with young children who might knock the face, crowds. If you suffer a knock to the nose, it is advisable to see the surgeon to check that nothing has moved.

Swimming can resume after three to four weeks, but diving, scuba diving and water sports with a risk of knocks wait longer. Water pressure and knocks can affect the healing nose.

Swelling is the main feature of recovery. On the nose, it decreases markedly within two to three weeks, but residual swelling, especially at the tip, persists for several months, sometimes a year, particularly when the skin is thick. On the cheeks, swelling masks the effect of the buccal fat removal for several weeks; slimming appears gradually between the second and fourth months.

Just after buccal fat removal, the cheeks often swell more than before the procedure. This normal swelling can be worrying: you expected slimmer cheeks and discover a rounder face. It decreases markedly within two to three weeks, but slight swelling persists for several weeks. Real slimming appears between the second and fourth months. Knowing this in advance avoids needless worry.

Swelling peaks during the first three days, then decreases rapidly over the first two weeks. At one month, those around you hardly notice it, but some remains, especially at the nasal tip and in the cheeks. Between three and six months, most of it has gone. The nasal tip continues to refine for up to a year, sometimes longer in people with thick skin. This timetable explains why great patience is needed before judging the result.

Several simple steps help reduce swelling: sleeping with your head raised, applying cold compresses in the first few days, avoiding salt, alcohol, heat and exertion, walking regularly and staying well hydrated. Some surgeons prescribe treatment to limit swelling. Facial lymphatic drainage is sometimes offered, but it must avoid the nose in the first few weeks.

The first month is marked by the gradual resolution of swelling, removal of the splint, the return to social and professional life, and nasal rinses. Avoid knocks, glasses, the sun and intense sport. By the end of the month, the face is already clearly transformed, even if the final result is still a long way off.

The first week is dominated by a blocked nose, swelling of the cheeks and nose, any bruising around the eyes and a soft diet. You sleep with your head raised, do nasal rinses and use mouthwash, and avoid all exertion. At the end of the week, the splint is removed. In the second week, bruising fades, breathing begins to improve, eating returns to normal and social life resumes. Between the third and sixth weeks, swelling decreases further, light sport resumes and the face becomes presentable without make-up. Between the second and fourth months, the cheeks become clearly defined and the nose refines. The tip continues to change for up to a year.

At three months, the cheeks have slimmed and the nose has taken its general shape, with a tip that is still slightly swollen. Almost all sport has resumed. This is often when patients begin to fully appreciate their new face.

At one year, the nose has almost reached its final shape, the cheeks have stabilised and any scars are discreet. The surgeon compares before-and-after photographs, assesses breathing and discusses a possible touch-up. It is also the time to take stock of overall satisfaction.

At one year, it is useful to review things with the surgeon: does the result match what was discussed? Is breathing good? Do the cheeks look as desired? This review brings the journey to a close and, if necessary, allows a small touch-up to be discussed.

At around six weeks, most activities have resumed, including intense sport. Contact sports wait two to three months. Glasses can rest on the nose again after a few weeks, according to the surgeon's advice. The face continues to refine for several months.

The nasal tip is the last area to lose its swelling. In people with thick skin, it can remain slightly swollen and rounded for a year. It is important not to judge the final result too early. Regular photographs, taken under the same conditions, help track this slow development.

Regular photographs, from the front, in profile and at three-quarters, at the same distance and in the same light, help track the resolution of swelling and the gradual emergence of the nose and cheeks. They are much more reliable than selfies, which distort the face.

The sun encourages swelling and pigmentation of bruises. It is advisable to protect the face from the sun for several weeks, with a hat and sunscreen. Saunas, steam rooms and very hot baths should be avoided for about a month.

For several weeks, the sun encourages swelling of the nose and can leave marks on bruises. A wide-brimmed hat and high-factor sunscreen, applied without rubbing, protect the face. Tanning sessions and prolonged exposure should be avoided for at least two months.

Heat dilates the blood vessels and increases swelling. Very hot baths, saunas, steam rooms and intense exertion should be avoided for about a month. A lukewarm shower is preferable.

Make-up can be used to hide bruising around the eyes as soon as it allows, generally after a few days, without pressing on the nose. Avoid products on incision areas and remove make-up gently. Foundation on the nose waits until the splint and strips have been removed.

In the first few weeks, the skin of the nose may be oilier or have small spots, linked to the splint and swelling. Gentle cleansing is enough. Scrubs, peels, firm massage and facial beauty treatments are postponed for several weeks. Sun protection is advised.

You are seen again after about seven days to remove the splint and check the mouth; further visits at the first, third, sixth and twelfth months allow the resolution of swelling and the development of the shape of the nose and cheeks to be followed. Photographs are taken at each stage.

At around one week, the surgeon removes the splint and any internal splints, cleans the nose, checks the incisions in the mouth and answers your questions. They may apply strips to the nose for a few more days.

Do not hesitate to call the team if bleeding persists, one cheek swells asymmetrically, or you have a fever or increasing pain. Sending a photograph, if the team offers this, often allows a quick response.

After the first check-up at one week, appointments become less frequent: at one month, three months, six months and one year. For patients coming from far away, some intermediate check-ups can sometimes be done by sending photographs, in agreement with the surgeon. The one-year check-up, which judges the final result for the nose, is ideally done in person.

The combination adds together the risks of rhinoplasty and those of buccal fat removal, which are generally uncommon.

Slight bleeding from the nose is normal in the first few days. A small gauze pad under the nostrils is enough. Heavy bleeding that does not stop after ten minutes of gentle pressure requires a call to the team. Avoiding exertion, aspirin and heat reduces this risk.

Bleeding into the space of the buccal fat pad can cause rapid, tense and painful swelling of one cheek, clearly more marked than on the other side. It is rare. It requires prompt medical attention, sometimes drainage. Gentle compression of the cheeks and cold compresses in the first few days help prevent it.

The parotid gland duct opens into the mouth, on the inner surface of the cheek, close to where the buccal fat removal incision is made. Injury to this duct is rare; it can cause saliva to accumulate in the cheek, with swelling that increases during meals. It is generally treated with simple measures, sometimes with an additional procedure.

Fine branches of the facial nerve run close to the buccal fat pad. Damage to them is very rare; it can cause temporary weakness of the smile or upper lip on one side. In the vast majority of cases, recovery is spontaneous within a few weeks to a few months. A gentle technique and avoiding traction on the deep extensions of the fat limit this risk.

After buccal fat removal, it is common to feel discomfort opening the mouth and chewing for a few days, linked to swelling and irritation of the muscles. It disappears quickly. Lasting limitation of mouth opening is exceptional and must be reported.

A few weeks after buccal fat removal, you may feel a small firmer area from inside the mouth, corresponding to healing. It softens within a few weeks. A lump that grows or becomes painful should be shown to the surgeon.

The main long-term risk of buccal fat removal is a face that is too hollow, especially with age. If a large amount of fat has been removed in a young person, the natural loss of facial fat over the years can accentuate this hollow and give a tired or aged appearance. This risk is why removal must remain partial and reserved for genuinely full faces. If a hollow appears, it can be corrected with fat transfer or fillers.

Regrets mainly concern people from whom too much fat was removed, or in whom the procedure was not really indicated: an already slim face, older age, roundness due to other causes. Over time, their face looks hollow and tired. These situations can be improved by adding volume, but they are a reminder of the importance of rigorous patient selection and measured removal.

A slight difference between the two cheeks or the two sides of the nose may persist or appear, especially as the face is rarely perfectly symmetrical. In the first few months, swelling may be uneven and give a false impression of asymmetry. A persistent, troublesome asymmetry after one year can be touched up.

The face is rarely perfectly symmetrical, and the two buccal fat pads may differ in volume. The surgeon takes this into account and may remove a slightly different amount on each side. Even so, a small asymmetry may persist, often also present before the procedure. Pre-operative photographs help identify it.

Almost every face has some asymmetry: one side fuller, one eye slightly higher, a nose deviated to one side. Rhinoplasty and buccal fat removal can soften some asymmetries, but rarely eliminate them completely. Pre-operative photographs allow them to be identified and discussed before the procedure, so that you do not discover afterwards an asymmetry that already existed.

After rhinoplasty, small irregularities of the bridge, a slightly asymmetrical tip or a result considered insufficient may persist. A touch-up, sometimes called revision rhinoplasty, is considered in a minority of cases, generally after one year, once healing is complete.

Rarely, a small hole can form in the nasal septum after septoplasty. It may go unnoticed or cause crusting, bleeding or whistling when breathing. It is treated with local care, sometimes with surgical repair. Careful technique and stopping smoking reduce this risk.

The sense of smell may be temporarily reduced for a few weeks after rhinoplasty, because of swelling of the lining. It generally returns to normal. Lasting reduction is rare.

The tip of the nose may remain numb for a few months, because small nerve endings have been affected. Some people also feel unusual sensitivity of the front teeth for a few weeks. These sensations generally disappear gradually.

A nose that is too reduced, too upturned or too refined can look artificial and hinder breathing. This is a risk that an experienced surgeon seeks to avoid by favouring a measured result suited to the face. It is often easier to touch up a slightly under-corrected nose than to rebuild an over-reduced one.

Infection after rhinoplasty is rare. It shows as redness, pain, unusual swelling or fever. It is treated with antibiotics. Good hygiene, saline rinses and stopping smoking help prevent it.

What people often fear is a nose that "looks done": an overly scooped bridge, a pinched tip, nostrils that show too much. Modern techniques, and in particular preservation approaches, seek to avoid this appearance. The key is restraint: a harmonious, proportionate nose that looks natural.

• A heavy nosebleed that does not stop.
• Rapid, tense and painful swelling of one cheek.
• Fever, redness or discharge inside the mouth.
• Weakness of the smile or lip on one side.
• Significant difficulty breathing through the mouth.
• Pain that increases instead of decreasing.

A nose touch-up can be considered after one year, for an irregularity or asymmetry. For the cheeks, a touch-up is rarely necessary; if the cheeks look too hollow in the long term, adding volume with fat or filler is more suitable than further removal. The surgeon's touch-up policy should be known from the quote stage.

It remains useful to be able to see your surgeon again after follow-up has ended, for a question, breathing difficulty or a wish for a touch-up. A surgeon who remains available after the procedure is a sign of trustworthiness.

When the combination is successful, the face looks more harmonious and defined: a refined or straightened nose, better in proportion with the rest of the face, and less rounded cheeks that better reveal the cheekbones. The change remains natural: those around you often notice a slimmer, more mature face, without always identifying a procedure.

A natural result depends on restraint and coherence. For the nose, this means a straight or slightly softened bridge rather than a scooped one, a defined but not pinched tip, nostrils that are barely visible from the front, and a width in proportion with the face. For the cheeks, it means discreet slimming that reveals the cheekbones without hollowing the face. The whole must remain in harmony with the forehead, eyes, mouth and chin. An experienced surgeon aims for this naturalness rather than a spectacular change.

The most satisfied patients are often those who had precise, realistic expectations: correcting a hump, refining a tip, revealing the cheekbones, without trying to change their face. They appreciate a result that blends into their face. Disappointments mainly come from expectations inspired by retouched images, or from judging too early, before the swelling has gone.

Satisfaction after rhinoplasty is generally high and lasting when expectations were realistic. For buccal fat removal, long-term satisfaction depends greatly on the initial selection: excellent in young adults with genuinely full cheeks, less good when the procedure was questionable. That is why the surgeon places so much emphasis on the indication.

Several observations come up repeatedly. The blocked nose in the first few days is the main discomfort. Cheek swelling is surprising, then disappears. Splint removal is an eagerly awaited moment, sometimes a little disappointing because of the swelling. And the face emerges gradually, with satisfaction that grows over the months as the nasal tip refines and the cheeks take shape.

Those around you often notice a slimmer, more harmonious face, without always identifying a procedure. Some people prefer not to talk about it, others are happy to. This choice remains personal. The fact that the change often goes unnoticed as a procedure is generally the sign of a successful result.

Even when the change is desired, it sometimes takes a few weeks or months to get used to a new nose and slimmer cheeks. Some people feel they do not recognise themselves at first, especially as swelling is still changing the face. This adaptation phase is normal and fades as the shape stabilises.

For many people, a nose that has bothered them since adolescence or cheeks considered too round weighed on their confidence, particularly in photos or in public. The procedure often allows them to feel more at ease, to show their profile without embarrassment and to accept their image better. This benefit, difficult to measure, often counts for more than the change itself.

The result of rhinoplasty is lasting, even though the nose continues to change slightly with age, like the whole face. The fat removed from the cheeks does not regrow. The face will nevertheless continue to age naturally, with a gradual loss of volume; that is why measured removal is preferable.

Even after rhinoplasty, the nose continues to change with age: the tip tends to drop slightly, the skin thins or thickens depending on the person, and the cartilages soften. A well-designed rhinoplasty partly anticipates this change by supporting the tip. The result remains lasting, but it ages with the face, which is desirable to keep a natural appearance.

Rhinoplasty can be performed at any adult age. After forty, the skin is less elastic, the cartilages more rigid, and the tip often tends to droop. The goals are frequently to lift a drooping tip and straighten a bridge, for a more rested face. At this age, however, buccal fat removal is often not advised; adding volume to the cheeks may instead be more suitable.

In older people, the goal of rhinoplasty is often different: less change of shape, more rejuvenation, by lifting a tip that has dropped, straightening a bridge and improving breathing. The result gives a more rested face without changing its character. In this context, buccal fat removal is rarely indicated; if the face lacks volume, adding fat or a filler may instead be discussed. Our page on facelift with fat transfer presents the approach to the ageing face.

Significant weight loss after buccal fat removal slims the face further, which can accentuate a hollow appearance. Weight gain rounds the cheeks again through superficial fat, even if the buccal fat pad has been reduced. A stable weight is preferable before the procedure and desirable afterwards.

Pregnancy can temporarily round the face through fluid retention and weight gain. This change is generally reversible. It is better not to have buccal fat removal during pregnancy or breastfeeding, and to let the face return to its usual state before deciding.

A stable weight, sun protection, not smoking and, later, appropriate management of how the face changes preserve the result. For the nose, avoid knocks in the following months; for high-risk sports, protection is advised.

Stopping smoking, keeping a stable weight, protecting your face from the sun and caring for your skin promote good healing and a lasting result. For the nose, avoiding knocks and treating allergies help preserve breathing.

Hyaluronic acid injections can camouflage a small hump or lift a tip, without surgery. The effect is temporary and does not reduce the volume of the nose. Nasal injections carry rare but serious risks, particularly vascular ones. They suit limited corrections and do not replace surgical rhinoplasty when a nose needs to be reduced.

If the width of the lower face comes from developed masseter muscles, often in people who clench their teeth, botulinum toxin injections can slim them gradually. This treatment, repeated every few months, is not a matter for buccal fat removal.

Rather than amounts, which vary from one practice to another, here are indices: a value of 100 corresponds to open cosmetic rhinoplasty combined with buccal fat removal, in Geneva.

More details on the page on rhinoplasty with buccal fat removal prices.

The difficulty of the nose, the choice of approach, the use of an ultrasonic device, combined septoplasty, the length of the procedure, the stay, the clinic and the surgeon's experience influence the amount. Buccal fat removal adds a short procedure whose cost is modest compared with rhinoplasty.

Cosmetic rhinoplasty and buccal fat removal are not covered by compulsory insurance. However, correction of documented breathing difficulty, by septoplasty or turbinate surgery, may be covered on prior request. When both parts are performed together, the invoice separates the functional part and the cosmetic part.

The cosmetic part of the rhinoplasty and the buccal fat removal remain at the patient's expense. When the functional part is accepted by insurance, the deductible (franchise) and co-payment (quote-part) apply to that part. It is useful to know these amounts in advance to avoid surprises.

Some clinics offer staggered payment for the cosmetic part. Compare the total cost and make sure the instalments remain manageable before committing.

A complete quote specifies the procedures performed on the nose, the buccal fat removal, any functional part, the anaesthesia, the stay, the splint, check-ups and the touch-up policy. Compare quotes for equivalent services.

The quote is sometimes supplemented by medicines, saline solution and mouthwash and, for self-employed people, loss of income. Any covered functional part reduces what remains to be paid. A future touch-up, which is rare, may have a cost.

To compare two proposals, check the planned procedures on the nose, the approach, the use of ultrasound, any septoplasty, the buccal fat removal, the anaesthesia, the stay, the splint, the check-ups and the touch-up policy. Price differences may be explained by differences in technique or included services.

Rhinoplasty is performed by plastic surgeons and by ENT surgeons specialising in facial surgery; buccal fat removal by plastic, maxillofacial or ENT surgeons. The combination is offered in most major cities. The table compares provision and price levels in twenty cities.

For a facial procedure that is often performed as day surgery, the journey matters less than for major surgery; the table shows which city residents of each canton most often turn to.

As the procedure is often performed as day surgery or with a single night in hospital, it is relatively easy to consult in another canton. You must nevertheless return for splint removal at around one week and for subsequent, more widely spaced check-ups. Arranging accommodation for the first night, if the journey is long, is often more comfortable.

In the Lake Geneva region, Geneva and Lausanne have many facial surgeons, plastic and ENT, used to combining rhinoplasty and buccal fat removal. Sion, Neuchâtel and Fribourg offer a local alternative. In German-speaking Switzerland, Zurich has the widest provision, followed by Basel and Bern; Lucerne, Zug and St. Gallen complete the choice. In Ticino, Lugano hosts most practitioners. As the procedure is often day surgery, travelling to a more distant centre is relatively simple.

In French-speaking Switzerland, patients have access to many facial specialists, plastic and ENT, particularly in Geneva and Lausanne. In Neuchâtel, Fribourg and Sion, provision is more limited but of good quality. In German-speaking Switzerland, Zurich has the widest provision, with surgeons specialising in ultrasonic and preservation rhinoplasty. Basel and Bern also have well-regarded teams. In Ticino, Lugano hosts most practitioners. The choice should above all be based on the surgeon's experience and the results they can show.

Rhinoplasty can be performed by a plastic surgeon or by an ENT surgeon trained in facial surgery; both hold recognised titles. ENT surgeons have particular expertise in the functional part and breathing. Buccal fat removal can also be performed by a maxillofacial surgeon. What matters is that the chosen surgeon regularly performs both procedures and can show comparable results.

For a facial procedure, fully understanding the explanations, risks and instructions is essential. In French-speaking Switzerland, consultations take place in French; in Zurich, Basel or Bern, many surgeons also see patients in French; in Ticino, Italian predominates, often with good French.

As the procedure is often day surgery, it is possible to choose a distant surgeon. Plan to stay nearby on the first night, to be accompanied home, and to attend the first check-up at around one week for splint removal. Subsequent check-ups can be more widely spaced.

For buccal fat removal in particular, a second opinion is useful: it confirms that the roundness of the cheeks really comes from the buccal fat pad and that removal will not risk accentuating a hollow with age. For the nose, it helps compare approaches and the proposed result.

Ask how many rhinoplasties and buccal fat removals the surgeon performs, and look at photographs of results at more than a year for the nose and more than six months for the cheeks, of people with a similar build. A surgeon who advises you against buccal fat removal because your face does not need it is showing seriousness. Check their specialist title in the register of medical professions.

The procedure involves a surgeon, an anaesthetist and the theatre team, then the nursing team. Ask who your contact is after discharge and how to reach the team in the event of bleeding or unusual swelling.

Your GP can be useful for general follow-up, managing a cold during recovery or documenting breathing difficulty for a coverage request. It is useful to send them the operative report.

A reputable surgeon will tell you whether buccal fat removal is really useful for your face, how much fat they intend to remove and why, how your face will change with age, which technique they use for the nose and how long the swelling will last. They will not hesitate to advise against an unnecessary procedure.

Ask to see results at more than a year for the nose, and more than six months for the cheeks, of people with a similar build. Look from the front, in profile and at three-quarters. Be wary of photos taken a few weeks after the procedure, still swollen, or retouched.

• Does the roundness of my cheeks really come from the buccal fat pad?
• How much fat do you intend to remove, and how will my face change with age?
• Which rhinoplasty technique do you propose, open or closed?
• Can my breathing be improved at the same time?
• How long will visible swelling last?
• What are the most common risks in your practice?
• What is your touch-up policy?

• Requesting buccal fat removal for a face that is already slim.
• Wanting very hollow cheeks modelled on social media.
• Confusing roundness due to weight or muscles with a large buccal fat pad.
• Judging the nasal tip before a year.
• Blowing your nose hard or wearing glasses too early.
• Neglecting oral hygiene after the procedure.

The young woman with a round face

A slim twenty-seven-year-old woman has had full cheeks since childhood and a hump on her nose. The surgeon confirms a large buccal fat pad. He proposes rhinoplasty with lowering of the hump and partial buccal fat removal. At four months, the face looks more defined, with more visible cheekbones.

The man with a deviated nose

A thirty-two-year-old man wants to correct a deviated nose that impairs his breathing and to slim a face he finds round. The surgeon proposes rhinoplasty with septoplasty, with the functional part submitted to the insurer, and very measured buccal fat removal to keep a masculine face.

A request to redirect

A forty-eight-year-old woman asks for buccal fat removal to slim her face. The surgeon notes that her cheeks are starting to hollow and advises against removal, which would accentuate this appearance over time. He proposes rhinoplasty alone and, possibly later, adding volume.

The square face

A twenty-nine-year-old man finds his face wide. The examination shows very developed masseters and cheeks with little fat. The surgeon proposes rhinoplasty and botulinum toxin injections into the masseters rather than buccal fat removal.

A twenty-eight-year-old woman of normal weight consults about a hump on her nose and cheeks she has always found round. The examination shows an osteocartilaginous hump, a slightly wide tip and large buccal fat pads. The surgeon proposes closed rhinoplasty with lowering of the hump and refinement of the tip, and partial buccal fat removal. The procedure takes three hours, as day surgery. The splint is removed on the seventh day; she returns to work after ten days. At three months, her cheeks are more defined; at one year, her nasal tip has reached its final shape. She says she is happy with a more harmonious face that she still recognises as her own.

• The cause of the roundness of my cheeks has been identified.
• I have understood the effect of age on the face after buccal fat removal.
• I know the proposed rhinoplasty technique.
• I know whether a functional part is planned and covered.
• I accept several weeks of swelling and a tip that loses its swelling over a year.
• I have stopped smoking and had my teeth treated.
• I have a detailed quote.

The decision rests on a few elements: a nose flaw that genuinely bothers you, cheeks whose roundness comes from the buccal fat pad, an age and build compatible with buccal fat removal, realistic expectations, and acceptance of several months of swelling. When these elements come together, the combination can bring a harmonious, lasting result.

Before committing, ask yourself whether the nose flaw genuinely bothers you, whether the roundness of your cheeks really comes from the buccal fat pad, whether you accept several months of swelling and a tip that takes a year to define, and whether you have properly understood the effect of buccal fat removal with age. If the answers are clear, the decision becomes simpler.

A facial procedure lastingly changes the image you project. It is normal to take several weeks, or even several months, to decide. Consulting two surgeons, reviewing the simulations, thinking about the effect of age on the cheeks: these are all steps that lead to a calmer decision and, often, greater satisfaction.

Combining rhinoplasty and buccal fat removal reshapes the middle third of the face: a refined or straightened nose, and less rounded cheeks that reveal the cheekbones. It suits young adults whose cheek roundness genuinely comes from a large buccal fat pad. Removal must remain measured so as not to hollow the face with age. Recovery takes one to two weeks for social life, but the result emerges over several months, up to a year for the nasal tip.

Only functional correction of breathing may be covered by insurance. Outside Geneva, fees can be up to fourteen per cent lower. Choosing an experienced surgeon who is able to advise you against an unnecessary procedure remains essential.

Choose an experienced surgeon who is able to advise you against an unnecessary procedure. Make sure buccal fat removal is indicated for your face and age. Keep realistic expectations, inspired by real faces rather than retouched images. Stop smoking and look after your teeth. Follow the instructions: head raised, soft diet, nasal rinses, no glasses on the nose. And be patient: the result emerges over several months.

If your nose and cheeks concern you, an appointment will help distinguish what each procedure can do and what will serve your face today as well as in twenty years. Medespoir Suisse can put you in touch, free of charge, with an experienced facial surgeon.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Rhinoplasty and buccal fat removal: prices in Switzerland.

Related procedures

• Rhinoplasty and genioplasty in Switzerland
• Breast implant exchange and breast lift in Switzerland
• Facelift and facial fat transfer in Switzerland
• Breast implant removal and breast lift in Switzerland
• Breast fat transfer and liposuction in Switzerland
• Profileplasty: nose, chin and double chin in Switzerland

The procedures that make up this combination

• Rhinoplasty in Switzerland
• Ultrasonic rhinoplasty in Switzerland
• Ethnic rhinoplasty in Switzerland

Our guides

• Combined procedures in Switzerland
• Cosmetic surgery in Switzerland

Buccal fat pad, age, swelling, diet, breathing and long-term results: the most frequent questions before this combination.

Understanding the combination

What is buccal fat removal? Partial removal of the buccal fat pad, a mass of fat located deep in the cheek, through a small incision inside the mouth.

Why combine it with rhinoplasty? Because the nose and cheeks work together on the harmony of the midface, and a single anaesthetic is enough.

Does buccal fat removal leave a visible scar? No, the incision is inside the cheek.

How much fat is removed? A few millilitres on each side, in a measured amount.

Does rhinoplasty leave a scar? With the closed approach, none is visible; with the open approach, a very small scar on the columella, usually discreet.

Does the combination change the face a lot? It reshapes it subtly: a more harmonious nose and more defined cheeks.

For whom?

Who can benefit from buccal fat removal? A young adult whose cheeks are full because of a large buccal fat pad, with a face that is otherwise slim or of normal weight.

From what age? Generally after twenty or twenty-five, once the face has stabilised.

Is it inadvisable after forty-five? Often yes, as facial fat begins to diminish and removal would accentuate a hollow appearance.

What if my face is round because of my weight? Buccal fat removal is not the right answer; weight loss or other treatments are more suitable.

What if it is my chewing muscles? Botulinum toxin injections into the masseters are more suitable.

Can men benefit from it? Yes, with very measured removal so as not to hollow a masculine face.

The nose

Which nose problems can be corrected? A hump, a wide or drooping tip, a long nose, a wide base or a deviation.

Can I breathe better afterwards? Yes, if septoplasty or turbinate correction is added.

What is ultrasonic rhinoplasty? A technique that works the nasal bone with an ultrasonic device, which is more precise.

Open or closed approach? The choice depends on the complexity of the nose and the surgeon's practice.

Does the nasal tip lose its swelling quickly? No, it can remain slightly swollen for up to a year, especially with thick skin.

The cheeks

How do I know if I have a large buccal fat pad? Only the surgeon's examination can tell; a suggestive sign is a full cheek below the cheekbone in a slim person.

Is the result on the cheeks immediate? No, it appears between the second and fourth months, once the swelling has resolved.

Can the cheeks become too hollow? Yes, if too much fat is removed, especially with age.

Can cheeks that are too hollow be corrected? Yes, with fat transfer or fillers.

Does the removed fat grow back? No, but the face continues to change with age.

The procedure

How long does it take in theatre? Generally between two and a half and four hours.

Do I need to stay at the clinic? Often not; a night is sometimes offered.

What type of anaesthesia? General anaesthesia when both procedures are combined.

In what order? Usually rhinoplasty first, then buccal fat removal.

Is nasal packing used? Sometimes, for one or two days; many surgeons use more comfortable internal splints.

Recovery

Is it painful? Rather uncomfortable: a blocked nose and tender cheeks, rarely real pain.

What should I eat in the first few days? Soft, lukewarm foods, avoiding anything hard, crunchy or very hot.

How long is the splint worn? About a week.

Will I have bruises? Often around the eyes if the nasal bone has been worked on; they disappear within ten to fifteen days.

When can I go back to work? After one to two weeks, depending on contact with the public.

Can I wear glasses? Not resting on the nose for several weeks.

When can I blow my nose? Gently after one to two weeks, according to the instructions.

How should I sleep? On your back, head raised, for one to two weeks.

Sport

When can I resume sport? Light sport at around three weeks, intense at four to six weeks, contact sports after two to three months.

Can I swim? After three to four weeks, without diving.

Risks

What are the risks of buccal fat removal? Haematoma, infection, damage to the salivary duct or a nerve branch, asymmetry, cheeks that are too hollow; they are rare.

Can the smile be changed? Very rarely, temporary weakness may occur; it usually recovers.

And for the nose? Bleeding, breathing difficulty, irregularities or asymmetry, sometimes a touch-up.

Is a nose touch-up common? It concerns a minority of patients, after one year.

Results

Is the result lasting? Yes, but the face continues to age naturally.

Will my face look thinner? More defined, with more visible cheekbones, without looking gaunt if the removal is measured.

When is the final result visible? At around four months for the cheeks, one year for the nasal tip.

Price and insurance

Does insurance reimburse it? Not the cosmetic part; functional correction of breathing may be reimbursed on request.

Is buccal fat removal expensive? It is a short procedure whose cost is modest compared with rhinoplasty.

Do prices vary by canton? Yes, the difference compared with Geneva can reach fourteen per cent.

Choosing

Which specialist should I consult? A plastic surgeon, an ENT surgeon trained in facial surgery or an experienced maxillofacial surgeon.

Is a second opinion needed? It is useful, especially to confirm whether buccal fat removal is worthwhile.

Particular situations

Can buccal fat removal be done without rhinoplasty? Yes, it is also performed on its own, often under local anaesthesia.

Can genioplasty be combined? Yes, if the chin is receding; this lengthens the procedure.

Can rhinoplasty be done after an injury to the nose? Yes, generally a few months after the fracture, once healing is complete.

Does buccal fat removal change the voice? No.

Can I chew normally afterwards? Yes, after a few days of soft food.

Does buccal fat removal hurt the jaw? Some discomfort when opening the mouth may occur for a few days.

Should orthodontic treatment be stopped? Not necessarily, but discuss it with the surgeon and orthodontist.

Can the procedure be done with a dental brace? It is often possible; the surgeon assesses access to the inside of the cheek.

Do wisdom teeth cause problems? A dental infection must be treated before the procedure.

Can rhinoplasty be done if I have had fillers in my nose? Yes, but you must mention it; sometimes the product is dissolved beforehand.

Can buccal fat removal be repeated? It is rarely useful; further removal risks hollowing the cheeks too much.

Is buccal fat removal reversible? Not directly, but a hollow can be filled with fat or a filler.

Can the nose change shape over time? It changes slightly with age, like the whole face.

Are the nostril scars visible? If the base is reduced, they are hidden in the crease of the nostrils.

Can I wear make-up after the procedure? Around the eyes, as soon as the bruising allows, without pressing on the nose.

When can facial treatments resume? After several weeks, avoiding firm massage of the nose and cheeks.

Does cold help? Yes, cold compresses in the first few days reduce swelling.

Can I fly after rhinoplasty? It is better to avoid flying in the first week because of nasal congestion; ask the surgeon's advice.

Can I smoke afterwards? No, smoking harms healing of the nose and mouth.

Does the result depend on skin thickness? Yes, thick skin masks the details of the nose more and loses its swelling more slowly.

Can a very wide nose be refined? Yes, by working the bone and sometimes the base of the nostrils, within the limits of facial harmony.

Does buccal fat removal change the smile? It may slightly change the appearance of the cheeks when smiling, without changing the smile itself.

Is dental follow-up needed afterwards? A check-up is not necessary, but good oral hygiene remains important.

Can I sing or play a wind instrument? After a few weeks, once the mouth and nose have healed.

Can bruising be hidden? With concealer after a few days, without pressing.

Can swelling be asymmetrical? Yes, in the first few weeks; it evens out afterwards.

Can the procedure be done at fifty? Rhinoplasty yes; buccal fat removal is generally not advised.

Does buccal fat removal help define the jaw? It can highlight the oval of the face, but does not change the jaw itself.

Does the buccal fat pad grow with weight? It is less sensitive to weight than superficial fat.

Can neck liposuction be combined? It is possible if a double chin is bothersome; this is discussed case by case.

What should I prepare for the consultation? Your expectations, reference photos, your medical history, your treatments and your questions.

Should I plan for someone to accompany me? Yes, someone must take you home and stay nearby on the first night.

Which season should I choose? Months without strong sunshine are more comfortable for protecting the face.

Should I tell my employer? No, a sick note is enough.

What does Medespoir Suisse offer? Free referral to a specialist in facial surgery.

Can an unsuccessful rhinoplasty be revised? Revision rhinoplasty is possible, generally after one year.

Are simulation photos reliable? They help communication, but the actual result depends on healing.

How long should I avoid the sun? Several weeks, with sunscreen and a hat.

Can buccal fat removal become infected? Rarely; redness, swelling or an unpleasant taste must be reported.

What should I do if my cheek swells during meals? Seek medical advice, as it may suggest damage to the salivary duct.

Will my nose be smaller? It will be more harmonious; the reduction depends on your request and anatomy.

Can I choose my future nose? The desired shape is discussed, within the limits of anatomy and facial harmony.

Will the cheeks come back? No, but the face will continue to change naturally with age.

What should I do if my nose bleeds at home? Apply gentle pressure, stay seated with your head tilted forward, and call if it persists.

Are nasal rinses needed? Yes, with saline solution, according to the instructions, for a few weeks.

Is combat sport possible afterwards? After two to three months, with protection, and according to the surgeon's advice.

Is a second consultation useful? Yes, to confirm the plan and ask questions that have come up in the meantime.

Can other facial procedures be combined? It is possible, but the procedure becomes longer; the surgeon discusses priorities.

Is the result visible in photos? Yes, particularly at three-quarters, where the oval of the face and the profile of the nose change.

Does the result look natural? That is the goal: a harmonious face, without obvious signs of surgery.

Will my friends notice the procedure? They often notice a slimmer face, without always guessing why.

Describe what bothers you about your nose and cheeks, your age and the region where you would like to consult. We will direct you, free of charge, to an experienced facial surgeon who can tell you what is useful and what is not.