Aesthetic Outcomes, Complications, and Reported Long-Term Effects of Buccal Fat Pad Reduction: A Systematic Review

Buccal fat pad reduction (BFPR) is increasingly used for lower facial contouring; however, long-term outcomes remain unclear. To evaluate aesthetic outcomes, patient satisfaction, complications, and long-term sequelae following BFPR. We hypothesized that the BFPR yields high satisfaction and favorable short-term outcomes with low complication rates, while long-term effects are underreported. Systematic review. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020-compliant review was conducted across MEDLINE, Embase, Web of Science, Scopus, and Cochrane CENTRAL through December 2025. Eligible studies reported aesthetic outcomes, satisfaction, or complications. PROSPERO registration: CRD420251274504. Ten studies (n = 1,123) were analyzed. Objective assessments demonstrated a reduction in lower facial volume. Satisfaction was high. Among 921 procedures, 39 complications occurred (4.2%), mostly minor. Long-term outcomes were poorly assessed because follow-up was limited; one study reported a gaunt appearance (1.6%). BFPR appears safe with high satisfaction; however, evidence is limited by low-level studies and short follow-up.