October 18, 2026 | Buccal Fat Pad Removal, Chin Implant, Facial Procedures, Male Cosmetic Surgery
He came in with a plan, not a question.
“The patient is a man in his late twenties who came in asking for buccal fat pad removal and improvement in his jawline. He really didn’t come in for recommendations. He had already done a lot of research. He had seen a video about buccal fat removal, how it made the face more triangulated, but he also wanted to have jawline filler and a chin implant to strengthen his lower face contour.”
More of my male patients arrive this way now. Every identifying detail below is removed; no photographs.
What He Asked For
Buccal fat removal, jawline filler, a chin implant. The internet’s recipe for a triangular face.
The Intake Form
What did the intake form show?
“On his pre-op intake form, I saw what I see often on this type of patient. No medical problems, but a long list of supplements, including peptides, peptide stacks, an LED home device, protein powders, and retinoid cream.”
The Exam
What did the exam actually show?
“When I examined him, he was already an attractive fellow. His chin projection was actually in line with the norms, lining up with the mouth and the nose. So he had a normal chin projection for his frame. Mild asymmetry, as expected, between the left and right side of the face and jawline. A slight amount of cheek fullness. And good jawline definition.”
Not the face the video assumed.
| What he asked for | What the exam showed | What we did |
|---|---|---|
| Buccal fat removal | A slight amount of cheek fullness | Buccal fat pad removal |
| Chin implant | Normal chin projection for his frame | Chin augmentation, after the 3D simulation |
| Jawline filler | Mild asymmetry, good jawline definition | Fat transfer to the jawline, for a more permanent result |
The 3D Simulation and the Decision
Were the procedures he wanted wrong for him?
“The procedures he was asking for were not inappropriate. We did a 3D simulation, which did show improvement in his facial balance and contours, which he liked. In the end, he decided on buccal fat pad removal with chin augmentation and fat transfer to the jawline, rather than jawline fillers, for a more permanent result. Of course, we stopped all supplements two weeks before surgery.”
The simulation did the arguing. Fat transfer replaced the filler entirely; the fat grafting versus fillers post and Fat Transfer 101 explain why.
Three Months Out
How is he doing now?
“It’s been three months since his surgery and he is very satisfied. I am surprised he has brought up his upper eyelids and his nose at post-op appointments, and I’ve asked him to wait at least six months to a year to allow this surgery to completely heal and give us a good idea of his facial features.”
What I Took Away
What did this case teach you?
“What I took away from this case is that these patients are very motivated. They have done their research and they understand the procedure they’re going to go through. Sometimes they do have unrealistic expectations. Tools like 3D imaging help the patient visualize what can actually be done and help them decide whether to undergo the procedure. I was happy to see that this patient, unlike many others, was obtaining his peptides and supplements through another doctor’s oversight and through a legitimate pharmacy.”
“Unlike many others.” The peptide monitoring post covers the vial question.
FAQ
Is buccal fat removal right for a young man?
Sometimes. Here the exam showed “a slight amount of cheek fullness.” Without it, removing the pad hollows a face that will hollow on its own with age.
Do you need a chin implant if your chin is normal?
He had “a normal chin projection for his frame” and still chose chin augmentation after the simulation. The simulation, not the video, made that call.
Why fat transfer instead of jawline filler?
In his words, “for a more permanent result.”
Do supplements and peptides have to stop before surgery?
“Of course, we stopped all supplements two weeks before surgery.”
When can a patient plan the next procedure?
“At least six months to a year to allow this surgery to completely heal.”
Why Choose Dr. Agullo
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026. He uses 3D simulation in facial consults so that patients decide with their own face on the screen.
Ready to Talk?
Bring your research. I will bring the exam and the simulation, and we will build the plan together.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
