Buccal fat pad sculpting and removal (BFPS) can create narrowing of the lower 1/3rd of the face by selective removal and reduction of soft tissue volume. Three-dimensional (3D) imaging allows for quantitative and objective assessment of volume changes over traditional 2-dimensional photographs that has not been previously studied in BFPS. A prospective study was designed in consecutive subjects undergoing BFPS from April 2018 through March 2020. Only those patients that underwent solely BFPS were included. Vectra^XT 3D imaging and software was used to compare preoperative and postoperative volume changes. Fifteen patients were enrolled in the study with 2 males and 13 females. The mean length of follow up was 7.7 months (range: 1-21 months). All patients were found to have volume reduction in the area evaluated. The mean volume reduction of the selected mid-lower face in the frontal view was 7.2 mL on the left side and 7.5 mL on the right side. There was no statistical difference between the volume change when the 2 sides were compared (P= 0.82). This study demonstrate the use of 3D photography to objectively and quantitatively assess volume change following BFPS and that the volume removed is significant enough to demonstrate favorable results using 3D imaging. Buccal fat pad sculpting is a safe and reliable option for creating a narrowed lower one-third of the face. This is accomplished by selective fat removal and cautery induced reduction of the lower one-third of the face soft tissue volume. Vectra^XT 3D imaging and analysis is a powerful tool to objectively and quantitatively assess volume changes in BFPS.