Buccal Fat Pad Removal for Thinner Cheeks: A Case Report (original) (raw)
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International Surgery Journal
Background: Despite the multitude of clinical and aesthetic uses, the correct surgical indications for buccal fat pad (BFP) removal have yet to be fully elucidated. Although the procedure is widely performed and promoted for aesthetic purpose, literature lacks of studies accounting for a proper evaluation of patients undergoing BFP removal.Methods: Between 2012 and 2016 patients seeking an improvement of the malar contour by reduction of the submalar prominence have been visited at the Department of Plastic Surgery of the Institution. A preoperative MRI was requested in order to correctly identify the volume of the BFP and the presence of a masseter muscle (MM) hypertrophy.Results: According to clinical examination and the results of the preoperative imaging, patients were offered different treatment options: patients with BFP hypertrophy underwent BFP removal through an itraoral approach; patients with MM hypertrophy received injection of 50 UI of botulinum toxin (BTX). No complica...
This review of the literature was performed to study the frequency and preference of usage of the buccal fat pad (BFP) in oral and maxillofacial reconstruction and to determine its potential versatility in various clinical applications. A computerized literature search using Medline, the JGate@Helinet database, and the Google internet search engine was performed for all relevant articles with specific keywords from February 2004 to July 2009. Focus was on the use of BFP regarding size, location, and types of defects and success and failure rates for various applications. It was found that BFP has been used most commonly for closure of oroantral communications/fistula, followed by reconstruction of maxillary defects; with closure of primary clefts, coverage of mucosal defects, etc. being other uses. Studies suggested that owing to favorable anatomic location, high vascularity, ease of handling, and low failure rate, the BFP has become the flap of choice for reconstruction of various oral defects. The size limitation of the BFP must be known to permit successful outcome. The results have been encouraging for clinicians to make use of potential benefits of the BFP in closure of defects in the oral and maxillofacial region. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:698-705)
Use of Buccal Fat Pad for Maxillary Defects
The buccal fat was first described by Heister (1732) 1 who believed this to be glandular in nature. Bichat (1802) 2 is credited with recognizing the true fatty nature of the buccal fat. According to Sicher (1965) 3 it is rounded, biconvex structure limited by a thin but distinctive capsule.The buccal pad of fat represents a specialized type of fat termed as syssarcosis, a fat that enhances inter-muscular motion. It lines the masticator space and is intimately associated with the muscles of mastication, facial nerve and parotid duct. The buccal fat pad consists of a main body and four extensions, buccal, pterygoid, superficial and deep temporal. The main body is situated deeply along the posterior maxilla and upper fibers of the buccinator. The buccal extension lies superficially within the cheek and is largely responsible for cheek fullness. The pterygoid extension lies deep to the medial aspect of the mandibular ramus, resting between the ramus and the lateral surfaces of the medial and lateral pterygoid muscles. The buccal extension is the largest segment accounting for 30-40% of the total weight. The body is slightly smaller, representing 25-30% of total weight. The sizes of the pterygoid and deep temporal extension are inconsistent but are usually smaller than either body or buccal extension. The buccal fat in the cheek is enclosed in a fascial envelope derived from massetric fascia.According to Tideman et al (1986) 4 the blood supply to the buccal fat pad is derived specifically from the buccal and deep temporal branches of the maxillary artery, the transverse facial branches of the superficial temporal artery and from small branches of the facial artery. The buccal fat pad can be exposed safely through an intraoral incision. According to Stuzin et al (1990) 5 the incision should be high in the maxillary vestibule, beginning above the second molar, extending posteriorly for 2 cm and is made 5 mm above the attached gingiva of the second molar and extends through mucosa, buccinator muscle to expose the periosteum. According to Lijie F (2002) 6 BFP began epithelializing within 2-4 weeks and was completely epithelialized within 4-6 weeks depending on the size of defects. Present study was undertaken to evaluate the efficacy of pedicled buccal fat pad in closure of oroantral communication / fistula / maxillary defects and to evaluate the advantages of buccal fat pad over Von Rehrmann buccal flap operation for closure of oroantral communication or fistula. Aims and Objectives 1. To evaluate the efficacy of pedicled buccal fat pad in closure of oroantral communication / fistula or maxillary defects. 2. To evaluate the advantages of buccal fat pad over Von Rehrmann Abstract The buccal pad of fat represents a specialized type of fat termed as syssarcosis, a fat that enhances inter-muscular motion. The present study was undertaken to evaluate the efficacy of pedicled buccal fat pad in closure of oroantral communication / fistula / maxillary defects and to evaluate the advantages of buccal fat pad over Von Rehrmann buccal flap operation for closure of oroantral communication / fistula. A minimum of 20 patients with the age ranged between 20 – 70 years (mean age 37.6 yrs) were selected and randomly divided into two groups of 10 patients each. The study concluded that BFP seems to be one of the safest reconstructive methods for small to medium sized intraoral defects. It should also be considered a reliable backup procedure in the event of failure of Von Rehrmann flap.
A review of the gross anatomy, functions, pathology, and clinical uses of the buccal fat pad
Surgical and Radiologic Anatomy, 2010
The buccal fat pad is a trigone-shaped adipose tissue located in the cheek that assumes numerous functional and aesthetic clinical uses. It has been studied extensively within the past four decades, and its use in repairing common and debilitating oral defects is the motive for continued research on this topic. It is vital to understand the etiology of any oral defect or of a lesion of the buccal fat pad, for a misdiagnosis can prevent eVective treatment of the underlying problem. In this review, we describe the embryology and anatomy of the buccal fat and its association with clinical condition and clinical procedures.
Buccal Fat Pad in Reconstruction of Oral Defects
2016
An ablative surgical procedure in the oral cavity is curative for oral and maxillofacial pathologies, but simultaneously produces hard and soft tissue defects. These defects produce functional and psychological problems in the post operative period. The Objective of the present study was to evaluate the efficacy of buccal fat pad in reconstruction of intra-oral defects, elaborate the surgical technique used and also identify its post operative complications A prospective study was conducted on patients with oral defects covered by Buccal fat pad between July 2008 and January 2016 in department of oral and maxillofacial surgery of Khyber College of Dentistry Peshawar. The variables of the study were, Age, gender, cause of surgery and location of intraoral defect. Patients were subsequently evaluated for signs of epithelialisation and Post operative complications. A total of 50 patients (33 males and 17 females) were recruited in the study. Male to female ratio of patients was 1.94: 1...
Aesthetic Surgery Journal, 2006
The author performs buccal fat pad excision to improve facial contour in some patients with buccal lipodystrophy and to treat buccal fat pad pseudoherniation. He recommends an intraoral approach, taking care not to pull on the fat pad and resecting only that which protrudes easily with gentle pressure. (Aesthetic Surg J 2006;26:330-336.)
Buccal Pad Of Fat -The Nature's Gift For Oral Reconstruction Case Report
SciDoc Publishers, 2020
The buccal pad of fat was initially believed to be an anatomic structure without any function, and was even considered to be a surgical nuisance. However with time, the buccal pad of fat has been used for various intraoral reconstructions. The buccal fat pad flap (BFP) is a simple and reliable flap because of its rich blood supply and location. It needs minimal dissection and can be mobilised easily. Good rate of epithelization and low failure rate makes it more favourable for oral reconstruction. The surgical procedure is simple and has shown very good results. Buccal pad of fat can be used for various surgeries like OAF closure, OSMF, Cleft Palate, Palatal Fistula, TMJ Surgery, Closure of small defects, Biological membrane for covering bone grafts. In this study we focused the clinical application of Buccal Pad of Fat in Oral and Maxillofacial Surgery.
Volumetric analysis of the buccal fat pad
European Journal of Plastic Surgery, 1999
There is still insufficient knowledge about the anatomical features of the buccal fat pad as well as its behavior in various clinical conditions. The aim of this study was to elucidate some of the anatomical features of the buccal fat pad using volumetric analysis. The volumes of the buccal fat pads were measured bilaterally in 106 individuals based on their 3-D CT scan images. There were five study groups. Twenty-eight individuals of various age groups were the controls while patients with congenital unilateral cleft (n=39), facial trauma (n=25), temporomandibular joint disease (n=7) and fibrous dysplasia (n=7) formed the groups with pathological conditions. Assessment of volume differences was performed between each side of the same individual, between males and females, and between the various age groups. Comparison of the pathologies with controls was done when necessary. The volume did not significantly differ between both sides of the same individual both in the control group, in the unilateral cleft group and in the fibrous dysplasia group (pb0.05), and between male and female, whereas significant differences appeared between the volumes of the both sides in trauma patients. The general volume of the buccal fat pad appeared to increase with growth. It appeared from this study that the buccal fat pad can be affected by clinical conditions and this fact should be kept in mind when planning its surgical use.