Buccal Fat Pad Reduction

Buccal fat pad reduction, or Bichat’s fat pad, is a common cosmetic facial surgery procedure that is performed to slim the cheeks or face.

The buccal fat pads, walnut sized fat deposits, are located in the cheeks between the nostril and corner of the mouth. Their function is to assist nursing in infants or to provide a smooth gliding plane for the jaw muscles. It is the large buccal fat pads that give infants and young children the cheeks that grandma likes to pinch.

Some patients have a very full and round face, in part from large buccal fat pads. The buccal fat pad is a large unit with mass in the temple region, the cheek region and the pterygoid region (back of the upper jaw). There is no indication to remove the entire buccal fat pad and it is the cheek region that is most frequently reduced.

Most commonly, patients requesting buccal fat reduction have chubby cheeks in relation to the rest of their face and body. It is frequently hereditary. Liposuction of the buccal fat pads can be done, but is not recommended since the pads have heavy fibrous capsules that do not lend themselves to common liposuction. More importantly, facial nerve branches, the anterior facial vein and parotid duct are frequently in close approximation to these fat pads and could be injured producing facial paralysis or severe bleeding. This is not the area for imprecise technique or using a surgeon without extensive experience.

The fat is located by making several small incisions on the inside of the cheek. The buccal extension of the fat pad is identified which is generally very plentiful and protrudes into the mouth. The amount of fat to be removed is determined and the fat pad is removed using a laser or radiowave device. This is important as it seals the blood vessels and prevents bleeding which can be problematic in that area.

Recovery generally takes three to five days and some patients experience swelling while others don’t. Although the result is immediately noticeable, the final result won’t be evident for several weeks when all swelling has stopped. This procedure will produce a slimming of the cheeks in the area lateral to the nostril and corner of the mouth. In some patients it is a very noticeable change and in others, minimal. While most patients are very happy with the results, some patients wish the results were more dramatic. Again, this is a procedure that demands some level of surgical conservatism as over correction can produce a very hollowed and unhealthy look.

The procedure takes about twenty minutes per side and is performed with IV anesthesia. This procedure may be performed with other cosmetic facial procedures such as facial implants, liposuction, or facelift surgery.

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