The buccal fat pad which is also called Bichet’s fat pad frequently causes fullness in the lower face and can be a cause of what some patients describe as chubby cheeks or a fat face.
What is a Buccal Fat Pad Removal?
Buccal fat pads weight between 7 and 8 grams on each side. I usually weigh both sides to ensure symmetry.
The fat pad is present deep in the muscles that are used in chewing. It provides a surface for the gliding motion of these muscles The central portion or buccal limb is frequently removed to thin out the lower face. This is usually done with an incision made in the mouth. The incision is made through the mucosa next to the upper first two molars. The fat pad is gently teased out. Important structures like the facial nerve and parotid gland lie in close proximity to the buccal extension. Care must be taken not to injure these structures.
The ideal youthful face has an inverted triangular shape. An enlarged buccal fat pad produces fullness in the lower face anterior and superior to the angle of the mandible. Removing the buccal fat pad will sculpt the lower face to produce a leaner look that appears more like the inverted triangle of youth.
Techniques We Perform
Sometimes a combination of procedures are needed to sculpt the lower face. Enlarged masseter muscles will also make the face look square due to the enlarged mass. I wrote previously about injecting the masseter with neurotoxins like Botox, Dysport and Xeomin to atrophy the muscle mass and create a more oval shaped face.
Buccal fat pad extraction by itself or in combination with other procedures will sculpt the lower face and produce a more youthful leaner oval face that resembles the inverted triangle of youth.
The patient shown had both buccal fat pads removed and she also had a lower face lift. She was thrilled with the results. She is shown a month after her procedures.