External approach to buccal fat excision in facelift. Buccal fat pad removal is a minor procedure, and the surgical technique is considered simple and safe if performed by trained and experienced professionals. Fullness is evident lateral to the jowl in small percentage due to prominent buccal fat pad. Often, their parents have the same facial configuration even in their 60s and 70s. When properly dissected and mobilized, the buccal fat pad can provide 7x4x3 cm graft.
It is the buccal extension and main body that are removed intraorally to achieve midfacial contouring. Anatomical structure of the buccal fat pad and its clinical adaptations. The buccal fat pad removal surgery is a vital step in the overall facial rejuvenation process. Buccal fat pad flap bfp has been used for the reconstruction of maxillary defects induced by tumor since it was first reported in 1977. The use of buccal fat pad for oroantralcommunication. The buccal fat pad is a distinct fat pad of face, and it is a separate fat pad from the jowl fat pad in the lower face and the malar fat pad in the midface below the eyes.
The periocular fat was clearly separated from the upper extension of the buccal fat pad by the sheet. For more information or to schedule a consultation, contact goals plastic surgery today. The inferior portion of the buccal fat pad is contained within the buccal space. Buccal mucosa graft for urethral reconstruction return to. This highlights the upper cheek for a more sculpted or chiseled facial appearance. Anatomy of the buccal fat pad and its clinical significance. Ridgway will carefully analyze your anatomy and facial features and discuss the results you hope to. Buccal fat pad removal must be weighed against the possibility of hollowness later on, of course. The buccal fat pad flap for periorbital reconstruction. The superior temporal extensions of the buccal fat are divided into the deep and superficial subdivisions with. Bichat 1802 2 is credited with recognizing the true fatty nature of the buccal fat.
The buccal fat pad appears at 3 months in utero and continuously grows. The buccal fat pad bichats fat pad has a complex relationship to the facial structures. The buccal fat pad flap bfp is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various. The use of buccal fat pad for oroantralcommunication closure. The buccal space, also known as the buccinator space, is one of the seven suprahyoid deep compartments of the head and neck gross anatomy the buccal spaces are paired fat containing spaces on each side of the face forming cheeks. Applications of the buccal fat pad in oral and maxillofacial. This pad, being a mass of particular fat tissue and distinct with hype fat, has the role in facilitating inter muscular movement of body for adults. The buccal fat pad bfp flap is an important reconstructive option in oral and maxillofacial surgery. Egyedi 3 was the first to report use of buccal fat pad bfp in oral reconstruction for the closure of oroantral and oronasal communications and tiedman 4.
The buccal fat pad is an anatomically complex structure that has great importance in facial contour. Buccal fat pad excision is also performed in patients who are properly diagnosed with a cheek mass because of. The defects in the oral cavity have a profound effect on esthetics, functional and psychological well being of the patient. In the past few years there have been a growing number of procedures for the removal of bichats buccal fat pad, also called cheek reduction surgery. Failure to recognise that it was buccal fat may have led to further mobilisation into the orbit and would have hindered repair of the orbital floor. Buccal fat removal is a quick, simple procedure that. The use of buccal fat pad for oroantralcommunication closure afshin harajia, reza zareb introduction.
The buccal mucosa is bordered vertically by the maxillary and mandibular vestibular folds, whereas its anterior and posterior borders are formed by the outer commissure of the lips and the. The buccal fat pad, is one of several encapsulated fat masses in the cheek. Ideas and innovations the buccal fat pad flap for periorbital. In this chapter, different aspects of the bfp such as its applications, anatomy, physiology, and complications are explained. Bichat fat pad is a fatty anatomical structure with body and numerous process enclosed between the bony and muscular structures in temporal, pterygopalatine fossae and extents to the cheek area. It is also important to note that the size of the buccal fat pads can vary on each side of the cheeks, even in the same patient. Its abundant vascularization, coming largely from the depth of the pterigomaxillary region, allows to transpose it with high reliability to fill posterior and lateral defects of the upper jaw. The anterior portion of the buccal fat pad extends anterior to the parotid duct and the facial vein. The use of the buccal fat pad for reconstruction of oral. Buccal fat is located in the midface and can contribute to the look of full or chubby cheeks, which many patients want corrected. Egyedi6 first reported its use as a pedicle graft and its embryology, vascularization, volume and function being. Use of the buccal fat pad as a pedicled graft sciencedirect. It can be done under light sedation or straight local anesthesia.
The buccal fat pad is composed of a main body and four extensions temporal, buccal, pterygoid, and pterygopalatine oroantral fistula treated by bfp surgical procedure for the buccal fat pad flap. Sechenovs first moscow state medical university, moscow, russia robert. Fat in this area can give the appearance of youth, but can also give a convex contour that is unwanted. Buccal fat removal decreases fullness in the lower cheek through removal of the fat pads from between the muscle plains in the cheeks.
This procedure specifically addresses fullness in the lower cheeks, or what some refer to as chipmunk cheeks, chubby cheeks or a baby face. Buccal fat removal is a facial plastic surgery procedure which can produce a slimmer, more sculpted contour to the face. It is a deep fat pad located on either side of the face between the buccinator muscle and several more superficial muscles. Buccal fat pad definition of buccal fat pad by medical. Everybodys anatomy is unique and requires an individualised approach. Each space is enveloped by the superficial investing layer of the deep cervical fascia it is located between the buccinator and platysma muscles, therefore it is. An intraoral approach for buccal fat harvesting is described based on these anatomic findings. The size of buccal fat pads vary in each individual patient. Versatility of the buccal fat pad flap italian journal of. Slupchynskyj carefully removes these fat deposits to create beautiful, sculpted cheeks. The purpose of this case report was to demonstrate the procedure of bichats buccal fat pad, due to the frequent habit of biting the oral mucosa by the patient. The buccal fat pad is composed of several parts, although exactly how many parts seems to be a point of disagreement and no single consistent nomenclature of these parts has been observed. Case example of buccal fat flap palate reconstruction anatomy of the buccal mucosa.
The author performs buccal fat pad excision to improve facial contour in some patients with buccal lipodystrophy and to treat buccal fat pad. Buccal fat is distinct from the cheek bone fat pad, which gives the face a more defined look. The buccal fat pad flap bfp is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects. Buccal fat pad, bichat s fat pad, oral defects, oral defects reconstruction, maxillectomy defects. T the use of buccal fat pad for oroantralcommunication closure afshin harajia, reza zareb introduction. The buccal mucosa is bordered vertically by the maxillary and mandibular vestibular folds, whereas its anterior and posterior borders are formed by the outer commissure of the lips and the anterior. Nowadays, the most reported application of the bfp is the closure of oroantral communications. Managing the buccal fat pad aesthetic surgery journal. To our knowledge this is the first reported case of abnormal anatomy of the inferior orbital fissure with herniation of the buccal fat pad. It should not be confused with the malar fat pad, which is directly below the skin of the cheek. Selected in a proper way, its sufficient removal can create many changes in the face. Our seattle buccal fat removal is generally performed as an outpatient procedure, which takes approximately one hour to perform. Buccal fat pad removal is an excellent way of reducing the chipmunk cheek appearance that plagues patients.
Application of buccal fat pad to improve aesthetic counter facial buccal fat pad bfp in terms of anatomy has a complicated structure which is of great importance in creation of counter facial. Excess buccal fat, on the other hand, can give the face a. Pdf gross anatomical, ct and mri analyses of the buccal fat pad. The buccal fat pad bfp has become more and more popular in oral and maxillofacial surgery. The use of the buccal fat pad flap for oral reconstruction. The buccal fat was first described by heister 1732 1 who believed this to be glandular in nature.
Buccal mucosa and masticator space anatomy iowa head and. Five of the patients underwent primary closure with bfp and 8 patients were treated with bfp after an. It is particularly prominent in infants and is often called a sucking pad. Dubin b1, jackson it, halim a, triplett ww, ferreira m. The aim of our study is the revision of the anatomy of buccal fat pad and its role in a volumetric pattern of face. Buccal fat pad removal buccal lipectomy beverly hills. The anatomy and clinical applications of the buccal fat pad.
Oct 16, 2018 buccal fat pad excision is offered as a means of obtaining a more aesthetic midface. The anatomy and clinical applications of the buccal fat. Utilization of the buccal fat pad for closure of oroantral andor oronasal communications. Applications of the buccal fat pad in oral and maxillofacial surgery. Pdf the use of the buccal fat pad flap for oral reconstruction. It is generally used to reduce chubby cheeks chipmunk cheeks that can be due to genetics or weight gain. Case reports case 1 a 74yearold man presented with metastatic melanoma. Nov 25, 2009 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 effective treatment of the underlying problem. Jul 02, 20 the buccal fat pad is composed of several parts, although exactly how many parts seems to be a point of disagreement and no single consistent nomenclature of these parts has been observed. Interest in the anatomy of the buccal fat pad was aroused by two clinical cases where the fat pad was involved by pathology. From then, many clinical applications of bfp have been introduced.
It is a deep fat pad located on either side of the face between the buccinator muscle and several more superficial muscles including the masseter, the zygomaticus major, and the zygomaticus minor. Ask our nyc and nj facial specialist about fat removal. The use of the buccal fat pad flap for oral reconstruction ncbi. Buccal fat pad adjacent to a posterior buccal defect the gingival mucosa overlies the alveolus. Buccal fat pad removal, also known as cheek fat removal or buccal lipectomy, is a surgery that removes excess fat pads from the cheeks to create a more contoured facial appearance. Buccal fat pad removal is a surgical procedure to remove the naturallyoccurring pad of fat in the hollow area of the cheeks. Abnormal anatomy of inferior orbital fissure and herniation. This report compares the use of a buccal fat pad bfp to oroantralfistula oaf closure. The buccal fat pad is fixed by six ligaments to the maxilla, posterior zygoma, and inner and outer rim of the infraorbital fissure, temporalis tendon, or buccinator. Buccal fat pad excision is offered as a means of obtaining a more aesthetic midface.
Dieting is not best way to decrease buccal fat volume, but dieting does help with reducing generalize facial fat volume. Pdf the use of the buccal fat pad bfp has increased in popularity in recent years because of its reliability, ease of harvest, and low complication. Pdf use of buccal fat pad for maxillary defects dr. Originally, it was described as an anatomic structure without any obvious function. To examine the anatomy of the buccal fat pad, triangulate the prominent bfp with surgical landmarks, and describe an external approach to excise the bfp during facelift surgery.
Clinical experience manipulating the buccal fat pad for aesthetic modification of facial contour is illustrated. Can you lose fat in the buccal fat pad by losing weight. The buccal fat pad appears 3 months in utero and continuously grows. Miller buccal fat excision surgery new york, ny youtube. A communication between the prestyloid fat and the buccal fat pad likely occurred through a potential space along the lingual nerve immediately superior to the deep part of the submandibular gland. It is often encountered as it bulges into the surgical field during surgery in the pterygomandibular region.
Buccal fat pad has a normal weight and mass even in cases such as cachexia or lowhype fat 1. This procedure has been documented in the form of countless videos on instagram and other social media platforms with no longterm patient followup. Bfp was used as a pedicle graft to oaf closure in patients. Buccal fat pad removal is a way to remove a fat pad around the cheeks through an incision inside the mouth. In this simple procedure, patients can expect a much thinner, streamlined, more wellcontoured face and overall face shape. Buccal fat removal surgery london greg bran gb aesthetics. Objectives to examine the anatomy of the buccal fat pad, triangulate the prominent bfp with surgical landmarks, and describe an external approach to excise the bfp during facelift surgery. Bichats buccal fat pad may be used as part of the therapeutic procedure in cases of oroantral communication, periorbital defects, congenital cleft palate, and plastic surgery of facial recontouring. A cadaver dissection and report of two cases luther h. In properly selected individuals, judicious harvesting of buccal fat can produce dramatic changes in facial appearance by reducing the fullness of the cheek and highlighting the malar eminences. Heister first described the buccal fat pad anatomy in 17321, and bichat2 verified its fatty histology in 1801, and there have been many authors 35who have studied its features. Philip miller performs a buccal fat excision or fat pad removal on a woman in new york. The buccal fat pad also called bichats fat pad, after xavier bichat, and the buccal pad of fat, is one of several encapsulated fat masses in the cheek. Managing the buccal fat pad aesthetic surgery journal oxford.
It has 4 parts divided by the parotid duct and facial nerve and vein into anterior and posterior portions figure 2. The bfp is divided into 3 lobes anterior, intermediate, and posterior. According to sicher 1965 3 it is rounded, biconvex structure. The buccal fat pad flap is an axial flap and may be used to fill smalltomedium sized soft tissue and bony defects in the palate, superior and inferior alveoli and buccal. 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 effective treatment of the underlying problem. This is something that will be taken into consideration should it be applicable. Adults with a capacious midface who desire refinement, sculpting, or enhancement of their skeletal features, and reduction of facial fullness by diminishing midface volume, are potential candidates for excision of the buccal fat pad. Buccal fat removal seattle best plastic surgeon bellevue.
The buccal fat pad is compo sed of a main body and four extensions temporal, buccal, pterygoid, and pterygopalatine kim et al. The buccal fat pad bfp is located anterior to the masseter muscle and deep to the buccinator muscle. The buccal fat pad lies in the masticatory space between the buccinator muscle medially and the masseter muscle laterally, and it is wrapped within a thin fascial envelope. Buccal mucosa and masticator space anatomy return to. Buccal fat pads pronounced buckle are pads of fat resulting from a familial predisposition, giving excessive fullness to the lower part of the cheeks, often resulting in a chubby cheek or chipmunk cheek appearance. Abstract the aim of our study is the revision of the anatomy of buccal fat pad and its role in a volumetric pattern of face. The buccal fat pad bichats fat pad, buccal pad of fat, is one of several encapsulated fat masses in the cheek.
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