Buccal Fat Pad-Bichet’s Fat Pad Extraction

Buccal Fat Pad Extraction

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.

GC b & a

The fat pad is present deep in the muscles that are B used in chewing. B 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. B This is usually done with an incision made in the mouth. B The incision is made through the mucosa next to the upper first two molars. B The fat pad is gently teased out. B Important structures like the facial nerve and parotid gland lie in close proximity to the buccal extension. B Care must be taken not to injure these structures.

Buccal fat pads weight between 7 and 8 grams on each side. B I B usually weigh both sides to ensure symmetry.

The ideal youthful face has an inverted triangular shape. B An enlarged buccal fat pad produces fullness in the lower face anterior and superior to the angle of the mandible. B Removing the buccal fat pad will sculpt B the lower face to produce a leaner look that appears more like the inverted triangle of youth.

Sometimes a combination of procedures are needed to sculpt the lower face. B Enlarged masseter muscles will also make the face look square due to the enlarged mass. B 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. B She was thrilled with the results. B She is shown a month after her procedures.

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