Buccal Fat Pad Excision: Hydrodissection Technique

Abstract

Background Buccal fat pad (BFP) excision is a procedure in which the fat pad is extracted in order to achieve a more youthful appearance. Objectives The aim of this study was to describe an alternative technique that utilizes hydrodissection to extract the BFP. Methods This is a controlled, prospective, randomized clinical study involving 2 groups. Group A (n = 27) underwent BFP excision with hydrodissection, during which 15 mL of a vasoconstricting anesthetic solution was injected into the BFP. Group B (n = 27) underwent BFP excision, during which 3 mL of lidocaine 2% with epinephrine was injected. All procedures were performed by the same surgeon. Variables analyzed were surgical time, intraoperative bleeding, and postoperative pain directly following surgery 2 hours after the procedure, as well as maximum pain within 72 hours of surgery and complications. Postoperative care was standardized, and patient follow-up extended over a 6-month period. Results Pain scores for 54 patients were recorded on a visual analog scale (0–10). Mean ± standard deviation transoperative pain scores were 0.5 ± 0.8 for Group A and 1.3 ± 1.3 for Group B (P = 0.01); 2 hours postoperation the scores were 1.2 ± 0.7 for Group A and 2.6 ± 1 for Group B (P < 0.0001). Maximum pain occurred within 72 hours, and scored 1.6 ± 0.6 for Group A and 3.1 ± 1 for Group B (P < 0.0001). Mean operative time was 8:18 ± 0:47 minutes for Group A and 14:08 ± 2:28 minutes for Group B (P < 0.0001). There was a positive correlation between operative time and pain. Overall, 5.5% of patients suffered postoperative complications. Conclusions BFP excision by hydrodissection is an effective procedure that decreases surgical times by facilitating extraction of the BFP with less manipulation, thereby resulting in decreased postoperative pain and a more tolerable recovery. Level of Evidence: 2

Buccal fat pad excision for cheek refinement: A systematic review

“…Finally, 3 case series studies ( 5 , 6 , 33 ) and 1 RCT ( 34 ) met the inclusion criteria and were selected for qualitative and quantitative synthesis (Fig. 1 ).…”

“…The included RCT ( 34 ) was considered to have a high risk of bias, mainly owing to selection and detection bias ( Table 1 ).…”

“…The four studies selected included 121 patients, with an age range of 18 to 60 years old and there were 7 times as many females ( Table 2 ) ( 5 , 6 , 33 , 34 ). Although all the included reports followed an intraoral approach for removing the BFP, the incision was made in two regions: at bite level ( 5 , 33 , 34 ) or at maxillary gingivobuccal sulcus ( 6 ).…”

Early Assessment of Computer-Assisted Malarplasty: A Novel Methodology for Both Reduction and Augmentation

“…By examining and comparing the appearance of person's faces after applying various techniques, it seems that the changes resulting from the use of the technique described in this study will create a more natural appearance than the other methods, which results, obviously, in the satisfaction of most patients in terms of shape, size, and volume. The use of other techniques, such as removing or lift of buccal fat pad, 27,28 can also help the cheeks to look more prominent, but the results are not as satisfactory and predictable as the use of this technique. It should be noted that this article is a preliminary study with limitations such as small group of samples, lack of statistical analyses, and failure to perform long-term follow-up in terms of the quality of the technique results and the degree of satisfaction of patients and surgeons.…”

A Simple Technique to Measure the Volume of Removed Buccal Fat

“…Buccal fat removal is a cosmetic procedure performed to reduce cheek “chubbiness” and create a more sculpted appearance of the face ( Figure 1 ). It is commonly performed transorally via an incision in the buccal mucosa, followed by dissection into the buccal cheek fat and excising an appropriate amount of fat ( Figure 2 ), 1 , 2 or transposing the fat to volumize other craniofacial regions. 3 One ultrasonographic study estimated the volume of buccal fat per cheek to be 11.67 mL and reported that the average amount of fat removed was 2.74 mL.…”