Buccal Fat Pad ExtractionMy experience at the Aesthetic Laser Center

The buccal fat pad which is also called Bichet’s fat pad frequently causes fullness in the lower face and is a cause of what some patients describe as chubby cheeks or a fat face. It is present deep in the muscles used in chewing. It provides a surface for the gliding motion of muscles of mastication. The central portion and buccal limb is fre-quently removed to thin out the lower face. This is usually removed through an incision made in the mouth. The incision is made through the mucosa next to the first two mo-lars. The fat pad is gently teased out. Important structures like the facial nerve and pa-rotid gland lie in close proximity to the buccal extension. Care must be taken not to in-jure these structures. Most buccal fat pads weigh between 7 and 8 grams. I usually weight both sides to en-sure symmetry. The ideal of youth is an inverted triangular shape to the face. An enlarged buccal fat pad produces fullness in the lower face anterior to the angle of the mandible. Some-times removing the buccal fat pad is all that is needed to achieve that ideal leaner look with an inverted triangle of youth. Sometimes a combination of procedures are needed to sculpt the lower face and make it look leaner. Enlarged masseter muscles will also make the face appear square due to the enlarged mass. I wrote previously about in-jecting the masseter muscle with neurotoxins like Botox, Dysport or Xeomin to atrophy the muscle mass and create more of an 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 closer resembles the in-

verted triangle of youth

After Buccal fat pad extraction. No-tice thinning of lower cheeks.

Before.

Before. After buccal fat pad extraction.

Before. After Buccal fat pad extraction.