Dr Lisa Friederich 1300 375 472
Buccal Fat Pad Removal
What are the Buccal Fat Pads?
The buccal fat pads sit in the lower cheek and give fullness in this area. It is part of a larger fat pad extending posteriorly into the jaw and superiorly up towards the temples. In some people, the lower cheek is quite full and rounded which can give the appearance of a chubby face with poorly defined bone structure.
Buccal fat pads can be removed surgically via an incision inside the mouth. This can be performed under local anaesthetic in the office, or under general anaesthetic in hospital. Performed this way, there is no external scar.
It can also be performed as an adjunct to facelift, in which case the fat pad can be accessed via this incision.
As a stand alone procedure it usually takes 45-60 minutes. Local anaesthetic is injected into the proposed incision site and surrounding area. This is a little uncomfortable and much like having a needle at the dentist. After you are numb, the incision site is wiped over with small swab of antiseptic prep.
An incision is made high up and posteriorly on the inside of the cheek, this is carried through the buccinator muscle layer. This is usually performed with a diathermy instrument to decrease bleeding. Once the muscle layer has been breached, the fat pad is accessed and gently teased out. Once the desired amount of fat has been removed the muscle and skin are sutured with dissolvable sutures. You can rinse your mouth out after this has been done to clear any blood in your mouth.
After the procedure
It is normal to have swelling and some pain after the procedure. The swelling will be worst in the first few days, but can take 8-12 weeks to fully resolve.
You may also have some bruising, this will resolve within a few days.
Your cheeks and lips will be numb for an hour or two afterwards, so you should take care with hot drinks and food to prevent burns.
You may take simple pain medication such as paracetamol or panadeine after the procedure, but avoid ibuprofen as this may increase bleeding.
Eat a soft diet for the first couple of days.
You can clean your teeth as normal.
Use Savcol mouthwash after meals.
From 2 weeks after surgery you can begin massage to the site to help scar softening.
The final result of Buccal fat pad removal will take 2-3 months to be seen.
Risks and complications
Infection – is unusual as the mucosa heals very quickly and has an excellent bloody supply. This is more of a risk in those with poor dental hygiene.
Bleeding – a small amount of blood may collect within the resected area, but sometimes a small vessel may continue bleeding and lead to a larger collection of blood. If this occurs, it is advised that your wound is reopened and checked for ongoing bleeding.
Swelling – may resolve asymmetrically, especially if you sleep on one side over the other.
Firmness – in the resected area may occur as the wound heals and makes scar tissue. Massage and time will help this to resolve this.
Over-resection or Under-resection- It is best to avoid taking too much fat out as it can lead to excessive hollowing and may give a prematurely aged appearance.
The results of this procedure are often subtle and you may feel that not enough fat has been resected, however, it is safer to under-resect than over-resect.
Dimpling of the skin- may occur as the wound heals and the scar contracts.