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What is Buccal Fat Pad Excision?

Buccal fat pad excision is a type of facial plastic surgery. During the surgery, the buccal pads are removed. Once removed, your cheeks will be more slender and a more defined facial contour will remain. The surgery is permanent and the return or re-growth of the buccal fat pads even with weight gain are very unlikely. However, buccal fat pad excision is not for every face, so a consultation to understand your goals and an assessment of facial shape, size and the integrity of the skin are important for your surgeon.

The Treatment

Surgery is performed under local anesthetic so you won’t feel any pain, but you will be awake during the procedure. A small incision is made on the inside of the cheek. Pressure will be applied to the outside of the cheek further exposing the buccal fat pad in view inside the cheek. The surgeon will remove the buccal fat by cutting it out and dissolvable stitches will be placed for you. In the immediate days to follow, you will be recommended a special mouthwash to protect the incisions from any infection. A liquid diet will be advised for several days before returning to soft foods. Bruising and swelling are normal and may occur. A full recovery takes approximately 3 weeks

What is the buccal fat pad?

The Buccal (pronounced ‘buckle’) fat pad is a naturally occurring area of fat in the middle of the cheek. The fat pads are supposed to be there and act as a cushion for the teeth and jaw. They also store baby fat in the cheeks and contribute to the “chubby baby face” we see in young children. Typically, with the onset of puberty, these fat pads become smaller. In some patients, these fat pads persist into adulthood.

What is buccal fat pad excision?

- Buccal fat pad excision is a surgical procedure in which a small incision is made inside the mouth, on the cheek, and the buccal fat pad dissected free and mostly removed. The incision is closed with a few dissolving stitches.n - The surgery reduces the “chubbiness” of the cheeks and any convex appearance of the outer cheek. Occasionally, the inside of the cheek also has a convex appearance and this is improved with the surgery.n - The surgery also brings out the natural appearance of the cheekbones and helps define the jaw.

Who is a good candidate for buccal fat pad excision?

Anyone who feels they have chubby cheeks or a “baby face” could be a good candidate for buccal fat pad excision. Patients with a convex appearance of the cheek typically see the most significant improvement in facial contour.

What is involved in the consultation?

The consultation begins by talking about a patient’s goals and reviewing medical history. Once it is confirmed that these goals can be achieved by buccal fat pad excision, the cheeks and the inside of the mouth are examined. Following this, surgery and recovery are discussed. Photographs are taken.

What should you expect post-surgery?

Patients see an immediate improvement in facial contour. Post-surgery, there is a small amount of discomfort experienced by patients. Over-the-counter and prescription pain medications are usually more than enough to manage this. There will be a some swelling and inflammation in the cheeks and around the incision. There may be a small amount of bruising. Over the course of the next several weeks, the post-operative swelling slowly comes down and final results are seen around the 3-6 month mark.

How is the surgery done?

The surgery is done in an operating room. Patients can elect to have general anesthesia (going to sleep) or can have local anesthesia with, or without, sedation. A small incision is made on the inside of the cheek, inside the mouth, and deepened to the level of the buccal fat. The fat is carefully dissected out and removed. The incision is then closed with dissolving stitches.

What kind of anesthesia is used?

Anesthesia can be general (going to sleep) or with local anesthesia with, or without, sedation, depending on patient preference.

What kind of stitches are used?

Stitches are dissolving.

How quickly are results seen?

Initial results are seen immediately post-surgery. There is some swelling immediately post-surgery that reduces over the next several weeks while results continue to improve. Final results are usually seen by about the 3-6 month mark.

What is the recovery time?

The recovery from surgery takes about 7-10 days. Results are seen immediately, but continue to improve over the next 3-6 months as swelling and inflammation decreases.

Are results permanent?

The results are permanent. The buccal fat pad does not regrow. If patients gain a significant amount of weight in the face, the results of the surgery may no longer be as apparent as they once were. Return of weight to what it was around the time of surgery usually remedies this.

What can I eat after surgery?

Generally, crunchy, or very chewy foods are not advisable for a couple of weeks post-surgery. Food does not need to puréed in a blender prior to eating, but the food should not contain anything that could be sharp and poke the incision. Overly acidic foods are also not advisable during this time. Multiple times per day, especially after eating or drinking anything, an alcohol-based mouthwash should be used to rinse the mouth. If possible, sleeping with you head elevated is helpful.

What are the benefits of buccal fat pad excision?

Buccal fat pad excision has multiple benefits including: improved facial contours; increased self-confidence; enhanced facial appearance and facial contours; and a rejuvenated facial shape. The procedure results in a permanent improvement and there are no external scars.

What are the risks of buccal fat pad excision?

When performed by an experienced surgeon, the risks of this procedure are low. Dr. Chitte will have a complete discussion with you regarding the risks of this procedure. Risks of buccal fat pad excision include: bleeding; infection; fluid or blood accumulation; salivary duct or gland injury; numbness and facial nerve injury; and asymmetric facial appearance. There is a small chance that you will not be happy with the results.

Can you get rid of buccal fat with diet and exercise?

The presence of buccal fat in adulthood can usually be caused by two factors: overall weight and genetics. For those patients who have higher body mass, weight loss may help the appearance of the buccal fat pads a small amount. For those patients who have a genetic cause for their buccal fat, diet and exercise does not change the appearance of the buccal fat. Typically, excision of the buccal fat gives the most predictable, effective results.

What should I do before surgery?

In the pre-operative discussion, Dr. Chitte and his team will go over all the information that you will need to know. This will include information regarding any pre-operative medications required, avoiding alcohol and tobacco, post-operative instructions and follow up appointments.

How much does buccal fat pad excision cost?

The cost of any procedure depends on many factors including the surgeon completing the procedure, where it is performed as well as other factors. Dr. Chitte will discuss these with you at your consultation.

Dr. MacIsaac was kind, patient and extremely trustworthy. She answered all questions, and was very transparent and made me feel quite comfortable. -Geraldine K.

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