Aesthetic Values of the Buccal Fat Pad Excision in Middle-Aged Patients

BACKGROUND: Despite buccal fat pad (BFP) excision being an effective and established surgery for the reduction of lower facial volume, there are very few reports explaining a systematic and reliable method for this surgery. The author will demonstrate one method for BFP excision surgery with some important tips and information on the procedure. OBJECTIVES: The author performed BFP excision surgery for patients seeking facial slimming or improvement of the ptotic lower face. To know the true efficacy of this surgery, objective facial scales were compared preoperatively and postoperatively. METHODS: Preoperative and postoperative three-dimensional (3D) pictures were taken, and numerical data for cheek volume and horizontal lower facial length were obtained from 3D picture analysis. The data were statistically analyzed to reveal postoperative improvements. RESULTS: The average age of the patients was 54.23 ± 10.31 years old. BFP excision surgery took 60.30 ± 5.93 minutes. Preoperative and 12 months postoperative body weight was 52.3 ± 6.84 and 52.3 ± 6.75 kg, respectively. The average weights for excised BFP were 1.74 ± 0.72 g right and 1.59 ± 0.71 g left. The average of preoperative lower facial volumes was 209.36 ± 30.22 mL right and 209.03 ± 30.13 mL left. The average 12 months postoperative lower facial volumes were 205.00 ± 30.37 mL right and 204.43 ± 30.02 mL left. The results showed a significant difference in both sides (P < 0.01). The average of horizontal lower facial lengths was 238.73 ± 10.87 mm preoperatively and 235.06 ± 10.57 mm 12 months postoperatively. The results affirm that there is a significant difference (P < 0.01). CONCLUSIONS: A properly executed BFP excision can achieve distinct facial slimming for the capacious face and can also contribute to improving lower face sagging due to BFP ptosis in middle-aged patients. LEVEL OF EVIDENCE: 4: [Image: see text]