While volume, in general, is associated with youth, some patients are bothered by an overly chubby face, too-full or “chipmunk cheeks.” When weight loss and exercise are not effective, or if excessive cheek fulness results from genetics, these individuals may be well treated by a minor surgical procedure called buccal fat pad reduction.
The human face is composed of multiple fat pads, which are important for support, structure, and our appearance, says our facial plastic surgeon, Dr. Inessa Fishman. The buccal fat pad, also known as the pad of Bichat (after the French anatomist and pathologist Xavier Bichat), is a large structure that extends from the temple all the way to the lower cheek. Some people can have excessive fulness in the lower part of this pad. The lower portion of the buccal fat pad can also “prolapse” or push forward through the facial tissues–almost like a hernia–leading to an undesirable fulness in the lower face. “During buccal fat pad reduction, also known as a bichectomy, I remove a small part of the buccal fat pad to reduce excessive volume in the lower cheek,” says Dr. Fishman, “and for the properly selected patient, this helps remove the cheekiness or too-full lower face appearance.” Buccal fat pad reduction also highlights the cheekbone while creating a flatter or more concave outline to the lower face.”
Because buccal fat is part of the face already, the removed portion of this tissue can also be used for facial fat grafting–or transferring fat back into the facial features that need more volume. Dr. Fishman likes to use the trimmed buccal fat to treat flat cheeks or add a more contoured, highlighted appearance to the cheekbones. “I normally harvest fat from the tummy, flanks, or inner knees,” says Dr. Fishman, “but if I can get healthy, nice fat from the buccal pad, I’m happy to use this as well.” The patient shown is a 29-year-old woman who was bothered by too-full cheeks and a heavy lower face; while she was interested in buccal fat pad reduction, Dr. Fishman also recommended added a bit of volume–using the patient’s own fat–to the upper part of her cheeks and cheekbones. This young woman is shown just 1 day after buccal fat pad reduction and a fat transfer to her upper face (the purple lines on her cheeks are remaining surgical marker used during her procedure), using fat from both her buccal fat pads as well as the lower abdomen. She looks great even at 1 day after treatment; however, her buccal fat pad reduction will result in more pronounced sculpting to her lower face in the next 4-6 months, leading to a more contoured look.
“Part of the beauty of the human face is the intricate interplay between light and shadows, fulness and slight concavity to highlight curves,” says Dr. Fishman. The youthful female face generally tapers from the width of the cheekbones to a heart-shaped or oval facial outline, and too-full lower cheeks can disrupt this ideal outline. “While a buccal fat reduction can help me taper the lower face in a subtle manner, adding volume to the upper cheek–in the right patient–can help me contour the face in a more comprehensive, cohesive, and beautiful way,” Dr. Fishman says.
Curious about buccal fat reduction? Contact us to schedule your consultation today.