I am a child of the ’80s, when heroin chic was in. All those chiseled hollow cheeked models were the thing. At the time, many plastic surgeons were creating this look by removing the cheek fat pad, called the buccal fat.
And then these women got older. And they looked terrible.
Fast forward to today, the current modern facial thinking is to ADD fat. I do tons of fat transfer to the face. We know you lose tons of facial fat as you age, which is part of why everything droops. This is why we do soft tissue fillers like Juvederm and Restylane, fat transfer, Sculptra, and others. So are people still removing buccal fat? Did they not get the memo?
Aesthetic Surgery Journal June 2019 “The Excision of the Buccal Fat Pad for Cheek Refinement: Volumetric Considerations.” This was a study which tried to add science to the fat volume in the buccal fat pad. These were patients who complained their faces were too full.
- They evaluated the patients to see if they were good candidates.
- Eligible patients had an ultrasound to determine tissue volume
- Follow ups were done at 6 months
- Findings:
- ultrasound showed the mean preop volume of the fat pads were 11.67ml
- The mean postop volume was 8.58 ml
- The mean amount removed was 2.75ml
- Conclusions?
- It is an effective technique to refine the facial shape. It should be reserved for patients who have too much buccal fat volume, and only remove the excessive portion of the fat pad.
- They acknowledge it is difficult to restore midface volume once aging starts to happen.
My thoughts?
I thought it was a thoughtful approach. There are a few patients who truly have too much volume there. I liked how they tried to quantitate numbers. The average removal is 3cc, which is tiny.
When removing any fat in the face, you have to always remember about the changes coming down the road. It is challenging to get fat back into the face. Removing what is there already should be done very carefully and conservatively.