Complications of buccal fat pad removal?

Question

I'm a 34 year old female considering a buccal fat removal surgery as my face is rather round and would like better definition. I read one review of a patient who had the procedure done reporting a complication of nerve damage. Is this a strong possibility even with an experienced facial plastic surgeon? If so, can it eventually reverse? Also, what other complications are possible with this procedure? Thanks!

Omar Lazos, MD · Answer

When a patient has a full and round face and despite weight loss the 
fullness persist or if the patient is in his normal weight and the 
chipmunk faces has stayed all the time, a bichectomy or buccal fat pad 
removal is useful. It´s true that with aging the buccal fat pad tends to diminish in volume do to 
atrophy, but if the volume is excessive a bichectomy will not hollow the
 cheek overtime. Many patients are happy with the results, a proper 
selection is a very important manner. Usually the procedure takes less 
than 10 min and you can go homethe same day. You'll be able to go back 
to work on the 3rd day post-op but 1 week off would be more comfortable.
 Combining this with chin lipo has a very powerful result. This will 
improve your jawline making it look masculine and chiseled.
Risks and complications: bleeding, bruising, hematoma, swelling, salivary duct damage, facial nerve damage (rarely) and infection.

John Mesa, MD · Answer

Severe complications psot buccal fat removal are usually minimal. The more experienced the surgeon, the less the risk.Also the risk could be minimized depending where the incisions for the surgery are placed. the safest one is the high gingivobuccal incision. The other incision placed in the middle of the cheek mucosa theroretically could have increased risk of complications due to its proximity to the nerves of the face.

Edward J. Gross, MD · Answer

I have yet to see any complications or nerve-related problems with BF removal. However, the buccal branch of the facial nerve is in general, not close, proximity. The only other structure in the area is the parotid salivary duct or Stenson's duct, which is well anterior to the incision site. We mark the duct with a purple marker prior to the incision, to avoid any inadvertent injury. Buccal Fat Removal is a safe, reliable, and rewarding procedure when performed by a specialist.

Jonathan Kulbersh, MD · Answer

If you're a candidate, buccal fat removal can give you great results. Buccal fat excision is an appropriate surgical procedure for patients that of overly full and wide cheek areas. In common terms, it is good for patients who have chipmunk cheeks. Liposuction can be used to further slim the face. You are a patient that would need an in person consultation for a complete evaluation and explanation of the positives and negatives of these procedures in your situation.
I hope this helps.

Miguel Mascaro, MD · Answer

Great question.  This is something that you should discuss in detail with your surgeon during consultation.  To be honest, nerve injury is rare during buccal fat excision, as is injury to the parotid duct.  That being said, inexperience with the anatomy can make injury much more likely to occur.  An experienced facial plastic surgeon should have no qualms talking to you about your ability to have this procedure done as well as what limitations they foresee.  Injury to the nerve and duct vary, and while permanent injury is possible, it is extremely unlikely.  Injury and complication rate usually varies but it is less than 1%.  I hope some of this helps! Best of luck!

Kapil Saigal, MD, FACS · Answer

This is a very safe procedure and can be performed under local anesthesia, but like all procedures has a small risk of bleeding, infection, pain, and the remote possibility of facial nerve weakness. Scarring is invisible because the incision is introral, but the salivary duct is in proximity of the incision so your surgeon should point this out to you. However, choose a qualified specialist and you will do great! Best of luck!

Complications of buccal fat pad removal?

Answers (6)

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