Question about buccal fat removal, above/below parotid duct - what is the safest option?

The safest option for buccal fat removal doesn’t depend on the location of the incision (whether it is above or below the parotid duct). The safest option is the technique used by a very experienced and ideally specialist buccal fat removal board-certified plastic surgeon.

In my practice, I perform the technique both above and below the parotid duct, depending on the goal and the patient’s anatomy. For example, if the parotid duct is too high in the mouth, it is safer to make the incision below it. However, if the parotid duct is too low, it is safer to go above it. No one incision fits all.

I hope this answers your question.

John Mesa, MD
Buccal Fat Removal Specialist
New York - New Jersey - Miami

The buccal fat can be removed through either approach. I like to identify the duct and make sure the incision is below it. This allows me to access the buccal fat as directly as possible with concern about encountering the duct.

However, some surgeons make an incision higher up and access the buccal fat pocket from above.

Either technique will work as long as the surgeon is comfortable with their preferred technique and is experienced.