Pseudoherniation of the Buccal Fat Pad from Botox Injection, is a Unilateral Buccal Lipectomy an Option?

I am suffering from a non-traumatic pseudoherniation of the Buccal fat pad in my left cheek. It was caused by an incorrectly placed botox injection to my buccinator muscle. Please don't tell me that if it's caused by Botox, then it's not permanent. That is not true. I'd like to know how a doctor might suture the fat back into place, as I don't want a unilateral Buccal lipectomy. Has anyone performed this operation?

Doctor Answers 5

Botox cheeks bulge

Dear NYCkitten in Manhattan, Pseudo herniation is by definition a FALSE herniation: there is nothing wrong with the fat pad! The weak buccinator will regain its normal strength within several weeks, & the bulge that u are noticing of the cheek will disappear. I strongly advise you against surgery, of any kind. Just be patient.; all will be back to normal.

Detroit Dermatologic Surgeon

Botox and pseudoherniation of the cheek fat pad

pseudoherniation vs true herniation of the buccal fat pad can be determined if the prominence was not present prior to the botox and persists substantially greater than six months after the botox injection. You didn't mention how long ago your injection was. What is inconceivable is that a tiny needle diameter used for Botox could traumatically injure the physical structure holding the fat pad in place or produce long term relaxation of the masseter or buccinator muscles.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

If you really don't want our opinion, you've come to the wrong place.

You don't want to hear it but if it was truly caused by BOTOX then it is going to be temporary.   It is possible that in your mind, the herniation of the buccal fat was associated in time with a BOTOX treatment so you feel the two events are related.  A photograph prior to BOTOX treatment and one now would be very helpful in understanding your issue.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Has Botox caused my buccal fat pseudoherniation?

I have not ever hreard of Botox causing this type of issue and have used Botox for well over 20 years.  before having any surgical intervention to treat this issue, IMHO, it might be best to wait 6 months to see if the effects of the Botox wear off and this issue resolves on its own.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Buccal fat pad herniation after Botox?

I have never heard of injecting the buccinator even by accident would cause bucal fat pad herniation. Right now specifically there is nothing to do. If this is truly the case, then it should go back tonormal within a few months.  I just do not think that that is the case.  You probably jsut have buccal fat pad herniation which does happen to some individuals especially in those that have had a previous face lift.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

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