The buccal lipectomy is a well known procedure that is done in certain patients for a cheek slimming effect. It is unique amongst most fat removal procedures in plastic surgery because it involves removal of fat within a surrounding capsule. (the only other procedure is the removal of the fad pads in blepharoplasty surgery) The buccal fat is a deep pad that is located between the buccinator muscle and the more superficial muscles including the zygomaticus and masseter muscles in the, appropriately named, buccal space. What is actual function is, large as it is, is not really known. It has been described the functions of aiding sucking in infants to facilitating the movement of the muscles it lies between. None of these explanations, however, are particularly satisfying.
While buccal fat pad removal is controversial today due to the potential long-term risks of excessive thinning and the creation of a gaunt face, the buccal fat pad has an interesting history. It is also often called Bichat’s fat pad and is so named after the famous French anatomist and physiologist Marie Francois Xavier Bichat. While he lived only a short thirty years (1771-1802), he is remembered as the father of modern histology and descriptive anatomy. While he never used a microscope (interestingly he did not trust them) he was able to describe tissues as distinct entities. (muscle, fat etc) Hence the ‘discovery’ of the large buccal fat pad and its four main extensions. (parotid, temporal, buccal and malar) While one could argue some anatomist somewhere would have found it eventually anyway (it is hard to miss when doing facial dissections), in the context of its day over 200 hundred years ago, such anatomic finds were revolutionary.
Dr. Barry Eppley