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The buccal lipectomy is a well known facial contouring procedure that is effective because of its discrete encapsulation of fat. Like Buccal fat extraction provides a unique aesthetic procedure that is unlike the traditional liposuction method and is performed no where else on the face or body. The fat is also quite distinctive in appearance being bright yellow with large globules and a small artery within it.

No one knows for sure what the exact purpose of the buccal fat pad is. But its relative ease for removal and its immediate upper cheek effect makes it a good surgical target. It also has no known adverse effect from its removal other than the long term risk of cheek hollowing in select patients.

What is often overlooked in a buccal lipectomy is that it is also a good source of a limited graft volume that can be used for fat injections, particularly for small defects of the face. Unlike aspirated fat from liposuction the large globules of the buccal fat pad does not permit it to be immediately recycled into a syringe for injection. It is going to require a method of preparation first.

buccal fat pad graft preparation for injection Dr Barry Eppley IndianapolisTo prepare buccal fat pads for injection they first need to be cut up into many smaller pieces using small scissors. The pieces can then be transferred into a 10cc syringe. Using a connector attached to an empty syringe, the fat pads are passed back and forth between the two syringes under pressure until it becomes adequately liquified. It is then placed into 1cc syringes for injection.

The buccal fat pads provide enough volume for injection into such facial structures as the lips, labiomental and nasolabial folds and the periorbital region.

It is not yet known what fat harvest areas may be better for injection transplantation survival. But the non-depot location of the buccal fat pads and its very large globules compared to other facial fat may suggest an enhanced capability for relocation survival after injection.

Dr. Barry Eppley

Indianapolis, Indiana

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