The buccal fat pad is the only completely encapsulated fat collection in the face. Besides its capsule it is a unique piece of fat anatomy as it is a distinct pad that has a well identified vascular pedicle providing its main blood supply. Because it is an easily found and removed piece of facial anatomy with little consequence in doing so, it is a common aesthetic procedure. Removal of the main body of the buccal fat pad (buccal lipectomy) can a visible external facial change by reducing the fullness of the cheeks which can create better cheekbone highlights.
But in facial derounding procedures the buccal lipectomy procedure is often misunderstood for where it creates it facial effects. Of the three aesthetic cheek zones influenced by fat (buccal, perioral mound and medial cheek), removal of buccal fad creates its effect just under the cheekbones. It does not go lower down to the mouth level and does not extend closer to the nose. Those are different fat zones which can also be treated. (perioral mound liposuction, medial cheek liposuction)
The best way to know what effect a buccal lipectomy will have on the face is by drawing specific horizontal and vertical lines. If a vertical line is drawn from the corner of the eye down the mouth corner and a horizontal line is drawn from the tragus of the ear to the mouth corner, the northwests section above the intersection of the lines is the buccal zone. This is where the fullness of the face will be reduced by a buccal lipectomy.
Dr. Barry Eppley