Facial Aging And Buccal Fat
Buccal fat pads are a smooth lump of fat that lies mid-way between the cheeks. It’s located between the facial muscles within the hollow region below the cheekbone. The size of the buccal fat pads can affect the shape of your face.
Everybody can be blessed by the buccal fat pad. But the size of the buccal fat pads can differ significantly.
If you have more cheek fat pads than usual, you may think that your face is too large or round. You might also feel that you have the appearance of a “baby facial appearance.”
It’s not a problem to have more prominent cheeks. If you’d prefer to slim them down, The plastic surgeon could suggest removing buccal fat. This procedure can be done to narrow the width of round faces.
Read on to find out about the procedure as well as the possible complications.
Buccal fat removal
Buccal fat reduction is one of the types of plastic surgery. It’s also known as cheek reduction or buccal lipectomy procedure.
During the procedure, buccal fat pads on the cheeks are surgically extracted. The cheeks are slender and create facial angles.
The process can be done as a stand-alone or combined with another type of procedure, like:
- Chin implants
- lip augmentation
- Botox injection
Who’s a great candidate for the removal of buccal fat?
You may be a great candidate to remove buccal fat If any of the following describes you:
- Physically, you’re in great shape.
- Your weight is healthy.
- You have a round face, a more prominent face.
- You aren’t a fan of the fullness that your cheeks have.
- There is a pseudoherniation (small oval fat mass inside the cheek caused by the soft buccal fat pad).
- You’re looking for female feminization of your face.
- You’ve got realistic expectations.
- You don’t smoke.
Buccal fat removal isn’t suitable for every patient. It’s not always advised in the following situations:
- Faces are small. If your face is thin by nature, The surgery could result in wrinkled cheeks as you get older.
- You suffer from progressive hemifacial atrophies (Parry-Romberg syndrome). This rare disorder causes the skin on one face side to become smaller. It is believed to affect buccal fat pads.
- You’re older. As you age, you’ll naturally lose fat on your face. The process can highlight the jowls and other indications of aging facial features.
The plastic surgeon will be the most qualified person to assess whether you’re a good candidate.
What’s the process like?
Before the procedure
Before the procedure, discuss with your plastic surgeon regarding:
- Expectations and goals
- medical ailments
- Current medications, which include vitamins and supplements
- smoking, alcohol, and other drugs
- Allergies to drugs
- past surgeries
This will allow your plastic surgeon to choose the best approach to surgery and determine the possible risk factors and the likelihood of recovery.
You may need to stop taking some medication or undergo blood tests before the procedure.
Your plastic surgeon will look at your face and take photos to help plan the procedure.
During the process
The procedure can be performed in a hospital or an office of a doctor. This is what it typically involves:
- If you’re having buccal fat removed, You’ll receive the local anesthesia within your face. There won’t be any discomfort, but you’ll remain awake throughout the procedure.
- If you’re having multiple surgeries, it is possible that you will be given general anesthesia. In this scenario, you’ll require transportation to and from the office of the surgeon.
- The MD will create an incision in your cheek. They’ll apply pressure to the cheek’s outside to expose the cheek’s buccal fat pad.
- The surgeon will cut the fat and then remove the fat.
- They’ll stitch the wound shut using stitching that dissolves.
Following the procedure
Before leaving, you will receive a specialized mouthwash to help prevent infections. They will instruct you on how to take care of the incision.
It is necessary to eat a liquid diet for several days. After, it is possible to move on to soft food before returning to your regular diet.
After surgery, the face may be swelling, and you might be prone to bleeding. These should go away as the healing process progresses.
The average recovery time is three weeks.
In the course of recovery, you should follow your doctor’s instructions regarding self-care and eating. Make sure you attend all follow-up appointments.
Expect to notice results after a few months. It will take the time needed for cheeks to adjust to their new form.
What could be the possible problems with the removal of buccal fat?
The removal of buccal fat is usually regarded as safe. However, as with any method, there is a chance of unintentional negative side adverse effects.
Potential complications include:
- excessive bleeding
- adverse reaction negative reaction anesthesia
- seroma (fluid accumulation)
- Damage to salivary glands
- facial nerve damage
- deep vein thrombosis
- heart or pulmonary adverse reactions
- the excess elimination of fat
- Asymmetry in the face
- poor results
Facial Aging And Various Techniques
There’s been a significant shift regarding the treatment of aging of the face. This results from a modification away from techniques for facial surgery that are subtractive and a change to treatments that restore. As the face ages, facial fat loss and depletion of volume cause a tired and sunken facial appearance.
To restore facial volume and shape, aesthetic surgeons search for the perfect filler to improve their patients’ appearance and eliminate lines, scars, depressions, and wrinkles. So far, no filler has been considered ideal. All soft-tissue fillers available in the market have drawbacks.
Transfer of fat (taking fat from a part of a patient’s body that is abundant and then transferring it to an area that is losing volume) is a great option to restore lost volume.
For more than a century, free autologous fat transfer–also referred to as fat facial rejuvenation, fat grafting, free fat transfer, autologous fat grafting/transfer/transplantation, liposculpture, lipostructure, microlipoinjection, and fat injection, as well as by numerous trade names–has been performed to correct facial defects.
Transferring the patient’s fat has always been a desirable option because there are no allergic reactions, the fat is easily accessible and affordable, and a wide range of ailments, such as facial volume loss, atrophic aging hands, postsurgical deformities, and posttraumatic injuries, can be addressed. If done correctly, this procedure will produce pleasing aesthetic results.
A few of the benefits of fat transfer are the absence of discomfort or pain, quick recovery times, no risk and the possibility of treating all types of skin, lasting results, low cost (mainly when used in conjunction and other treatments), and the removal of the chance of allergic or rejection.
The most significant drawbacks to fat transfer previously have been the inability to predict the amount of fat that is transferred, the amount that the patient’s body absorbs,s and the amount of time that the fat remains in place.
However, new methods used to extract and inject the fat have improved the longevity of post-transfer fat. It is often employed to boost the outcomes of other cosmetic procedures like facelifts.
The Fat-Transfer Method
Fat transfer can be described as two processes carried out in a single session lasting about one hour. The first is fat harvesting. A tiny amount (about 30 to 60 milliliters) of the fat gets taken from the donor site. The anesthetic treatment not only allows the procedure to be nearly painless, but it can also reduce the chance of bleeding and bruising on the donor site.
The most suitable donor sites are in the areas of the abdomen and trochanteric that contain fat cells. These have an abundance of antilipolytic receptors. They consequently are more likely to get removed. In contrast, the fatty tissues found in the face arms and upper torso have an abundance of lipolytic receptors. This makes these regions poor sites for harvesting.
Traditional methods for fat transfer involve manual processing and centrifugation of the fat harvested to prepare it to be transferred. These techniques aren’t just laborious, but they could be detrimental to the adipocytes.
Another option is using disposable sterile equipment that allows surgeons to collect the cells, clean, filter, and transfer fat cells in a manageable and time-saving manner.
Instead of centrifugation, these devices employ filtration using suction with low vacuum to harvest those delicate cells of fat to be implanted quickly, with no multiple transfers or excessive handling.
These systems aim to improve the accuracy of the outcomes and increase the efficacy and quality of the tissue being reinjected. These systems have improved the ease of the procedure, its predictability, and the ability to transfer fat to compete with the newer generation of facial fillers.
Once the fat has been prepared, it’s placed into the recipient’s area. The area that is to be enhanced is then treated with a local anesthetic. The fresh-cut tissue is rapidly injected into the desired region in small amounts until the required volume is achieved. The latest microdroplet or threading injector techniques have enhanced results by extending the life of the material grafted.
In addition to the injection technique, The location of the injection is also one of the most critical aspects of an effective fat transfer. Multilevel volume enhancement techniques yield the most effective results.
Injecting deep tissue injections over the bone and periosteum, and into muscles, and going outwards into the more superficial regions to increase the volume of the face in a three-dimensional method.
Instead of just filling in wrinkles and wrinkles, fat transfer can help improve the facial structure and strengthen the facial. A typical facial enhancement uses between 10 and 60 milliliters of the injected fat.
However, the amount of fat can be adapted to the individual’s requirements, age, and volume loss. There are no sutures required either at the donor or site of the recipient.
It is recommended to collect more fat than you need during the initial procedure and then keep the grease in a freezer to be used in future injections (to prevent further methods for harvesting). Fat will be reabsorbed regardless of how many times an area is grafted.
Additionally, some areas cannot respond to the transfer of fat, and the fat that is transferred lasts longer in areas with little movement. This is why the fat transfer is very effective in correcting sunken cheeks; this region is mainly inactive.
Lips are a common site for fat transfer. The smile lines and around the mouth cannot be ideal due to the excessive movement of these zones. Additional soft tissue fillers and skin treatments can create the desired improvement.
The facial-fat transfer is also effective when combined with other facial rejuvenation techniques, but only to achieve the best aesthetic results for the ideal person.
Potential Candidates to Fat Transfer
Many areas of the body and face may be treated using fat transfer. However, the most frequently used indications for treatment include hollow-appearing eyes, prominent tear troughs.
They can also be caused by active reduction of fat pads in lower blepharoplasty, facial wounds, depressions, ferocious buccal fat removal, or an average loss of fat around the cheeks below.
The fat transfer procedure can be applied to the temples and temporal fat pads. They can also be used on the areas of the upper and submalar such as the lips, chin (although it’s not a filler that defines the face), jawline forehead, buttocks, hips, sternum, the outer brow, and glabella, and also between the nose and upper lip and across your nose’s bridge, and the lateral fat pads and everywhere else where fat is desired or needed.
However, the transfer of fat to the breasts is not advised, as it could make mammographic screening for breast cancer more difficult.
Candidates for fat transfer who are suitable are healthy, do not have active illnesses or preexisting medical conditions, and are realistic about their expectations. An excellent fat transfer site is one in which there is a loss of fat caused by the effects of trauma or aging.
The fat transfer procedure alone is ideal for younger patients or those who do not want the facelift. It can also help improve unsatisfactory facial lifts (or other surgical results that are not satisfactory), particularly in cases when indentations must be filled in or stretched areas must be relaxed.
Fat transfer is an excellent alternative to a midface or complete facelift for improving the appearance of your face.
After birth, Some women experience facial volume diminution, with cheeks appearing flat and increased importance of the facial folds and the orbital rims. The younger women can be suitable applicants for fat transfer.
This procedure is also applied to older patients with mild or moderate facial laxity. This procedure can reduce deeper lines and folds and redundancy on the skin.
Fat transfer is an excellent option to correct the volume of hands. Often, patients undergo cosmetic procedures that improve their face, but hands remain, revealing the patient’s actual age.
The transfer of fat to the hand’s dorsum could create an appearance of the hands and face more in sync. Fat transfer may also be an effective method of correcting injuries caused by overtreatment or injuries caused by treatment with laser or radiofrequency therapy.
Complications and Time to Recovery
Recovery time following an operation to remove fat is quick. Most patients can resume their regular routines almost immediately. While the fat transfer is often not a cause of mortality, it’s still an operating procedure, which must not be overlooked.
The most common complications that arise from fat transfer include bruises and infections. Both can be quickly addressed; many surgeons recommend antimicrobial prophylaxis to stop infections.
There is also the risk of irregular contours and asymmetry and the possibility of permanent discoloration due to the rupture of blood vessels in the superficial region in the area of treatment during an injection.
Calcification, a different complication that is rare, could cause hard micronodules to form beneath the skin.
A fat embolism may be a common and severe complication when fat is incorrectly in a blood vessel. Overcorrection to the extreme or obstruction of graft circulation can result in a lack of vascularization of the graft’s materials, fat cysts, fatty cysts, or even fat necrosis.
Since the patient’s body fat is transferred, it is not risk an allergic reaction or graft rejection. Complications could include donor-area imperfections in abdominal fat, upper, or outside hips.
One of the most challenging aspects in performing autologous fat transfer is to ensure that patients realize that a permanent, complete and unalterable outcome may not be an achievable goal.
The period that fat stays after the transfer can be unpredictable. Sometimes, fat transfer is gone within a few months, but it will usually last longer, possibly for many years. It is not unusual to see patients require as many as three injections before desired results last for a long time.
Patients should be assessed to determine if any issues affect the viability of the graft. It is essential to quit smoking since smoking cigarettes significantly affects the life span of the fat grafted. The life expectancy of the newly grafted fat is greatly affected by the constriction of blood vessels caused by smoking.
Patients taking blood thinners might have a negative experience because the medication can cause bleeding in the area of transfer. People with body image and eating issues may not be happy with the fat-transfer process if their excessive pursuit of a lower than ideal weight loss hinders an increase in volume.
Numerous factors are involved in the survival of grafts that have been transferred to fat. They include techniques for removing fat cells and fat-handling methods; use of emulsions, centrifugation as well as serums (including vitamin C complex plasma, plasma, patient-derived plasma, and emulsions containing vitamin C complex oxygen-rich serums, as well as albumin) and reimplantation procedures as well as the metabolism of the patient, movement of the site where the graft was placed and the post-procedural treatment of the area treated; and the degree of angiogenesis and vascularization at the site of the graft site.1-3
Certain studies have shown improved longevity of fat-transfer tissues when Hyperbaric oxygen therapy is used. Patients with impaired vascularity of their tissues, infections, or trauma are reported to have experienced increased cell survival due to oxygenation of deeper or damaged tissues.
This has been demonstrated to stop the spread of necrotic tissue even in an advanced stage. There are many scientific uncertainties regarding the viability of fat transfer and methods. More research is required to improve the survival rate of fat and increase our understanding of fat transfer.
As part of the transition from tightening to volume reduction as the primary method of treating the aging face, fat transfer is becoming a growing component of facial rejuvenation cosmetically.
1. Johnson GW. Body contouring by macro injection of autogenous fat. Paper presented at: First World Congress of the American Academy of Cosmetic Surgery; October 1986; New Orleans.
2. Har-Shai Y, Lindenbaum E, Gamliel-Lazorovich A, Beach D, Hirshowitz B. An integrated approach for increasing the survival of autologous fat grafts in the treatment of contour defects. Plast Reconstr Surg. 1999;4: 945-954.
3. Narins RS, Tope WD, Pope K, Ross CE. Overtreatment effects associated with a radiofrequency tissue-tightening device: Rare, preventable, and correctable with subcision and autologous fat transfer. Dermatol Surg. 2006;32: 115-124.
4. Shoshani O, Shupak A, Ullmann Y, et al. The effect of hyperbaric oxygenation on the viability of human fat injected into nude mice. Plast Reconstr Surg. 2000;106:1390-1398.