Buccal Fat Removal | Surgical Technique and Intraoral Anatomy
Medically authored and verified by Verified by Dr. Vishal Purohit, MBBS, MS, MCh (Plastic Surgery) • RMC Reg. 28041/14185 • Oct 2026
Surgical Technique and Intraoral AnatomyHow is the buccal fat pad removal procedure surgically performed?
#
How is the buccal fat pad removal procedure surgically performed?
#Buccal fat removal is performed intraorally through a small 1 to 2 cm horizontal incision in the buccal mucosa opposite the upper second molar under local anesthesia.
After mucosal incision, the fibers of the buccinator muscle are gently spread bluntly with dissecting scissors to expose the glistening yellow capsule of the buccal fat pad. Gentle external pressure on the cheek causes the buccal extension to herniate smoothly into the surgical field. The surgeon teases the necessary volume forward, achieves meticulous bipolar hemostasis at the vascular base, and excises the measured portion before closing with absorbable sutures.
Operating time is typically 30 to 45 minutes for both sides. Patients rinse with antiseptic mouthwash and are discharged home within one hour of completion.
Surgical Technique and Intraoral AnatomyWhat vital anatomical structures must be protected during buccal fat extraction?
#
What vital anatomical structures must be protected during buccal fat extraction?
#The surgeon must meticulously identify and protect the parotid duct (Stensen's duct), the buccal branch of the facial nerve, and the facial vein and artery.
Stensen’s duct opens into the oral cavity directly opposite the maxillary second molar and courses immediately superior and lateral to the buccal fat capsule. The buccal branches of cranial nerve VII, providing motor innervation to the upper lip and oral sphincter, run across the outer surface of the pad. Employing blunt dissection without sharp, blind cutting ensures these neurovascular structures remain completely uninjured.
Specialized plastic surgical training in head and neck anatomy guarantees the safety margin required for zero functional morbidity.
