Buccal Fat Pad Removal and Zygoma Reduction: A CT Analysis Case Study

The buccal fat pad can significantly influence facial appearance after zygoma reduction surgery. Inward movement of the zygomatic bone can cause the buccal fat pad to bulge, creating an undesirable "balloon effect". Dr. Park has observed that removing the buccal fat pad can mitigate this effect and improve overall facial contour.

soft tissue redistribution during zygomatic bone reduction surgery

"balloon effect" in the buccal fat pad

Case Study: Zygoma Reduction and Buccal Fat Pad Removal

This case study examines a patient who underwent zygoma reduction surgery and, 1 year and 7 months later, had buccal fat pad removal along with hardware removal. This unique situation provides valuable insights into the isolated effects of buccal fat pad removal on facial appearance.

Zygoma Reduction Procedure

Surgical Plan:

• 45-degree zygoma bone resection of 3mm with 45-degree inward movement (using a 3mm plate).

• Lateral zygoma movement (using an 8mm plate on the right side and a 7mm plate on the left side).

Zygoma Reduction

Zygoma Reduction

• Surgical Outcome:

  • Lateral zygoma

• Right side: 6.01mm bone displacement with a 2.62mm reduction in soft tissue (approximately 43% of bone movement).

• Left side: 5.87mm bone displacement with a 2.32mm change in soft tissue (32% of bone movement).

Zygoma Reduction

• 45-degree zygoma

  • Both side: 5.40mm bone displacement with a 2.78mm reduction in soft tissue.

Zygoma Reduction

Buccal Fat Pad Removal Procedure

• Volume Removed:

  • Right side: 2.6 cc

  • Left side: 2.2 cc

• Additional Procedure: Botulinum toxin injection in the temples.

CT Scan Analysis

• Buccal Fat Pad Removal: CT images confirm a reduction in the specific area (indicated by yellow arrows) after buccal fat pad removal. This effect is independent of weight or body fat changes.

  

  Buccal Fat Pad Removal: CT images confirm a reduction in the specific area (indicated by yellow arrows) after buccal fat pad removal. This effect is independent of weight or body fat changes.

  
  

• Botulinum Toxin:  The red arrows highlight the reduction in temple width due to botulinum toxin injection.

• Masseter Muscle:  While the masseter muscle thickened slightly over time, the anterior border shifted forward, contributing to a slimmer midface appearance.

  

  While the masseter muscle thickened slightly over time, the anterior border shifted forward, contributing to a slimmer midface appearance.

Comparison: Zygoma Reduction with and without Buccal Fat Pad Removal

CT images comparing patients who underwent zygoma reduction with and without buccal fat pad removal clearly demonstrate the impact of the buccal fat pad on facial contour.

zygoma reduction without buccal fat pad removal

zygoma reduction with buccal fat pad removal

Comparison of outcomes with and without buccal fat pad removal in conjunction with zygoma reduction surgery confirms that the buccal fat pad generally affects the area indicated by the yellow arrows.

buccal fat pad removal in conjunction with zygoma reduction surgery confirms that the buccal fat pad generally affects the area indicated by the yellow arrows.

Conclusion

This case study provides evidence that buccal fat pad removal can significantly refine facial contours, especially when combined with zygoma reduction surgery. Dr. Park's analysis highlights the importance of considering the buccal fat pad in achieving optimal aesthetic outcomes in oral and maxillofacial surgery.

Dr. Park Jong-chul, a specialist in oral and maxillofacial surgery, presents CT scan analysis to demonstrate the effects of this procedure.

For more detail

https://blog.naver.com/vvsaz144/223563426877