Study Evaluates Buccal Fat Pad Flap in Complex Facial Reconstruction

A prospective cohort study published online in Aesthetic Plastic Surgery evaluated the reconstructive utility of the buccal fat pad flap in patients undergoing permanent filler removal followed by deep plane facelift. Conducted at a single center in Cairo between 2016 and 2022, the study included 151 patients, predominantly female (92.7%), with a mean age of 47.8 years.

All patients underwent surgical removal of permanent fillers, with immediate reconstruction of resultant soft tissue defects using a buccal fat pad flap in conjunction with a deep plane facelift. Follow-up ranged from 6 months to 5 years, with outcomes assessed based on contour restoration and complication rates.

Overall satisfaction was high, with 80.7% of patients rating results as “very good” or “excellent.” Stratified analysis showed markedly higher satisfaction in primary procedures compared with revision surgeries (88.5% vs 33.4%). Contour irregularities were reported in 10.6% of cases and were significantly associated with postoperative complications (P < .001). The authors also identified smoking, prior surgical interventions, and postoperative complications as negative predictors of outcomes.

Limitations include the single-center design, lack of a control group, and Level IV evidence, which may limit generalizability.

“The buccal fat pad flap combined with a deep plane facelift after permanent filler removal is a safe and effective reconstructive method with high patient satisfaction,” the authors wrote. “Primary surgeries generally have better outcomes than secondary revisions. The outcome of the buccal fat pad procedure has shown to be negatively affected by smoking, previous surgeries and the presence of post-operative complications.”