Buccal Fat Pad Removal Surgery

Written by Dr. Jonathan Zelken

To make the concept of buccal fat pad removal less ambiguous, Dr. Zelken introduces his concept of framing the face. In addition, he offers advice on how to make your own DIY BUCC-O-METER assessment tool to educate you and guide expectations for buccal fat pad removal surgery. The concept is rather simple. In previous videos, you may have gathered that ideal candidates for buccal fat pad removal surgery have strong jawbones (mandibles) and strong cheekbones (malar mound/positive vector).

Also, a well-developed masseter muscle comes in handy to frame the buccal space (think Jennifer Garner). If you think of the buccal space as a window or a picture within a frame, you can understand not only where the buccal space lives, but whether or not you would benefit, and what to expect from the buccal fat pad removal surgery.

THE 4 MS

Let us start with the “4 Ms” of buccal fat pad anatomy and framing. The first M stands for masseter (chewing muscle), and this is the posterior wall of the frame. The second M is mandible (jawbone, jawline), which can be thought of as the floor of the frame. The third M, the front wall, is the mouth (technically, the deep nasolabial fat compartment). Finally, the fourth M, the ceiling, is the malar eminence- better known as her cheekbone.

Within the context of these 4 walls, the ideal shape is very subjective. I think we can all agree that convexity or bulging from this space is not attractive. Whether or not you think a smooth versus concave contour is attractive is subjective and addressed on an individual basis. For example, many thin young patients in the modeling industry come to me for the removal of the buccal fat pad to create a more sculpted look even though they may not “objectively” benefit from it.

Finally, in this video, Dr. Zelken will show you how to make your own BUCC-O-METER. This inexpensive and simple device is designed to help you determine not only where your buccal fat pad lies, but whether or not you may benefit from this operation. Of course, nothing beats an in-person examination to better guide your expectations and to assess your candidacy for the procedure.

HOW TO MAKE YOUR OWN BUCC-O-METER IN 10 EASY STEPS:

Supplies needed: cardboard or construction paper, scissors or x-acto knife, marker, ruler, post-it-note.

To conform to the LEFT cheek (for right, flip it over)

• Mark and cut out a 9 cm (3.5 in) square.
• On the bottom edge, mark 2 cm from the left.
• On the right edge mark 3 cm up from the bottom.
• Connect the dots and cut out 2 triangles.
• Cut out the center leaving about 2 cm of borders.
• On the bottom write “mandible” (jaw)
• On the top write “malar” (cheek)
• On the left write “mouth” (deep nasolabial fat compartment)
• On the right write “masseter” (jaw muscle)
• Then place a piece of leftover material inside and move it to line up with the front edge of your masseter muscle. (Optional: take a post it note and line the adhesive up with the front edge of the masseter)
• To find your masseter, clench your jaw and look for an angled shadow from your cheek to the angle of your jaw OR feel for it with your thumb.
• The remaining space is where the buccal fat can herniate.

To make an in-person or virtual consultation, please call (949) 432-4730.