Assessment of clinical and ultrasonographic parameters as indicators for buccal fat pad excision by esthetic reasons

• Published in: Oral and maxillofacial surgery 2023-03, Vol.27 (1), p.151-161
• Main Authors: Cardona-Gómez, Natalia, Gil-Cárdenas, Félix Antonio, Molina-Cárdenas, Elkin Andrés, Cardona-Estrada, Jorge Iván, Tobón-Arroyave, Sergio Iván
• Format: Article
• Language: English
• Subjects: Adipose Tissue - surgery; Body mass index; Cheek - diagnostic imaging; Cheek - surgery; Cross-Sectional Studies; Decision making; Dentistry; Esthetics, Dental; Face; Humans; Magnetic resonance imaging; Maxillofacial surgery; Medicine; Medicine & Public Health; Observational studies; Oral and Maxillofacial Surgery; Original Article; Patients; Ultrasonic imaging
• ISSN: 1865-1569; 1865-1550; 1865-1569
• DOI: 10.1007/s10006-022-01043-4

Purpose The selection of candidates for buccal fat pad (BFP) removal depends on the patient’s requirements, the subjective surgeons’ evaluation, and objective clinical factors. This cross-sectional observational study aimed to identify objective clinical and ultrasonographic parameters as indicators of cheek contouring with BFP excision. Methods Sixty-six patients with cheek fullness complaints were examined by two experienced surgeons to determine if they were good candidates for the procedure. Thereafter, participants underwent clinical and ultrasonographic assessments in a separate session to aid in the surgical decision-making. The association between the clinical judgment for BFP excision and the study variables was analyzed individually and adjusted for confounders using binary logistic regression and grouping analyses. Results Forty-nine participants were regarded as suitable and 17 as non-suitable for the procedure. After regression analysis, cheek skin-fold thickness > 6.00 mm, midfacial contour > 2.20 mm, ovoid/triangular facial form, and ultrasonographic BFP volume > 2.05 mL remained as robust individual indicators for the suitability for the procedure. However, the grouping analysis showed that patients having three-to-four significant criteria synchronously had significantly higher odds for eligibility with excellent discrimination capability. Conclusion Although high values of cheek skin-fold thickness, midfacial contour, and ultrasonographic BFP volume, as well as an ovoid/triangular facial form, might be robust indicators for the suitability for BFP excision, the surgical decision-making should not be based on isolated parameters. Instead, those patients possessing a combination of at least three of these specific eligibility criteria above the threshold value might be considered the best candidates for the procedure.