Buccal fat pad removal is gaining a lot of popularity. It is surgery, though, and this scares away a lot of people both in terms of price and risk. Dependable plastic surgeons who perform this operation are few and far between, and the results of a successful operation are inherently subtle. Therefore, it is understandable that minimally invasive or even nonsurgical options for the same procedure would be very desirable. Especially if the procedure could be performed by non-physicians, such as nurses, physician assistants, and nurse practitioners. Some people are promoting the injection of Kybella, which is an injectable acid, to the fat pad. This is unsafe and unlikely to work. Another YouTube video shows a physician provider using radiofrequency assisted lipolysis to “remove” the buccal fat pad. In that video, the provider is simply treating the subcutaneous tissues overlying the approximate location of the buccal fat pad.
Here’s the story:
Bichectomy, or buccal fat pad removal, tends to be relatively inexpensive and takes less time than most plastic surgical procedures. The operation can take as little as 10-15 minutes, and as long as 30 minutes. There is minimal blood loss for the procedure, and most patients choose to do this operation awake. Alternatively, injections of acid into this space would put a lot of important structures such as nerves, salivary structures, and muscles at unnecessary risk. Multiple treatments may be required, results would probably not be seen, and the series may cost more than surgery itself. For those of you who wonder whether or not Facetite or Accutite is an option, this video’s for you.
In this video, Dr. Zelken discusses the possibility of minimally invasive surgical buccal fat pad removal. He demonstrates the act of Facetite versus an intact, freshly removed buccal fat pad. While the treatment causes a one third reduction in the size of the fat pad, it is impossible to apply that type of energy on a living patient with the buccal fat pad in situ. Not only that, a minimally invasive procedure would entail that energy travels from deep to the buccal fat pad to the skin surface. Invariably, this would place motor nerves, sensory nerves, salivary structures, muscles, and skin at risk of injury. As it worth it? Is it possible? For the time being, absolutely not.