Advertisement
Research Article| Volume 34, ISSUE 1, P50-56, March 2023

Download started.

Ok

Feminization of the midface: Cheek augmentation and buccal fat pad removal

Published:January 18, 2023DOI:https://doi.org/10.1016/j.otot.2023.01.008

      Abstract

      A feminine face is typically heart-shaped with a prominent malar region and lean midface. This ideal is dependent on both the skeletal architecture and the soft-tissue structures. Cheek augmentation and buccal lipectomy aid in the inverted triangulation between the points of the cheeks and the chin, feminizing the midface. Herein, we describe the anatomy and operative technique for facial feminization of the midface.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Operative Techniques in Otolaryngology-Head and Neck Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Altman K.
        Facial feminization surgery: current state of the art.
        Int J Oral Maxillofac Surg. 2012; 41 (Epub 2012/06/12): 885-894https://doi.org/10.1016/j.ijom.2012.04.024
        • Morrison SD
        • Vyas KS
        • Motakef S
        • et al.
        Facial feminization: systematic review of the literature.
        Plast Reconstr Surg. 2016; 137 (Epub 2016/05/25): 1759-1770https://doi.org/10.1097/PRS.0000000000002171
        • Tessier P.
        The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis. Crouzon's and Apert's diseases.
        Plast Reconstr Surg. 1971; 48: 419-442https://doi.org/10.1097/00006534-197111000-00002
        • Spadafora A
        • De los Rios E
        • Toledo Rios R.
        Flat cheeks. Polyethylene endoprostheses inserted subperiosteally along the zygomatic arch.
        Prensa Med Argent. 1971; 58: 1946-1950
        • Hinderer UT.
        Malar implants for improvement of the facial appearance.
        Plast Reconstr Surg. 1975; 56: 157-165https://doi.org/10.1097/00006534-197508000-00007
        • González-Ulloa M.
        Building out the malar prominences as an addition to rhytidectomy.
        Plast Reconstr Surg. 1974; 53: 293-296https://doi.org/10.1097/00006534-197403000-00007
        • Binder WJ.
        Submalar augmentation. An alternative to face-lift surgery.
        Arch Otolaryngol Head Neck Surg. 1989; 115: 797-801https://doi.org/10.1001/archotol.1989.01860310035017
        • Terino EO.
        Alloplastic facial contouring by zonal principles of skeletal anatomy.
        Clin Plast Surg. 1992; 19: 487-510
        • Few J
        • Cox SE
        • Paradkar-Mitragotri D
        • et al.
        A multicenter, single-blind randomized, controlled study of a volumizing hyaluronic acid filler for midface volume deficit: patient-reported outcomes at 2 years.
        Aesthet Surg J. 2015; 35 (Epub 20150511): 589-599https://doi.org/10.1093/asj/sjv050
        • Whitehead DM
        • Schechter LS.
        Cheek augmentation techniques.
        Facial Plast Surg Clin North Am. 2019; 27 (Epub 20190302): 199-206https://doi.org/10.1016/j.fsc.2018.12.003
        • Hage JJ
        • Becking AG
        • de Graaf FH
        • et al.
        Gender-confirming facial surgery: considerations on the masculinity and femininity of faces.
        Plast Reconstr Surg. 1997; 99: 1799-1807https://doi.org/10.1097/00006534-199706000-00001
        • Becking AG
        • Tuinzing DB
        • Hage JJ
        • et al.
        Transgender feminization of the facial skeleton.
        Clin Plast Surg. 2007; 34: 557-564https://doi.org/10.1016/j.cps.2007.04.009
        • Kaptein YE
        • Kaptein JS
        • Markarian A.
        Vertical localization of the malar prominence.
        Plast Reconstr Surg Glob Open. 2015; 3 (Epub 20150708): e411https://doi.org/10.1097/gox.0000000000000383
        • Schlager S
        • Rüdell A.
        Sexual dimorphism and population affinity in the human zygomatic structure—comparing surface to outline data.
        Anat Rec. 2017; 300: 226-237https://doi.org/10.1002/ar.23450
        • Arnett GW
        • Jelic JS
        • Kim J
        • et al.
        Soft tissue cephalometric analysis: diagnosis and treatment planning of dentofacial deformity.
        Am J Orthod Dentofacial Orthop. 1999; 116: 239-253https://doi.org/10.1016/s0889-5406(99)70234-9
        • Binder WJ
        • Azizzadeh B.
        Malar and submalar augmentation.
        Facial Plast Surg Clin North Am. 2008; 16 (v): 11-32https://doi.org/10.1016/j.fsc.2007.09.008
        • Donofrio LM.
        Techniques in facial fat grafting.
        Aesthet Surg J. 2008; 28: 681-687https://doi.org/10.1016/j.asj.2008.09.003
        • Rayess HM
        • Svider P
        • Hanba C
        • et al.
        Adverse events in facial implant surgery and associated malpractice litigation.
        JAMA Facial Plast Surg. 2018; 20: 244-248https://doi.org/10.1001/jamafacial.2017.2242
        • Rubin JP
        • Yaremchuk MJ.
        Complications and toxicities of implantable biomaterials used in facial reconstructive and aesthetic surgery: a comprehensive review of the literature.
        Plast Reconstr Surg. 1997; 100: 1336-1353https://doi.org/10.1097/00006534-199710000-00043
      1. Bichat X. Anatomie générale: appliquée à la physiologie et à la médecine. A Paris: chez Brosson, Gabon et Cie, Libraires, rue Pierre-Sarrazin, no. 6, et place de l'Ecole-de-Médecine; 1801.

        • Matarasso A.
        Buccal fat pad excision: aesthetic improvement of the midface.
        Ann Plast Surg. 1991; 26: 413-418https://doi.org/10.1097/00000637-199105000-00001
        • Zhang HM
        • Yan YP
        • Qi KM
        • et al.
        Anatomical structure of the buccal fat pad and its clinical adaptations.
        Plast Reconstr Surg. 2002; 109 (discussion 19-20): 2509-2518https://doi.org/10.1097/00006534-200206000-00052
        • Stuzin JM
        • Wagstrom L
        • Kawamoto HK
        • et al.
        The anatomy and clinical applications of the buccal fat pad.
        Plast Reconstr Surg. 1990; 85: 29-37https://doi.org/10.1097/00006534-199001000-00006
        • Yousuf S
        • Tubbs RS
        • Wartmann CT
        • et al.
        A review of the gross anatomy, functions, pathology, and clinical uses of the buccal fat pad.
        Surg Radiol Anat. 2010; 32 (Epub 20091125): 427-436https://doi.org/10.1007/s00276-009-0596-6
        • Lin MJ
        • Hazan E
        • John AM
        • et al.
        Buccal fat pad reduction with intraoperative fat transfer to the temple.
        Cutis. 2022; 109: 46-48https://doi.org/10.12788/cutis.0430
        • Sezgin B
        • Tatar S
        • Boge M
        • et al.
        The excision of the buccal fat pad for cheek refinement: volumetric considerations.
        Aesthet Surg J. 2019; 39: 585-592https://doi.org/10.1093/asj/sjy188
        • Matarasso A.
        Managing the buccal fat pad.
        Aesthet Surg J. 2006; 26: 330-336https://doi.org/10.1016/j.asj.2006.03.009
        • Xiao H
        • Bayramiçli M
        • Jackson IT
        Volumetric analysis of the buccal fat pad.
        Eur J Plast Surg. 1999; 22: 177-180
        • Benjamin M
        • Reish RG.
        Buccal fat pad excision: proceed with caution.
        Plast Reconstr Surg Glob Open. 2018; 6 (Epub 20181016): e1970https://doi.org/10.1097/gox.0000000000001970
        • Rohrich RJ
        • Stuzin JM
        • Savetsky IL
        • et al.
        The role of the buccal fat pad in facial aesthetic surgery.
        Plast Reconstr Surg. 2021; 148: 334-338https://doi.org/10.1097/prs.0000000000008230
        • Traboulsi-Garet B
        • Camps-Font O
        • Traboulsi-Garet M
        • et al.
        Buccal fat pad excision for cheek refinement: a systematic review.
        Med Oral Patol Oral Cir Bucal. 2021; 26 (Epub 20210701): e474-ee81https://doi.org/10.4317/medoral.24335
        • Jackson IT.
        Buccal fat pad removal.
        Aesthet Surg J. 2003; 23: 484-485https://doi.org/10.1016/j.asj.2003.08.005
        • Hwang K
        • Cho HJ
        • Battuvshin D
        • et al.
        Interrelated buccal fat pad with facial buccal branches and parotid duct.
        J Craniofac Surg. 2005; 16: 658-660https://doi.org/10.1097/01.scs.0000157019.35407.55