3.8 Article

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

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ORAL AND MAXILLOFACIAL SURGERY-HEIDELBERG
卷 27, 期 1, 页码 151-161

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SPRINGER HEIDELBERG
DOI: 10.1007/s10006-022-01043-4

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Esthetic surgery; Buccal fat pad; Clinical assessment; Decision-making; Ultrasonography

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This study aimed to identify objective clinical and ultrasonographic parameters for the selection of candidates for buccal fat pad (BFP) removal. The results showed that cheek skin-fold thickness, midfacial contour, ultrasonographic BFP volume, and facial form could be robust indicators for the suitability for the procedure. It is recommended to consider a combination of at least three of these criteria for surgical decision-making.
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 decisionmaking 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.

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