Introduction

In recent years, the demand for improving the buccal fat pad has been on the rise in New York City. People are increasingly concerned about their facial aesthetics, and buccal fat pad removal or adjustment has become a popular cosmetic option. This article aims to explore the charging standards of hospitals for improving the buccal fat pad in New York City, while also delving into related aspects such as the procedure, benefits, risks, and more.

Understanding the Buccal Fat Pad

Anatomy and Function

The buccal fat pad, also known as Bichat’s fat pad, is an important anatomical structure. It is located between the anterior margin of the masseter and the buccinator. For centuries, anatomists have studied its complex nature. In neonates, it is thought to support the suckling function. As children age and start chewing, it facilitates the gliding function among the muscles of mastication. It also serves as a cushion to protect neurovascular structures from external forces and plays a role in facial aesthetics from neonates to the elderly.

The size of the buccal fat pad varies from person to person. For males, the mean volumetric variation is found to be 7.8 to 11.2 milliliters, and for females, it is 7.2 to 10.8 ml, with a mean thickness of 6 millimeters. Imaging studies show that it grows significantly from ages 10 to 20, increasing from 4000 to 8000 cubic millimeters, and then declines in size over the next 30 years to an average volume of 7000 cubic millimeters. It has a complex structure closely related to the facial nerve, parotid duct, and masticatory muscles.

Role in Facial Appearance

The buccal fat pad fills the hollow area of the cheeks and can make a face appear fuller. Some people accumulate extra fat in this area, resulting in a fuller and rounded face, often referred to as “chubby cheeks” or “chipmunk cheeks.” Excessive buccal fat can mask the prominent zygomatic or cheekbones, lacking an angular appearance to the face. On the other hand, a reduction in buccal fat can enhance the zygomatic prominences and overall facial contour.

Buccal Fat Pad Improvement Procedures

Buccal Fat Pad Removal

How it's Performed

Buccal fat pad removal, also called cheek reduction surgery or buccal lipectomy, is a facial contouring procedure. The safest method for facial aesthetics is via intraoral access. The key structure to identify before creating an incision is the Stenson duct, the opening of the parotid gland into the oral cavity. An incision may be created superior to the duct in the maxillary vestibule or inferior to the parotid duct at approximately the level of occlusion.

At the Madigan Army Medical Center, the preferred method is to access the buccal fat pad inferior to Stenson’s duct. A Minnesota retractor is used to retract the cheek, and local anesthesia is first injected into the buccal mucosa. The Stenson’s duct is positively identified, and a shallow 1.5 cm horizontal incision is placed with a 15 - blade in the buccal mucosa midway between the occlusal plane and Stenson’s duct. The opposite hand is used extra - orally to apply pressure on the contents of the buccal fat pad to facilitate exposure into the oral cavity. Hemostats are then used to bluntly dissect through the buccinator muscle and access the buccal fat pad. 3 to 5 cc of the fat pad is gently teased out of the buccal space, clamped, and excised. The mucosa is then reapproximated with two single 4.0 interrupted absorbable sutures.

Duration and Anesthesia

The entire procedure can take as little as 30 minutes to an hour or two, depending on various factors such as the complexity of the case and the surgeon’s technique. It can be performed under local anesthesia with or without sedation (oral or iv sedation) or general anesthesia.

Combination with Other Procedures

Buccal fat pad removal can be combined with other plastic surgery procedures. Some common combinations include liposuction of the neck or chin, rhinoplasty, filler (Voluma, Radiesse, or fat grafting to augment the midface area), and eyelid surgery or blepharoplasty. Combining procedures can provide a more comprehensive facial enhancement and achieve better overall results.

Benefits of Buccal Fat Pad Improvement

Facial Contouring

One of the main benefits of buccal fat pad removal is facial contouring. It can reduce the lower cheek volume, enhance the upper cheek and cheekbone contour from the lower cheek hollows, and create a more slender, narrower facial contour. The face takes on a more triangular shape, which is often considered more aesthetically pleasing. Men may achieve a more chiseled jawline and cheeks, while women can have a more sculpted lower facial contour.

Improvement in Facial Proportions

By reducing the fullness of the cheeks, buccal fat pad removal can improve the balance of facial proportions. The upper to lower cheek ratio becomes more harmonious, and the overall facial appearance becomes more refined. Cheekbones may appear higher with more definition, giving the face a more youthful and attractive look.

Boost in Self - Confidence

For many people who are unhappy with their chubby cheeks, the improvement in facial appearance after buccal fat pad removal can lead to a significant boost in self - confidence. They may feel more comfortable in social situations and more satisfied with their overall appearance, which can have a positive impact on their personal and professional lives.

Candidates for Buccal Fat Pad Improvement

Ideal Physical Characteristics

Ideal candidates for buccal fat pad removal are typically in their late 20s or early 30s, at or near their goal weight, and in good health. They should have excess fat in the cheeks, be unhappy with the chubby appearance of their cheeks, and have realistic expectations regarding the results possible through surgery. Good candidates usually have prominent zygomatic or cheekbones that are masked due to pronounced cheeks.

Medical Considerations

Patients need to disclose their complete medical history, including any medications, herbal supplements, or vitamins they are currently taking. Conditions such as bleeding disorders, allergies, and previous facial surgeries can affect the suitability of the procedure. A consultation with a qualified plastic surgeon is essential to determine if a patient is a good candidate.

Charging Standards of Hospitals in New York City

Factors Affecting the Cost

The cost of buccal fat pad improvement in New York City can vary significantly based on several factors:

• Surgeon's Experience and Reputation: Highly experienced and well - known surgeons may charge more for their services. Surgeons with a long history of successful buccal fat pad removal procedures and a good reputation in the industry are likely to command higher fees. For example, a double - board - certified facial plastic surgeon with 20 + years of experience, like Dr. Philip Miller, may charge at a premium compared to a less experienced surgeon.
• Hospital or Clinic Facilities: The quality and location of the surgical facility can impact the cost. Hospitals or clinics in prime locations in New York City with state - of - the - art equipment and high - quality amenities may charge more. Facilities that are fully accredited by the Joint Commission and uphold the highest standards of safety and care may also have higher costs.
• Complexity of the Procedure: If the buccal fat pad removal is combined with other procedures, the cost will be higher. The amount of fat to be removed and the difficulty of accessing the buccal fat pad can also affect the price. For instance, if a patient has a particularly large or stubborn buccal fat pad, or if there are anatomical complexities, the procedure may take longer and require more skill, resulting in a higher cost.
• Anesthesia Fees: The type of anesthesia used (local, sedation, or general) and the services of the anesthesiologist can contribute to the overall cost. General anesthesia usually incurs higher fees compared to local anesthesia with or without sedation.
• Post - operative Care: The cost of follow - up appointments, medications, and any necessary post - operative support is also factored into the total cost. Some clinics may include comprehensive post - operative care packages in their pricing, while others may charge separately for these services.

Range of Costs

In New York, buccal fat removal typically costs between $2,500 and $6,500, according to Dr. Philip Miller. However, this is just an average range, and the final price can be higher or lower depending on the factors mentioned above. It's important to note that this is an elective cosmetic procedure, and insurance does not cover it. Some clinics may offer financing options to help patients manage the cost.

Risks and Complications

Common Risks

Although buccal fat pad reduction is generally considered a safe and relatively simple procedure, there are still some risks involved. Some of the common risks include swelling of the cheeks, which is normal after the procedure and usually subsides within a few weeks. Bruising may occur, but it is rare since the incision is inside the mouth. Mild soreness is also common, but pain is usually minimal and can be managed with pain medication.

Rare Complications

Some of the rare complications associated with buccal fat pad removal include parotid duct injury, hematoma, trismus (difficulty opening the mouth), neuromotor deficits, and infection. There is also a risk of over - resection, which can lead to a hollowed - out appearance of the cheeks. Severe bleeding due to vessel damage during the procedure is a rare but serious complication that may require emergency treatment. In theory, nerve injury is a significant risk, but it can be minimized by following proper surgical techniques.

Recovery Process

Immediate Post - operative Period

After the buccal fat pad removal procedure, patients may experience some swelling and discomfort. The cheeks may appear more round than before, but this is normal and will subside over time. Most patients will be able to resume 90% of their normal activities with minimal downtime. However, it is recommended to avoid vigorous exercise or activities for one to two weeks after the procedure to allow for proper healing.

Patients are usually provided with a list of post - operative instructions, which may include avoiding touching the sutures with the tongue, using cold compresses to reduce swelling, and following a soft diet for the first few days. Some patients may need to wear a facial compression garment to facilitate the resolution of swelling.

Long - term Recovery

The full results of buccal fat pad removal may take up to three or more months to fully settle in. Early results can be seen as soon as the third week after the procedure, and definitive results become noticeable in six weeks. During the recovery period, it is important to attend all follow - up appointments with the surgeon to monitor the healing process and address any concerns.

Making an Informed Decision

Consultation with a Surgeon

If you are considering buccal fat pad improvement, it is crucial to schedule a consultation with a qualified plastic surgeon. During the consultation, the surgeon will assess your facial structure, discuss your aesthetic goals, and determine if you are a suitable candidate for the procedure. They will also explain the procedure in detail, including the risks, benefits, and expected results.

You should come prepared with a list of questions, such as the surgeon's qualifications and experience in buccal fat removal, before - and - after photos of past patients, the specific steps of the procedure, the recovery process, and the total cost, including all associated fees.

Research and Comparison

It's also important to do your own research and compare different surgeons and clinics in New York City. Look for reviews and testimonials from previous patients to get an idea of their experiences. Check the credentials and certifications of the surgeons and the facilities where the procedures will be performed. By making an informed decision, you can increase the chances of achieving the desired results and having a positive experience.

Conclusion

Improving the buccal fat pad can be an effective way to enhance facial aesthetics and boost self - confidence. In New York City, the charging standards of hospitals for this procedure vary based on multiple factors such as the surgeon's experience, facility quality, procedure complexity, and more. While there are benefits to the procedure, it is not without risks, and a proper recovery process is essential.

If you are interested in buccal fat pad improvement, take the time to consult with a qualified surgeon, ask the right questions, and make an informed decision. Remember to follow all post - operative instructions for a smooth recovery and to achieve the best possible results. To learn more about buccal fat pad improvement in New York City, schedule a consultation with a reputable plastic surgeon today.