Can A Dermal-Fat Graft Be Used For Buccal Lipectomy Reversal?
Q: Dr. Eppley, several years ago I had a buccal lipectomy. I never liked the result and am searching for a “reversal”. In your blog I have read about the possibility to place a dermal fat graft in the buccal space. This is my preferred option since a dermal fat graft creates more assured volume than fat injections and is a solid graft. I don’t mind having a scar somewhere on the body to harvest the graft. Am I correct in assuming this solid graft would not absorb but replace the lost volume I had pre-buccal fat removal? How many of these procedures have you done in the past to correct buccal fat removal?
Could you please tell me how much would that approximately cost? Is general anesthesia needed?
I look forward to hearing from you.
A: In answer to your Buccal Lipectomy Reversal questions:
1) It would seem logical that the type of fat graft tor replacement of a previously removed buccal fat pad would be a solid fat graft. As the buccal fat pad is an encapsulated fat pocket of around 3ccs, its replacement could similarly be a solid fat graft of similar volume.
2) While the volume retention of the implantation of a solid fat graft or fat injections can be debated, and never really proven either way on a truly comparative basis, it is more about what the patient wants to go through. Do they prefer having a body harvest site for a likely one time fat grafting procedure (solid fat graft) or do they prefer having less surgery but likely to have to repeat it more than once. (fat injections)
3) My experience in buccal space fat grating has been primarily that of the HIV facial lipoatrophy patient (type 4 and 5) and not a cosmetic buccal lipectomy patient. Although the results should be similar if not better given a more normal ‘fat state’ in a non-HIV patient..
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.