The use of the buccal fat pad for reconstruction of oral defects: Review of the literature and report of 15 cases

Abstract

Purpose: Although the buccal fat pad (BFP) was originally used as an alternative method for the closure of small to medium-sized oroantral and oronasal communications, its use has now been extended to use after excision of oral malignancies. This report describes experience with this technique.Patients and Methods: The BFP was used as a pedicled graft to reconstruct medium-sized surgical defects of the oral soft and hard tissues in 15 patients suffering from oral malignant tumors. Six of the defects were in the maxilla, 3 in the retromandibular area, and 6 in the cheek and oral commissure. The BFP was left uncovered to epithelialize in 14 patients, and in one it was covered with lyophiliazed dura.Results: The BFP healed without complications within 3 to 4 weeks in 13 patients, whereas in 2 patients with maxillary defects there was partial loss of the graft, requiring the additional use of an obturator in 1 case and a tongue flap in another to prevent oronasal leakage. Harvesting the graft proved to be extremely easy, and care was only necessary to avoid severing the supporting vascular plexus and the thin capsule covering the BFP.Conclusions: The findings support the view that the BFP is a useful, easy, and uncomplicated alternative method for the reconstruction of small to medium-sized surgical defects of the oral hard and soft tissues.