Facial Plast Surg
DOI: 10.1055/a-2622-2896
Original Article

Modified Buccal Fat Pad Reduction as a Component of Perioral Mound Rejuvenation “The Mouth Pouch”

Benjamin P. Caughlin
1   Many Faces of Chicago LLC, Chicago, Illinois
2   Division of Facial Plastic and Reconstructive Surgery, University of Illinois Health Hospital System, Chicago, Illinois
,
Brittany Abud
2   Division of Facial Plastic and Reconstructive Surgery, University of Illinois Health Hospital System, Chicago, Illinois
› Institutsangaben

Abstract

Aim and Background

To evaluate the effectiveness of a comprehensive surgical approach addressing perioral mounds—the “mouth pouch”—through modified buccal fat pad sculpting, targeted mucosal and muscle resection, and focal skin tightening for enhanced lower facial contouring.

Historical Aspects

Conventional techniques often fall short in resolving contour irregularities in the perioral region due to intricate anatomy and high functional mobility.

Anatomy

The perioral area includes a complex interplay of superficial and deep fat compartments, musculature, vasculature, and nerves. Aging-related atrophy of superficial fat and pseudoherniation of buccal fat contribute to soft tissue compartmentalization and visible mounding.

Technology

Radiofrequency-assisted dermal tightening is combined with intraoral fat sculpting to promote further definition.

Patient Selection

Ideal candidates have distinct perioral mounds, robust buccal fat pads, thickened oral mucosa, and visible lines of parakeratosis.

Techniques

A seven-step intraoral technique under local anesthesia include mucosal resection, buccinator stripping, buccal fat pad sculpting, and radiofrequency treatment.

Postoperative Care

Dual compression with intraoral packing and external head wrap minimizes hematoma and infection risk.

Current and Future Developments

Combining bony augmentation (e.g., chin implants) with soft tissue contouring yields comprehensive lower face rejuvenation.

Conclusion and Clinical Relevance

This technique for treating perioral mounds, in carefully selected patients, provides a reproducible, and safe method for lower facial contour enhancement.



Publikationsverlauf

Accepted Manuscript online:
27. Mai 2025

Artikel online veröffentlicht:
13. Juni 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Akşamoğlu M, Bayar Muluk N, Şahan MH. Changes of the buccal fat pad volume according to the different age groups, gender, and body mass index: an evaluation with computed tomography. J Comput Assist Tomogr 2025; 49 (01) 156-164
  • 2 Cristel RT, Caughlin BP. Buccal fat pad sculpting for lower facial contouring with 3-dimensional volume assessment. Am J Cosmet Surg 2020; 38 (04) 074880682098086
  • 3 Cristel RT, Caughlin BP. Buccal fat pad sculpting for lower facial contouring. Facial Plast Surg Aesthet Med 2021; 23 (02) 143