Gross anatomical, CT and MRI analyses of the buccal fat pad with special emphasis on volumetric variations.

The use of the buccal fat pad (BFP) has increased in popularity in recent years because of its reliability, ease of harvest, and low complication rate during oral and maxillofacial procedures. The aim of this study was to evaluate the volumetric variations of the BFP with a CT and MRI, as well as the thickness, weight and volume with conventional methods. We have examined the BFP from 80 formalin fixed adult cadavers (mean age 59) derived from both males (45) and females (35). In addition, we also examined 20 cadaveric BFPs using MR and CT imaging. Digital image analysis software was used to measure the volumetric distribution and to characterize the morphology of BFP. The BFP can be divided into three lobes (anterior, intermediate, and posterior) and has four extensions (buccal, pterygoid, pterygopalatine, and temporal). The BFP is fixed by six ligaments, to the maxilla, posterior zygoma, inner and outer rim of infraorbital fissure, temporalis tendon, and buccinator membrane. The mean volume in males was 10.2 ml and ranged 7.8-11.2 ml, while in females the mean volume was 8.9 ml and ranged 7.2-10.8 ml. Additionally, the mean thickness was 6 mm, with a mean weight of 9.7 g. These facts may be important when considering the use of the BFP in reconstruction, particularly whether the correct volume has been removed from each side in aesthetic, oral, or maxillofacial procedures.