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

Purpose: Although the buccal fat pad (BFP) was originally used as an altern ative method for the closure of small to medium-sized oroantral and oronasa l communications, its use has now been extended to use after excision of or al malignancies. This report describes experience with this technique. Patients and Methods: The BFP was used as a pedicled graft to reconstruct m edium-sized surgical defects of the oral soft and hard tissues in 15 patien ts suffering from oral malignant tumors. Six of the defects were in the max illa, 3 in the retromandibular area, and 6 in the cheek. and oral commissur e. The BFP was left uncovered to epithelialize in 14 patients, and in one i t was covered with lyophiliazed dura, Results: The BFP healed without complications within 3 to 4 weeks in 13 pat ients, 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 pr oved to be extremely easy, and care was only necessary to avoid severing th e 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 med ium-sized surgical defects of the oral hard and soft tissues.