Visual criteria for a harmonious midface depends on (1) a distinction between the anterior border of the parotid gland and cheek hollow, (2) a visible posterior border of the nasolabial fold (this signifying the most variable criterion), (3) an intervening cheek soft-tissue convexity that does not exceed the plane of a perpendicular from the midzygoma to the mandible (subtle submalar depression), (4) prominent zygomatic eminences, and (5) a well-defined mandible, particularly the angle. The space within the zygomatic arch and the mandible that defines the ideal midfacial “cheek hollow” has been established. This can be achieved through a combination of: aesthetic contouring of the facial skeleton, facial liposculpture, and cervipofacialplasty. A series of 25 consecutive patients undergoing submuscular fat removal by buccal fat pad excision to improve aesthetic mid-face were treated and are presented. To preserve the subcutaneous fat commonly lost with aging and to avoid late secondary deformities, only submuscular buccal fat excision is recommended in a carefully selected group of patients. The anatomy, indications, and technique for buccal hpectomy in midface contouring are discussed.
© Williams & Wilkins 1991. All Rights Reserved.