What is the procedure for a buccal fat pad (BFP) flap?

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Last updated: April 7, 2025View editorial policy

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From the Research

A buccal fat flap procedure involves surgically accessing and mobilizing the buccal fat pad to repair defects in the oral cavity, and according to the most recent study 1, it can be effectively used in primary and secondary palatoplasty with a low incidence of complications. The surgeon begins by making an incision in the oral mucosa, typically in the upper molar region or through an existing defect. After careful dissection through the buccinator muscle, the buccal fat pad is identified and gently teased out without disrupting its blood supply from the maxillary artery branches. The fat pad is then rotated and positioned to cover the defect, whether it's an oroantral communication, palatal defect, or other oral cavity wound. The flap is secured in place with absorbable sutures, and within 3-4 weeks, the exposed fat undergoes epithelialization, transforming into oral mucosa. This procedure is effective because the buccal fat pad has excellent blood supply, is easily accessible, and provides adequate volume for moderate-sized defects, as noted in 2 and 3. Some key points to consider when performing a buccal fat flap procedure include:

  • The importance of preserving the blood supply to the fat pad, as highlighted in 4
  • The need for careful dissection and handling of the tissue to minimize complications
  • The potential for the flap to be used in a variety of applications, including primary and secondary palatoplasty, as described in 1 Patients typically require a soft diet for 1-2 weeks post-procedure and antimicrobial mouth rinses to prevent infection while healing occurs. The main advantages of the buccal fat flap procedure include its versatility, minimal donor site morbidity, and the fact that it can be performed under local anesthesia in many cases, making it a valuable option for repairing defects in the oral cavity.

References

Research

An Algorithmic Approach for Deploying Buccal Fat Pad Flaps and Buccal Myomucosal Flaps Strategically in Primary and Secondary Palatoplasty.

The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, 2023

Research

The Buccal Fat Pad Flap.

Oral and maxillofacial surgery clinics of North America, 2021

Research

Buccal Fat Reduction: Indications, Surgical Techniques, Complications.

Facial plastic surgery clinics of North America, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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