Buccal Fat Pad Advancement

Open Dropdown

Preoperative Considerations


  • Potential for failure if closing OAF, possible need for more invasive procedure like temporalis flap 
  • Damage to Stensen's duct
  • Buccal artery bleed


  • Local or general anesthesia 


  • None


  • #15 blade
  • Tissue forcep
  • Tonsil or similar hemostat
  • 3-0 Vicryl suture
  • Bite block or mouth prop
  • #9 Periosteal elevator


Postoperative Considerations


  • Soft diet

Follow Up:

  • Monitor for several weeks in case of breakdown and OAF

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): ***

Anesthesia: General

Implants: None


Drains: None

Fluids: See anesthesia record

EBL: Minimal

Complications: None

Counts:  Correct x2

Indications: ​***

Findings: As expected

Procedure in Detail:

The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

A curvilinear incision was made intraorally along the attached gingiva. Subperiosteal dissection was performed. The buccal fat pad was identified and dissected free from its surrounding attachments. Gentle traction was applied to mobilize the buccal fat pad, allowing for advancement from the buccal space. The defect in the oroantral region was carefully assessed and the mobilized buccal fat pad was then transposed and used for closure of the oroantral communication, ensuring adequate coverage and closure. The fat pad was secured in place using absorbable sutures to achieve watertight closure of the oroantral communication.

Once the closure was completed, the wound was irrigated with a sterile saline solution, and meticulous hemostasis was achieved. The intraoral incision was closed in layers using absorbable sutures, ensuring proper approximation of tissue planes and minimizing tension on the wound edges.

The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.


  • 14040 Buccal fat pad transfer reconstruction palate/maxilla
  • 30580 Closure of oral antral communication/fistula
  • D7260 Closure of oral antral-fistula
  • D7261 Primary closure of a sinus perforation