Residents, Department of Plastic Surgery, National Autonomous University of Mexico, Mexico City, Mexico.
Resident, Department of Plastic Surgery, Baylor College of Medicine, Houston, TX.
Aesthet Surg J. 2019 Sep 13;39(10):1037-1045. doi: 10.1093/asj/sjz040.
Buccal fat pad (BFP) excision is a procedure in which the fat pad is extracted in order to achieve a more youthful appearance.
The aim of this study was to describe an alternative technique that utilizes hydrodissection to extract the BFP.
This is a controlled, prospective, randomized clinical study involving 2 groups. Group A (n = 27) underwent BFP excision with hydrodissection, during which 15 mL of a vasoconstricting anesthetic solution was injected into the BFP. Group B (n = 27) underwent BFP excision, during which 3 mL of lidocaine 2% with epinephrine was injected. All procedures were performed by the same surgeon. Variables analyzed were surgical time, intraoperative bleeding, and postoperative pain directly following surgery 2 hours after the procedure, as well as maximum pain within 72 hours of surgery and complications. Postoperative care was standardized, and patient follow-up extended over a 6-month period.
Pain scores for 54 patients were recorded on a visual analog scale (0-10). Mean ± standard deviation transoperative pain scores were 0.5 ± 0.8 for Group A and 1.3 ± 1.3 for Group B (P = 0.01); 2 hours postoperation the scores were 1.2 ± 0.7 for Group A and 2.6 ± 1 for Group B (P < 0.0001). Maximum pain occurred within 72 hours, and scored 1.6 ± 0.6 for Group A and 3.1 ± 1 for Group B (P < 0.0001). Mean operative time was 8:18 ± 0:47 minutes for Group A and 14:08 ± 2:28 minutes for Group B (P < 0.0001). There was a positive correlation between operative time and pain. Overall, 5.5% of patients suffered postoperative complications.
BFP excision by hydrodissection is an effective procedure that decreases surgical times by facilitating extraction of the BFP with less manipulation, thereby resulting in decreased postoperative pain and a more tolerable recovery.
颊脂垫（BFP）切除术是一种通过提取脂肪垫来实现更年轻外观的手术。
本研究旨在描述一种利用水分离技术提取 BFP 的替代技术。
这是一项对照、前瞻性、随机临床研究，涉及两组。A 组（n=27）行 BFP 切除术，术中向 BFP 内注射 15ml 血管收缩麻醉剂。B 组（n=27）行 BFP 切除术，术中向 BFP 内注射 3ml 2%利多卡因加肾上腺素。所有手术均由同一位外科医生完成。分析的变量包括手术时间、术中出血和术后即刻疼痛（术后 2 小时）、术后 72 小时内最大疼痛以及并发症。术后护理标准化，患者随访时间超过 6 个月。
54 例患者的疼痛评分记录在视觉模拟量表（0-10）上。A 组平均标准差术中疼痛评分为 0.5±0.8，B 组为 1.3±1.3（P=0.01）；术后 2 小时，A 组评分为 1.2±0.7，B 组为 2.6±1（P<0.0001）。最大疼痛发生在术后 72 小时内，A 组评分为 1.6±0.6，B 组评分为 3.1±1（P<0.0001）。A 组平均手术时间为 8:18±0:47 分钟，B 组为 14:08±2:28 分钟（P<0.0001）。手术时间与疼痛之间呈正相关。总的来说，5.5%的患者发生术后并发症。
水分离法切除颊脂垫是一种有效的手术方法，通过减少对 BFP 的操作，促进其提取，从而减少术后疼痛和更可耐受的恢复。
