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April 1989

Jowl Sculpting by Buccal Fat Removal and Rhytidectomy

Author Affiliations

Oakalnd, Calif

Arch Otolaryngol Head Neck Surg. 1989;115(4):421-423. doi:10.1001/archotol.1989.01860280015004

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During the fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Washington, DC, William J. Wolfenden, Jr, San Francisco, presented a technique of jowl sculpting by buccal fat removal and rhytidectomy. According to Wolfenden, 20% of patients undergoing rhytidectomy could benefit from reduction of the cheek rounding accomplished by this procedure. He has used this technique since 1987 in 20% of rhytidectomies performed, and, in an occasional patient, as the only procedure. The technique is strictly intraoral through a 1-mm incision just inferior and posterior to the parotid duct orifice. The buccal fat pad is uncovered with a blunt-tip suction cannula or scissors. A suction-assisted lipectomy is then performed removing half to two thirds of the fat pad. The mucosal incision is closed with an absorbable suture. Perioperative cephalosporin is used to prevent infection. Wolfenden cautions that outcome cannot be appreciated before one year, at which time

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