[Bichat's buccal fat pad for reconstruction of posterior oral cavity defects]

Abstract

Some losses of matter in the posterior area of the oral cavity require reconstruction with vascularized tissue to prevent retraction and a limited mouth opening. Bichat's fat pad or Bichat's fat ball is rarely used for oral mucosal reconstruction despite its proximity, easy availability, plasticity and simple use as a flap. Bichat's fat pad is resistant to lipolysis even in case of major weight-loss. It usually herniates in the exeresis site of a jugal tumor or intermaxillary commissure. When this is not the case, it can be obtained by a horizontal vestibular incision. The fat pad is unfolded and sutured without tension to the margin of the defect. The flap may be protected by a Bourdonnet dressing. Epithelialization begins 8 to 10 days after surgery. It is completed in the second or third week. The fat volume is variable, thus filling can only be applied to areas with loss of matter under 6cm. The technique is simple and quick. Postoperative evolution is usually uneventful; healing is quick as well as recovery of normal feeding function.