The buccal fat pad (BFP), also known as Bichat’s fat pad, is an encapsulated mass of adipose tissue located deep within the cheek. It is a unique structure in the human face that significantly influences the appearance and contour of the mid-cheek region. This collection of fat is present in all individuals, but its size varies, which contributes to differences in facial fullness and shape. Unlike subcutaneous fat, which lies directly beneath the skin, the BFP is a deep fat compartment that provides structural support. It is particularly prominent in infants, where it is sometimes called the “sucking pad,” but remains a feature of the adult face.
Precise Anatomical Location
The buccal fat pad is not situated just under the skin of the cheek but lies in the deep tissue space known as the buccal space. It is a biconvex mass positioned along the anterior border of the Masseter muscle, a primary muscle of mastication. The location is deep, between the Masseter muscle on the lateral side and the Buccinator muscle on the medial side.
The main body of the fat pad is situated along the posterior maxilla, extending toward the deep facial muscles near the back of the jaw. Its superior border is closely associated with the Zygomatic arch, or cheekbone, which helps define the upper boundary of the mid-cheek region. The entire structure is enclosed within a thin, fibrous capsule that helps maintain its distinct shape and keeps it separate from the surrounding subcutaneous fat. This deep positioning means that the volume of the BFP directly affects the prominence and contour of the lower cheek, below the cheekbone.
Structural Components of the Buccal Fat Pad
The buccal fat pad is not a homogenous, single mass; rather, it is anatomically complex, consisting of a central body and several distinct extensions or lobes. The main body is the most substantial component, giving rise to processes that anchor the fat pad to various surrounding structures. The BFP is divided into three primary lobes—anterior, intermediate, and posterior—each contained within its own fibrous envelope.
The posterior lobe, often considered the main body, is the largest and is positioned in the masticatory space. From this central structure, four main extensions project into surrounding areas of the face. These extensions include the temporal extension (toward the temple area), the pterygoid extension (toward the pterygoid muscles), the buccal extension (the most superficial part affecting cheek contour), and the pterygopalatine extension. This lobulated structure allows the fat pad to act as a gliding surface for muscle movement.
Primary Function in Facial Dynamics
The primary role of the buccal fat pad is to serve as a cushioning and gliding mechanism for the muscles of the face. It acts as a shock absorber, protecting sensitive neurovascular structures, such as branches of the facial nerve and blood vessels, from trauma caused by muscle contraction or external forces. This cushioning is important during the actions of chewing and facial expression.
A specialized function of the BFP is observed in infants, which is why it is sometimes called the “sucking pad.” In newborns, the fat pad provides structural rigidity to the cheek walls. This rigidity is necessary to prevent the cheeks from collapsing inward, allowing the infant to create the negative pressure required for effective suckling and breastfeeding. As a gliding pad, the BFP facilitates smooth movement between the Masseter and Buccinator muscles.
Changes in Buccal Fat Appearance Over Time
The visible prominence of the buccal fat pad changes from infancy to adulthood, leading to shifts in facial contour. In children, the BFP is relatively large compared to the rest of the facial structure, contributing to the characteristic rounded, full cheeks associated with a “baby face.” Although the BFP continues to grow slightly during childhood, the surrounding facial bones and muscles grow at a much faster rate.
This disproportionate growth causes the BFP’s relative size to decrease, which results in the face appearing more sculpted and less full in adulthood. While subcutaneous fat elsewhere on the body can fluctuate significantly with weight, the BFP does not necessarily shrink with weight loss. However, its apparent prominence can change, and as the face ages, the fat pad may descend slightly, potentially contributing to the appearance of folds in the lower face.