Versatility of the Pedicled Buccal Fat Flap

The pedicled buccal fat flap (PBFF) is a versatile and robust regional flap used for a variety of maxillofacial reconstructions. However, recent literature has questioned the popularity of this flap. The goal of this single-instruction, retrospective study is to review the outcomes and complications of the PBFF. Our study included 27 patients and 28 PBFFs with 13 males, 14 females, and an average age of 68. The most common primary pathologies included squamous cell carcinoma and a fistula (oroantral or oronasal). Persistent postoperative complications were experienced in 31.3% of the cohort. The most common subsite was the retromolar trigone, and the higher complication rates per subsite were noted in the hard and soft palate groups (66.7% each). Higher total complication rates were seen in cases of SCC and fistula (33.3% each). Our study demonstrates the low morbidity and high tolerance of the procedure despite a patient having older age, significant comorbidities (67.9%), smoking history (60.7%), preoperative radiation (17.9%), and postoperative radiation (28.6%). The authors conclude the PBFF remains a durable and reliable reconstructive option in a variety of patient cases.