Ultrasonographic Analysis of the Subcutaneous Tissue of the Middle Third of the Face and Its Influence on Diagnosis for Bichectomy

The primary complaint of patients who require bichectomy surgery is primarily related to facial esthetics, which should be considered in conjunction with the surgeon’s clinical analysis of the face. Studies are needed to evaluate the parameters associated with the buccal fat pad (BFP) volume, since there may be an erroneous indication for surgical intervention, which occurs due to the impossibility of clinically evaluating the facial anatomical layers that may be responsible for the increase in the volume of the middle third of the face, not just the BFP. This study aims to investigate whether the thickness of the subcutaneous tissue (ST) affects the excess volume in the middle third of the face. Data from ultrasound (US) measurements (volume of the buccal portion of the BFP and average thickness of the ST), as well as the age and sex of a sample of 28 patients, were extracted. The results of the statistical tests showed that there was no significant difference between the volumes of BFP right and BFP left ( P = .678), as well as no significance between ST right and ST left ( P = .088), indicating symmetry between the 2 sides of the individuals in the sample. When cross-testing between BFP and ST values on each side of the patients, it was possible to obtain some results: ST did not show a significant correlation with age, while the right BFP showed a weak tendency for a negative correlation with age; it is concluded that the volume of the middle third of the face is also related to the thickness of the ST, with US analysis being a complementary diagnostic method for indicating bichectomy.