The impact of partially removing the Bichat fat pad in the linear facial measurements, satisfaction with facial aesthetics and quality of life: a single-arm CONSORT-guided clinical trial

• Published in: Clinical oral investigations Vol. 27; no. 1; pp. 249 - 262
• Main Authors: Pimentel, Kamila França, de Lima Sousa, Maria Gabriela, dos Santos Passos, Andressa, Farias, Ravy Jucá, Guerra, Janaina Motta, Costa, Fabio Wildson Gurgel, Sousa, Fabrício Bitu, Silva, Paulo Goberlânio Barros, Cetira Filho, Edson Luiz
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-01-2023; Springer Nature B.V
• Subjects: Adipose Tissue - transplantation; Adult; Clinical trials; Dentistry; Edema; Esthetics; Face; Humans; Inflammation; Medicine; Mouth; Oral hygiene; Original Article; Pain; Patient Satisfaction; Personal Satisfaction; Quality of Life; Esthetics; Surgery, Plastic; Oral; Surgery; Mouth mucosa; Quality of life
• ISSN: 1436-3771; 1432-6981; 1436-3771
• DOI: 10.1007/s00784-022-04718-0

Objective
To evaluate the influence of Bichat’s ball removal on postoperative inflammatory parameters (pain, edema, and trismus), facial volume reduction, facial esthetic satisfaction, and oral health-related quality of life.
Material and methods
A single-arm clinical trial with 21 patients undergoing Bichat’s ball removal. The following parameters were assessed at baseline and up to 3 months postoperatively: Visual Analogue Scale pain scores (0–10), rescue medication consumption, mouth opening, AM-Tr, AM-CEO, AM-NA, AM-CL, and AM-PM measurements, Oral Health Impact Profile (OHIP)-14 QoL scores, and satisfaction with facial esthetics (FACE-Q Satisfaction with Facial Appearance Overall Scale (SFAOS).
X
2
, analysis of variance-repeated measures/Bonferroni, or Friedman/Dunn tests were used (
p
 < 0.05, SPSS v20.0).
Results
Peak pain occurred after 2 h and, 10 h later, the levels returned to baseline values (
p
 < 0.001). Rescue medication consumption peaked in the first 24 h reducing significantly after 72 h (
p
 < 0.001). Mean mouth opening decreased after 24 h and returned to baseline levels after 1 month, and all linear facial measures reduced significantly after 1 or 3 months (
p
 < 0.05). OHIP-14 scores and FACE-Q SFAOS scores showed significant improvement after 1 month (
p
 < 0.001), but patients aged > 25 years showed a significant reduction in FACE-Q SFAOS at the end of the study (
p
 = 0.006).
Conclusions
Surgical removal of the Bichat’s ball induces a mild inflammatory process controlled by rescue medication, significantly reduces face volume, and improves QoL and satisfaction with facial esthetics 3 months postoperatively. However, the efficacy of this procedure in patients > 25 years old is questionable.
Clinical relevance
Evaluate the effectiveness of bichectomy in terms of clinical effects and impact on quality of life.