Abstract Background Deep plane facelift in patients with prior permanent filler injection is a formidable reconstructive and aesthetic procedure. Various reconstructive techniques have been previously described in the literature to address the defects after permanent fillers removal. This study investigates the effectiveness and complication rate of reconstruction of these soft tissue defects using the buccal pad of fat flap. Materials and Methods This prospective cohort study was conducted at Opal Aesthetic Center in Cairo from 2016 to 2022. Patients underwent removal of the permanent fillers, followed by a deep plane facelift and reconstruction of the resulting defect using a buccal pad of fat flap. Follow up was done for a minimum period of six months to a maximum of five years to assess contour and complications. Results A study of 151 patients, comprising 92.7% females with a mean age of 47.8 years, examined the outcomes of reconstruction using buccal pad of fat flap following permanent filler removal in conjunction with a deep plane facelift procedure. Patient satisfaction was high, with 80.7% rating their outcomes as “very good” or “excellent”. Primary surgeries had an 88.5% satisfaction rate, whereas revision surgeries had only a 33.4% satisfaction rate. Contour irregularities were reported in 10.6% of cases and were linked to the occurrence of complications ( p < 0.001). Conclusion The buccal fat pad flap combined with a deep plane facelift after permanent filler removal is a safe and effective reconstructive method with high patient satisfaction. Primary surgeries generally have better outcomes than secondary revisions. The outcome of the buccal fat pad procedure has shown to be negatively affected by smoking, previous surgeries and the presence of post-operative complications. Future research should refine techniques for secondary cases and investigate treatments to improve tissue quality. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Ghoraba et al. (Mon,) studied this question.