Abstract
Aim and Background
To evaluate the effectiveness of a comprehensive surgical approach addressing perioral
mounds—the “mouth pouch”—through modified buccal fat pad sculpting, targeted mucosal
and muscle resection, and focal skin tightening for enhanced lower facial contouring.
Historical Aspects
Conventional techniques often fall short in resolving contour irregularities in the
perioral region due to intricate anatomy and high functional mobility.
Anatomy
The perioral area includes a complex interplay of superficial and deep fat compartments,
musculature, vasculature, and nerves. Aging-related atrophy of superficial fat and
pseudoherniation of buccal fat contribute to soft tissue compartmentalization and
visible mounding.
Technology
Radiofrequency-assisted dermal tightening is combined with intraoral fat sculpting
to promote further definition.
Patient Selection
Ideal candidates have distinct perioral mounds, robust buccal fat pads, thickened
oral mucosa, and visible lines of parakeratosis.
Techniques
A seven-step intraoral technique under local anesthesia include mucosal resection,
buccinator stripping, buccal fat pad sculpting, and radiofrequency treatment.
Postoperative Care
Dual compression with intraoral packing and external head wrap minimizes hematoma
and infection risk.
Current and Future Developments
Combining bony augmentation (e.g., chin implants) with soft tissue contouring yields
comprehensive lower face rejuvenation.
Conclusion and Clinical Relevance
This technique for treating perioral mounds, in carefully selected patients, provides
a reproducible, and safe method for lower facial contour enhancement.
Keywords
perioral mounds - buccal fat pad sculpting - lower facial rejuvenation - facial contouring
- oral mucosa resection
