The Buccal Fat Pad: A Unique Human Anatomical Structure and Rich and Easily Accessible Source of Mesenchymal Stem Cells for Tissue Repair

Abstract

Buccal fat pads are biconvex adipose tissue bags that are uniquely found on both sides of the human face along the anterior border of the masseter muscles. Buccal fat pads are important determinants of facial appearance, facilitating gliding movements of facial masticatory and mimetic muscles. Buccal fad pad flaps are used for the repair of oral defects and as a rich and easily accessible source of mesenchymal stem cells. Here, we introduce the buccal fat pad anatomy and morphology and report its functions and applications for oral reconstructive surgery and for harvesting mesenchymal stem cells for clinical use. Future frontiers of buccal fat pad research are discussed. It is concluded that many biological and molecular aspects still need to be elucidated for the optimal application of buccal fat pad tissue in regenerative medicine.

Keywords: buccal fat pad; human anatomy; mesenchymal stem cells source; oral surgery.

Figure 1

Buccal fat pad gross anatomy. Buccal fat pad anatomical localization and its relationship with landmarks in the face (such as parotid gland, buccinator muscle, and masseter muscle). Anatomage Inc. (Santa Clara, CA, USA)—Anatomage Table EDU. The 3D rendering of the body donated to scientific data is from Anatomage Table (the Head and Neck dataset).

Figure 2

Buccal fat pad lobes and extensions. Schematic representation of the three buccal fat pad lobes (anterior, intermediate, and posterior lobes) and of the four buccal fat pad extensions (buccal, pterygoid, pterygopalatine, and temporal extensions). Illustration inspired by Loukas et al. [19].

Figure 3

Buccal fat pad blood supply. The buccal fat pad blood supply is shown on the right side of the face after the removal of the masseter muscle, zygomatic major muscle, zygomatic minor muscle, orbicularis oculis, maxillary bone and jaw. The deep temporalis artery is indicated by a red dotted line to demonstrate that it runs underneath the temporalis muscle. Anatomage Inc. (Santa Clara, CA, USA)—Anatomage Table EDU. The 3D rendering of the body donated to scientific data is from Anatomage Table (the Head and Neck dataset).

Figure 4

Scanning electron microscopical (SEM) images (A–C) and transmission electron microscopical (TEM) image (D) of adipocytes of a human buccal fat pad. In photomicrographs (A) and (B), mature adipocytes organized in lobules in the buccal fat pad are shown in low-magnification SEM images, and in photomicrograph (C), cultured mesenchymal stem cells harvested from the buccal fat pad are shown at higher magnification. The TNT-like long and thin cytoplasmic protrusions are visible both in situ (A,B) and in cultures of mesenchymal stem cells (C). The high-magnification TEM photomicrograph (D) of cultured mesenchymal stem cells shows intracellular small lipid droplets and an organelle-poor cytoplasm. (LD): lipid droplets. The photomicrographs are from Conti et al. [22].