The buccal fat pad consists of a main body and four extensions: bucal, pterigoid, pterygomandibular, and temporal. The body is centrally positioned. The buccal extension lies superficially within the cheek, and the pterigoid, pterygomandibular, and temporal extension are situated more deeply.
The main body of the fat pad is located above the parotid duct and extends along the upper portion of the anterior border of the masseter. It then courses medially to rest on the periosteum of the posterior maxilla (Fig. 7-3). In this region, the body of the fat pad overlies the uppermost fibers of the buccinator muscle and travels forward along the vestibule overlying the maxillary second molar. Posteriorly, it wraps around the maxilla and travels through the pterygomaxillary fissure, where it is in intimate contact with branches of the internal maxillary artery and maxillary division of the trigeminal nerve.
Figure 7- 3 Axial section through the maxilla at the level of the tooth root apices showing the relationship of the buccal fat pad (BFP) to the lateral maxilla. Note that the fat pad extends anteriorly to approximately the first molar. Also, posterior to the origin of the buccinator muscle on the maxilla, the buccal fat pad is just lateral to the periosteum.
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