Updated anatomy of the buccal space and its implications for plastic, reconstructive and aesthetic procedures

J Plast Reconstr Aesthet Surg. 2018 Feb;71(2):162-170. doi: 10.1016/j.bjps.2017.11.005. Epub 2017 Dec 8.

Abstract

Background: The buccal space is an integral deep facial space which is involved in a variety of intra- and extra-oral pathologies and provides a good location for the harvest of the facial artery. The age-related anatomy of this space was investigated and compared to previous reports.

Methods: We conducted anatomic dissections in 102 fresh frozen human cephalic specimens (45 males, 57 females; age range 50-100 years) and performed additional computed tomographic, magnetic resonance and 3-D surface volumetric imaging studies to visualize the boundaries and the contents of the buccal space after injection of contrast enhancing material.

Results: The mean vertical extent of contrast agent injected into the buccal space was 25.2 ± 4.3 mm and did not significantly differ between individuals of different age (p = 0.77) or gender (p = 0.13). The maximal injected volume was 10.02 cc [range: 3.09-10.02] without significant influence of age (p = 0.13) or gender (p = 0.81). The change in surface volume was 3.64 ± 1.04 cc resulting in a mean surface-volume-coefficient of 0.87 ± 0.12 without being statistically significant influenced by age (p = 0.53) or gender (p = 0.78).

Conclusions: The facial artery was constantly identified within the buccal space whereas the facial vein was found to course within its posterior boundary. The buccal space did not undergo age-related changes in volume or size which highlights this space is a reliable and predictable landmark for various plastic, reconstructive and aesthetic procedures.

Keywords: Facial artery; Facial fat compartments; Facial nerve; Facial vein; Plastic surgery; Reconstructive surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cadaver
  • Cheek / anatomy & histology*
  • Cheek / blood supply*
  • Cheek / surgery
  • Dissection
  • Face / anatomy & histology
  • Face / blood supply
  • Face / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures
  • Plastic Surgery Procedures*