Buccal Fat Removal (Bichectomy)
Bichectomy is a surgical procedure in which part of the buccal fat pad (Bichat's fat pad) inside the cheek is removed through the mouth to reduce cheek fullness. It is also commonly known as buccal fat removal. The aim is to make the facial contours appear more defined. The doctor decides at the examination whether it is suitable. Results vary from person to person.
The buccal fat pad is fatty tissue located between the chewing muscles in the cheek. In some people, even if they are not overweight, this fatty tissue is prominent and the face looks round. Losing weight can affect the overall appearance of the face; however, the volume of this fatty tissue does not always change noticeably with weight loss.
Who Is Bichectomy Suitable For?
It is considered for people whose cheek fullness is due to their genetic make-up and who would like their facial contours to appear more defined. In some people it may also be considered for functional complaints such as frequently biting the inside of the cheek while chewing. It is not suitable for people whose cheeks are already thin, as it may lead to a hollow appearance of the face in the future.
Because facial structure changes with age, the doctor decides at the examination on the right timing and suitability. If cheek fullness is due to general weight gain, losing weight first may be recommended. For other methods used to slim the cheeks you can read our article Cheek Slimming Methods.
Before Surgery
At least two weeks before surgery, smoking, aspirin and blood-thinning medicines, which increase the risk of bleeding, are stopped on the doctor's advice. If there is an infection in the mouth or teeth, the procedure is postponed. All medicines being used should be reported to the doctor.
How Is Bichectomy Performed?
The procedure is usually performed under local anaesthesia, and under general anaesthesia when necessary. A small incision is made inside the mouth, on the inner surface of the cheek; the buccal fat pad is reached through this incision and part of it is removed. The incision is usually closed with self-dissolving stitches. Because the incision is inside the mouth, no visible scar remains on the skin of the face. The amount of fat to be removed is planned according to the person's facial structure. For detailed information you can read our bichectomy page.
Recovery
- In the first days, swelling, mild pain and bruising of the cheeks are expected; these usually subside within a short time.
- In the first days, liquids and soft foods are eaten, and solid foods are introduced gradually on the doctor's advice.
- Care is taken with oral hygiene; the mouthwash and medicines recommended by the doctor are used regularly.
- To reduce swelling, cold compresses can be applied as recommended by the doctor and the head can be kept elevated.
Most people can return to daily life within a short time. As the swelling subsides, the new appearance of the cheeks becomes clear within a few months.
Is the Result Permanent and What Are the Risks?
The result of bichectomy is permanent; the removed fat does not come back. For this reason, removing more fat than necessary may lead to a hollow appearance of the face in the future, and the decision should be made carefully. Ageing and weight changes continue to affect the appearance of the face over time.
Like any surgical procedure, bichectomy has risks. Pain, swelling, bruising, bleeding and infection may occur; these are mostly temporary. There are also risks related to anaesthesia. The risks should be discussed in detail with the doctor before the procedure.
Author: Op. Dr. Yücel Sarıaltın