What is Buccal Fat Removal (Bichectomy)? Frequently Asked Questions About Facial Slimming Surgery.

For individuals who desire more defined facial features, more prominent cheekbones, and a slimmer lower face contour, one of the aesthetic procedures is buccal fat removal (bichectomy). This surgical procedure, also known as buccal fat removal in medicine , involves the controlled removal of buccal fat pads located in the deep part of the cheeks.

Bichectomy is not a suitable procedure for every individual. The goal of the operation is not to slim the face as much as possible, but to create a balanced and natural contour that is appropriate to the person’s existing facial anatomy. Therefore, facial shape, skin quality, age, bone structure, and the long-term aging process should be evaluated together before the procedure.

This procedure, also known as “Hollywood cheek lift,” can help give the face a more V-shaped appearance with proper patient selection and surgical planning. However, since removing excessive fat tissue can lead to an unnatural look, surgical planning must be tailored to each individual.

What is a Bichectomy Surgery?

Bichectomy is a surgical procedure in which the buccal fat pads located in the middle of the cheeks are removed in a controlled manner through small incisions made inside the mouth.

The primary goal of the procedure is not to slim the facial features, but rather to define the facial contours and make the cheekbones more visible.

During the procedure, only the amount of fat tissue deemed aesthetically necessary is removed. This approach aims to preserve the natural volume of the face while reducing the risk of an excessively thin or sunken appearance.

The goal of modern bichectomy procedures is not to create a uniform facial appearance, but to achieve balanced and natural results that are in harmony with the individual’s facial proportions.

Who is a suitable candidate for bichectomy?

Bichectomy is one of the aesthetic surgical options that can be considered, especially for individuals with noticeable fullness in the lower and middle sections of their face.

The following individuals may be suitable candidates:

  • Those with noticeably full cheeks
  • People who want their cheekbones to appear more prominent
  • Individuals with round facial features
  • Patients whose general health condition is suitable for surgery
  • Adults with realistic expectations
  • People whose cheek fullness persists regardless of weight changes.

Before a decision is made regarding surgery, facial anatomy should be evaluated in detail.

Who is not suitable for bichectomy?

Like any cosmetic procedure, bichectomy may not be suitable for everyone.

Different treatment options may be considered, especially in the following situations:

  • People who naturally have a thin facial structure
  • Individuals with significant facial volume reduction in old age
  • Patients with severely reduced skin elasticity
  • People with active infection
  • Uncontrolled chronic diseases
  • Individuals with unrealistic aesthetic expectations

As the face ages, there is a decrease in natural fat tissue, so long-term aesthetic results should also be considered during the planning process.

Advantages of Bichectomy

In suitable candidates, bichectomy surgery can provide various aesthetic advantages.

These include:

  • More defined facial contours
  • Prominent cheekbones
  • A more defined jawline.
  • More balanced proportions in the lower facial region.
  • A slimmer appearance in facial profile.
  • Makeup and light-shadow effects become more pronounced.
  • No visible surgical scars.

It is important to remember that results can vary from person to person and the same aesthetic effect may not be achieved in every patient.

In what situations might a bichectomy be preferred?

Bichectomy is generally planned to meet the following aesthetic expectations:

  • Reducing the appearance of a round face
  • Balancing cheek fullness.
  • Making the cheekbones more prominent
  • Strengthening the lower facial contour.
  • Planning in combination with other facial aesthetic procedures.

In some patients, bichectomy may be considered in conjunction with other facial aesthetic procedures such as chin augmentation, facelift, or fat grafting. However, it is important that the decision regarding the combination is made after a thorough examination.

How is a bichectomy surgery performed?

Bichectomy is a surgical procedure that aims to remove buccal fat pads in the cheek area in a controlled manner while preserving the natural anatomy of the face. The scope of the operation is planned according to each patient’s facial structure, and the amount of fat to be removed is determined by considering the long-term appearance of the face.

A detailed facial analysis is performed before the procedure. The prominence of the cheekbones, the structure of the jawline, skin quality, and cheek volume are all evaluated together to create a personalized surgical plan.

The operation is usually performed under local anesthesia. If necessary, sedation may also be administered to increase the patient’s comfort.

The surgeon makes a small incision of about 1-2 centimeters inside the mouth to access the buccal fat pad. After carefully removing an amount of fat tissue that will not disrupt aesthetic balance, the incision is closed with dissolvable sutures.

The procedure is usually completed within 30 to 45 minutes , and patients are often discharged the same day.

Pre-operative assessment process for bichectomy surgery.

The foundation of a successful bichectomy operation is the correct patient selection. Therefore, not only cheek fullness but the entire face should be evaluated before surgery.

During the examination, the following criteria are usually examined:

  • Face shape and proportions
  • Cheekbone structure
  • Defined jawline
  • Skin elasticity
  • Cheek volume
  • Age
  • Body mass index
  • Previous cosmetic surgeries
  • General health status
  • Medications used
  • Smoking

For some patients, bichectomy alone may not be sufficient. Other aesthetic procedures may also be considered to achieve a more balanced facial profile.

Recovery Process After Bichectomy

Although the healing process is generally rapid, each patient’s recovery rate is different. Swelling and mild tenderness seen after surgery are a natural consequence of the surgical procedure.

You may experience a feeling of fullness in your cheeks during the first few days. This is an expected finding due to swelling from the procedure and will subside on its own over time.

Because the stitches are inside the mouth, there will be no visible scars.

Following the care instructions recommended by your doctor can contribute to a more comfortable recovery process.

First 24 Hours

It is considered normal to experience the following situations in the first few days after the operation:

  • Mild swelling
  • A feeling of tightness in the cheeks.
  • Minimal pain
  • Sensitivity during chewing.
  • Mild edema

During this period, it is recommended to avoid hot food and drinks, use oral care products regularly as prescribed by your doctor, and drink plenty of fluids.

First Week

Swelling may reach its most noticeable level during the first week.

During this process;

  • Choosing soft foods,
  • Paying attention to oral hygiene,
  • Avoiding smoking and alcohol use,
  • Postponing strenuous physical activity.

It can support the healing process.

Most patients are able to easily return to their daily lives by the end of this period.

First Month

Most of the swelling subsides within the first month, and facial contours begin to become more defined.

However, the appearance obtained during this period should not be considered the final result. Complete tissue healing may take time.

When will the final results be seen?

The true results of bichectomy surgery usually become more apparent within 2 to 4 months .

During this process;

  • The cheek contour becomes thinner.
  • Your cheekbones may start to appear more prominent.
  • The jawline becomes more clearly visible.
  • A more balanced appearance can be achieved in the lower part of the face.

People with thin skin tend to notice the changes sooner, while those with thicker skin may take a little longer to see results.

Nutrition After Bichectomy

Since the operation is performed through the mouth, it is important to pay attention to diet in the first few days.

The generally recommended practices are as follows:

  • In the first few days, warm and soft foods should be preferred.
  • Drink plenty of fluids.
  • Avoid hard and crusty foods.
  • Limiting spicy foods
  • Regular oral care as recommended by the doctor.

Maintaining oral hygiene is an important part of the healing process.

What precautions should be taken after a bichectomy?

Following these recommendations after surgery can support the recovery process:

  • Avoid blows to the face in the first few days.
  • Do not use medication without a doctor’s supervision.
  • Avoiding cigarettes and tobacco products.
  • Maintaining regular oral hygiene
  • Don’t miss your check-up appointments.
  • Avoiding strenuous exercise for a certain period of time.
  • Follow the diet plan recommended by the doctor.

Since each patient’s recovery process can be different, personalized recommendations should always be prioritized.

Possible Risks of Bichectomy Surgery

Bichectomy is considered a safe surgical procedure when appropriate patient selection is made. However, as with any surgical procedure, there are some risks.

Possible complications may include:

  • Infection
  • Bleeding
  • Temporary payment
  • Temporary numbness
  • Asymmetry
  • Aesthetic results that do not fully meet expectations.
  • Need for revision
  • Nerve injuries occur in very rare cases.

The likelihood of these risks occurring may vary depending on surgical planning, the patient’s anatomical structure, and the postoperative care process.

Will the cheeks sink after a bichectomy?

One of the most frequently asked questions about bichectomy is whether it will cause sunken cheeks after the operation.

With careful patient selection and controlled surgical planning, the goal of bichectomy operations is not to excessively slim the face, but to make the existing facial features more balanced and defined.

However, the risk of unwanted volume loss may increase in the following situations:

  • The procedure is suitable for individuals with naturally thin facial features.
  • Removal of excess fat tissue
  • Insufficient analysis of facial anatomy.
  • Decrease in natural fat tissue in old age

Therefore, before surgery, not only the current appearance but also the future aging process of the face should be considered. Personalized planning by an experienced surgeon helps preserve natural facial features.

Is Bichectomy a Permanent Procedure?

Buccal fat pads do not regenerate in the same area after removal. Therefore, the anatomical changes achieved with bichectomy are generally considered permanent.

However, the facial appearance after the operation;

  • The aging process,
  • Weight changes,
  • Changes in skin elasticity,
  • Genetic factors

It can change over time due to reasons such as these.

Maintaining healthy lifestyle habits and ideal weight after surgery is important for achieving lasting results.

Can a bichectomy be performed again?

For most patients, bichectomy is a one-time surgical procedure because the removed buccal fat tissue does not regenerate.

However, a second assessment may be necessary in some cases.

For example;

  • Only a limited amount of fat tissue was removed in the first operation.
  • The need for reassessment of facial contours.
  • The first operation was performed at a different center.
  • Aesthetic irregularities requiring revision

A detailed assessment of facial anatomy is necessary before a decision is made regarding a second surgical intervention.

Aesthetic Procedures That Can Be Performed in Conjunction with Bichectomy

In some patients, bichectomy may be combined with other aesthetic procedures to achieve a more balanced facial appearance.

The following are some of the operations that can be planned in combination:

  • Chin aesthetics
  • Jawline shaping
  • Facelift surgery
  •  Neck lift
  • Fat injection
  •  Eyelid surgery
  •  Nose surgery
  •  Cheekbone enhancement procedures

The decision regarding combination surgery should be made based on the patient’s needs, facial proportions, and surgical suitability.

How are bichectomy prices determined?

The cost of bichectomy surgery can vary for each patient. This is because the operation is not a standard procedure and is planned individually for each patient.

The main factors influencing pricing are:

  • Patient’s facial anatomy
  • Scope of the surgical plan
  • The experience of the surgeon performing the operation
  • The hospital or clinic where the procedure will be performed
  • Surgical technique used
  • Anesthesia method
  • Postoperative follow-up and monitoring process

The exact price can only be given after a detailed examination and treatment plan.

Things You Should Know About Bichectomy

Bichectomy, when performed with the right patient selection, is an effective aesthetic surgical procedure aimed at enhancing facial contours. However, this operation is not suitable for every face type.

To achieve a successful outcome;

  • Accurate analysis of facial anatomy,
  • Careful planning of the amount of oil to be purchased,
  • Preserving natural facial proportions,
  • Assessment of the patient’s long-term expectations,
  • Following the surgeon’s recommendations

It is of great importance.

The goal of modern facial aesthetics is not simply to create a slimmer facial appearance, but to achieve a balanced and aesthetically pleasing contour while preserving the individual’s natural facial features.

Personalized Bichectomy Assessment

Every facial structure is different, and the suitability of bichectomy surgery should be evaluated on an individual basis.

A detailed pre-operative examination will assess your facial anatomy, cheek volume, skin type, and aesthetic expectations to create the most suitable treatment plan for you.

To learn more about bichectomy, to have your facial aesthetics evaluated, or to discover personalized treatment options, you can contact our expert team and schedule an appointment for a doctor’s consultation.

Frequently Asked Questions

Is bichectomy surgery painful?

During bichectomy surgery, local anesthesia or, if necessary, sedation is administered, so no pain is felt during the procedure. Any mild pain or tenderness that may occur after the operation can usually be controlled with medication prescribed by the doctor and will subside within a few days.

How long does a bichectomy surgery take?

Although the duration of the operation can vary depending on the patient’s anatomical structure and surgical plan, bichectomy surgery is usually completed within 30 to 45 minutes . Patients are generally discharged the same day.

When can one return to work after a bichectomy?

Most patients can return to their daily lives within 2 to 5 days . However, those who do physically demanding work may need to rest for a longer period, as recommended by their doctor.

Will the face become thinner immediately after a bichectomy?

No. Due to swelling after the operation, the face may appear fuller in the first few days. As the swelling subsides, the facial contours will begin to become more defined. However, the final results are usually visible after 2 to 4 months .

Will there be a visible scar after a bichectomy?

No. In bichectomy surgery, all incisions are made inside the mouth, so there is no visible surgical scar on the face. The incisions inside the mouth heal over time and become unnoticeable in most patients.

Is bichectomy surgery permanent?

Since the buccal fat tissue removed during the operation does not regenerate, the resulting anatomical changes are generally permanent. However, the aging process, weight changes, and natural changes in skin structure can affect facial appearance over the years.

Does bichectomy make the face look much thinner?

The goal is not to make the face as thin as possible. In the modern bichectomy approach, the aim is to balance the fullness in the cheek area and make the cheekbones more prominent while preserving the natural proportions of the face. Since removing too much fat can lead to unnatural results, the operation should be planned individually for each patient.

At what age can a bichectomy be performed?

Surgery can be considered in adult individuals whose facial development is complete and whose general health is suitable for the procedure. The decision to operate should be made not only based on age, but also taking into account facial anatomy and aesthetic expectations.

Can bichectomy be a substitute for weight loss?

No. Bichectomy is not a weight loss method. The operation only aims to remove the buccal fat pads in the cheek area. It does not reduce body weight or change the overall facial fat percentage.

Can other cosmetic procedures be performed in conjunction with a bichectomy?

Yes. In suitable patients, bichectomy can be planned in conjunction with other facial aesthetic procedures such as chin augmentation, facelift, neck lift, rhinoplasty, or fat grafting. The decision regarding combination should be made after a detailed examination.

Is a special diet required after the operation?

It is recommended to prefer soft and warm foods for the first few days. Avoiding hard, crunchy, or excessively hot foods until the healing process in the mouth is complete can ensure a more comfortable recovery.

When can sports be resumed after a bichectomy?

Light daily activities can be performed in a short time. However, the time recommended by your doctor should be waited before starting strenuous exercise and intense physical activities.

Does facial symmetry change after a bichectomy?

Surgery can aim to improve facial symmetry, but every face naturally contains a certain degree of asymmetry. These differences are evaluated during surgical planning to achieve the most balanced result possible.

Is it okay to smoke after a bichectomy?

Smoking and other tobacco products can negatively affect wound healing and increase the risk of infection. Therefore, it is recommended to avoid their use before and after surgery for the period suggested by your doctor.

Is a follow-up doctor necessary after a bichectomy?

Yes. Post-operative follow-up examinations are important for evaluating the healing process and detecting potential problems early. It is recommended to attend these check-ups regularly.