What is Bichectomy (Buccal Fat Removal), and how is it different from other surgical procedures?

Bichectomy (Buccal Fat Removing) or Hollywood Cheek Surgery as it is commonly known, is a surgery performed to create a thin feature and highlight the cheekbones. This operation is performed to provide a V-shaped feature to patients who have a square or round face shape. It removes the buccal fat pad in the inner parts of the cheek through a small incision. This surgery exposes the cheekbones and makes the face seem slimmer and helps achieve a slender and young appearance.
The procedure takes about half an hour and causes no scars on the cheeks. It is applied to the right and left cheek from the inside of the oral mucosa and the amount of fat is reduced in the middle cheek area. Our midface has deep and superficial fat pads and Bichat's fat pad. The volume of the Bichat's fat pad is constant because it has its capsule. As only this fat pad may be removed and its volume is constant, there will be no facial collapse in the future. However, the effect of the surgery will appear approximately 3-6 months later, because there will be swelling on the face after the surgery.

What does the Bichectomy procedure imply?

Bichectomy, or Hollywood Cheek Surgery, is performed by making an about 1 cm incision and removing 40 to 50 percent of the fat from that area.

How long does the Bichectomy procedure take? Is the process painful?

An experienced doctor can complete a bichectomy in around 30 minutes under local anesthesia. A small incision (approximately 1cm) is made on the inside of the cheek. The surgeon will place pressure on the outside of the cheek, exposing the buccal fat pad. The fat is cut away and carefully removed, and the wound is then sealed with absorbable sutures.

It is possible to combine this surgery with other facial procedures, including rhinoplasty, lip augmentation, and Botox injections. There are three options for anesthesia: local, sedation, and general. Patients undergoing multiple surgeries will likely be put under general anesthesia and will require someone to take them home post-surgery.

Who is a good candidate for a Bichectomy Procedure?

Those with large amounts of fat in their cheeks who lack facial outlines, making their face seem obese, are good candidates for Bichectomy surgery. Men may also have this surgery done, even though women are the ones who often request it. Male patients' bone and fat structures vary from those of female patients; hence less fat is removed during the surgery on males.

Selection of Doctors

One of the most critical aspects of a cheek reduction procedure is the selection of a surgeon. When it comes to a cheek reduction, it's important to consider where the fat will be taken from and how much of it will be removed, as well as where the filler will be injected if it's needed. To get a V-shape on the face, a competent plastic surgeon should assess all the facial characteristics.

Things to think about before undergoing the procedure

You should abstain from smoking and drinking alcohol for at least a week before a Bichectomy. It is critical to do this to speed up the healing process. Before the procedure, avoid using blood thinners. In addition, be sure to tell your doctor about any drugs you use on a daily basis.


After-surgery considerations

Do not eat anything solid the next day since there will be stitches in your mouth. There may be a problem with chewing on the first day after surgery, which might cause damage to the sutures. After the first day of eating liquid food, you may go on to somewhat solid food on the second day and then solid meals on the third and subsequent days. For the first three days after surgery, refrain from using mouthwash. After cheek surgery, the stitches are hardly noticeable. To avoid an infection, brush your teeth and floss carefully. In a few days, the sutures in your mouth will be gone. There will be no more tenderness in the cheeks.

After a cheek reduction, some edema and swelling at the surgical site are usual for 2-3 weeks. Swelling and edema may be reduced with the application of an ice pack. After surgery, most patients can return to normal social activities right away. The operation’s outcomes will be apparent in three weeks.


Who is a good candidate for a Bichectomy Procedure?

It is possible for anybody with a square or round face owing to excess fat in the cheek area to have this treatment. Bichectomy is advised for those who have fat accumulation exclusively in the cheek area, but who are not overweight, to achieve proportional and aesthetically pleasing face proportions.

Bichectomy surgery may be performed on patients of any age.
Patients over the age of 20-25 are eligible for this procedure, which has grown more widespread in Turkey in recent years.


What are the dangers of Bichectomy (Buccal Fat Removal) Surgery?

• Infection or poor wound healing
• Excessive bleeding
• A negative reaction to anesthesia
• Issues with speaking or chewing, due to the role of buccal fat in lubricating mouth muscles
• Fluid accumulation or seroma
• Damage to saliva glands
• Loss of sensation or damage to facial nerves
• Deep vein thrombosis (DVT)
• Facial asymmetry or otherwise poor results

The best way to avoid side effects is to see a professional, licensed plastic surgeon, and carefully follow all aftercare advice.

Bichectomy may also increase the general aging process of the face. This is due to the buccal fat removal combined with the natural fat and collagen loss we endure as we age. The usual advice is to take care of your skin and avoid habits such as smoking and excessive alcohol drinking, though cheek fillers are also an option if appropriate.

If you experience any serious side effects, including severe pain, shortness of breath, or chest pain, contact a doctor or your nearest emergency apartment immediately.

How long does it take to recover from Bichectomy (Buccal Fat Removal) surgery?

There is no need for hospitalization after the operation since it is performed under local anesthesia and the patients are discharged within an hour. The recovery process is also very fast, and it does not cause any aesthetic problems as the incision is in the inner part of the cheeks. The face shape isn’t likely to return to its original shape, even if the patients gain weight afterward.