Bichectomy (Buccal Fat Removal Surgery)

Definition

Bichectomy, also known as buccal fat removal or cheek reduction surgery, is a minimally invasive aesthetic procedure designed to remove excess buccal fat pads. This results in a slimmer, more sculpted facial contour with enhanced cheekbone and jawline definition. The procedure is often chosen by patients who are dissatisfied with the fullness of their cheeks and desire a more contoured and balanced facial profile.

Indications

Bichectomy is indicated in patients who present with:

Round or full face shape: Excess buccal fat leading to cheek fullness.
Desire to highlight cheekbones: Reduction of buccal fat enhances malar prominence.
Sharper jawline definition: Contributes to a more angular mandibular contour.
Slimmer facial profile: Ideal for those who feel their face appears “chubby” despite weight loss.

Best candidates are individuals in good health, non-smokers, with realistic expectations. The procedure is typically recommended for patients in their late 20s or older, when facial fat distribution has stabilized.

Surgical Technique

Anesthesia: Local anesthesia with sedation, or general anesthesia if required.
Duration: Approximately 30–60 minutes.
Steps:
- A small (~1 cm) incision is made on the inside of the cheek.
- Partial removal of the buccal fat pad.
- Closure with absorbable sutures; no external scars remain.

Patients are usually discharged the same day.

Preoperative Considerations

Cease smoking at least 2 weeks before surgery.
Stop anticoagulants such as aspirin under medical supervision
Undergo a full medical evaluation before surgery.

Postoperative Course

Recovery speed: Patients return to daily activities within a few days.
Swelling & bruising: Mild, subsides within 1–2 weeks.
Oral hygiene: Essential to prevent infection; antiseptic rinses and antibiotics may be prescribed.
Diet: Soft foods recommended for the first few days.
Final results: Become apparent within 2–3 months as swelling resolves.