What is Buccal Fat Removal (Bichectomy)?

Bichectomy is a facial slimming surgery that has become popular in recent years, especially in the world of aesthetics. Also known as “cheek reduction surgery,” this procedure removes the so-called “Bichat” fat pads inside the cheeks to create a thinner, sharper and more contoured appearance. As the jawline and cheekbones become more prominent, the patient gains a more aesthetic facial profile.
 Although bichectomy is actually an old surgical method, it has become more widely known in recent years under the influence of social media. The fact that many celebrities have sharper facial features has increased the popularity of this surgery. Many people realize that even with diet and exercise, the fat in the facial area is not easily lost. At this point, bichectomy becomes one of the most effective ways to get rid of stubborn facial fat.
 The operation is a short procedure that usually lasts 30–45 minutes and can be performed under local anesthesia. This allows people to return to their daily lives quickly. Bichectomy can produce effective results on its own, but when combined with other procedures such as rhinoplasty or chin fillers, it creates a more dramatic and striking facial transformation.

Who Is a Good Candidate for Bichectomy?

 Bichectomy is not a procedure that can be performed on everyone. Certain criteria must be met. It gives highly successful results for people with good general health and suitable facial structure.
 Facial Structure and Genetic Factors
 Bichectomy is especially suitable for people with genetically round faces and full cheeks. Some people may look overweight even though they are slim due to fat accumulation in their cheeks. Bichectomy makes the face thinner and more proportional.
 However, it is not recommended for very thin people or those who already have prominent facial features. In such cases, the face may look hollow and create an aged appearance. Therefore, the best candidates are those with more oval or round facial shapes.
 Psychological and Aesthetic Expectations
 The expectations of the patient before surgery are also important. People who want bichectomy should know that this operation will not miraculously change their face completely. It is a procedure that highlights facial features and thins the cheeks. However, the results may vary from person to person.
 In addition to aesthetic concerns, people who want to feel better psychologically also prefer this surgery. Gaining self-confidence and feeling more comfortable in social relationships can also be motivating factors.

How Is Bichectomy Performed?

Bichectomy is a simple yet meticulous surgical procedure.
 Pre-operative Preparation
 Before the surgery, the patient’s general health is evaluated. Blood tests, blood pressure, and chronic diseases are considered. Blood thinners may need to be stopped under medical advice. Alcohol and smoking should be avoided for a few days before the procedure.
 Surgical Process
 Bichectomy is usually performed under local anesthesia, meaning the patient is awake but does not feel pain. Sometimes sedation is applied. The operation takes about 30–45 minutes. A small incision is made inside the mouth, and the Bichat fat pads are removed. Dissolvable stitches are used, so no external scar remains.
 First Days After Surgery
 The patient is discharged shortly after the surgery. Mild pain, swelling, and bruising can occur during the first few days. This is completely normal. Painkillers and antibiotics prescribed by the doctor help manage this process. Paying attention to oral hygiene minimizes infection risk.

Recovery After Bichectomy

Swelling and Bruising
Swelling and bruising may occur in the cheeks for the first few days but largely subside within 1–2 weeks. Applying cold compresses helps swelling go down faster. Diet and Return to Daily Life, In the first days after surgery, liquid foods are recommended. Then soft foods can be eaten. A normal diet can usually be resumed after about one week. Paying attention to oral hygiene helps the incisions inside the mouth heal faster.

Risk of Excessive Weight Loss After Bichectomy

Bichectomy is performed to achieve more defined facial features and a slimmer look. However, if the patient experiences a significant weight loss after the surgery —especially more than about 10% of their body weight— the aesthetic results may not be as desired.
 As facial fat decreases, the cheeks may appear overly sunken, creating an unnatural look. Therefore, people planning bichectomy should consider not only the surgery but also their lifestyle and possible weight changes afterward.

When Are the Final Results Seen?

 Patience is needed to see the real results of bichectomy. Although the face may look swollen in the first weeks, facial contours begin to become clear within 2–3 months. Final results generally appear within 6 months. At the end of this period, the cheeks are thinner and the face achieves a sharper appearance.