Bichectomy – Buccal Fat Removal

Bichectomy, also known as buccal fat removal, is a minimally invasive surgical procedure that focuses on thinning the cheeks, especially in the cheek hollow areas. Bichectomy is a straightforward cosmetic surgical procedure that targets the buccal fat pad; the area deep in the cheeks on both sides of the face.

Everyone has buccal fat pads, but some people might have larger fat pads and therefore have a more round or full face. This surgery is done strictly for cosmetic reasons, as some people might find it more appealing to have a slimmer face and want to have surgery to change their facial appearance.

The buccal fat removal surgery aims to remove buccal fat from the cheeks resulting in a more defined jaw-line, slimmer and more sculpted facial look.

Who is suitable for a Bichectomy?

Like all other cosmetic surgeries, the patient will be advised by the specialist doctor to decide if the person is suitable for this surgical operation.

This plastic surgery is usually considered by people who are not satisfied with chubby or full cheeks. The procedure is ideal for all ages and for people who are struggling with losing weight in the face by trying diets and facial exercises.

An ideal candidate for buccal fat removal would be someone who has a healthy weight and good physical health but has a round or full face, also the candidate ideally should not smoke.

What to expect from a Bichectomy operation?

Before the procedure

Before having the surgery, the patient will have to talk with the plastic surgeon about the following matters to decide the appropriate surgical approach and which medications can be used during the procedure:

• Expectations and goals
• Medical health conditions
• Current medications
• Previous surgeries
• Drug allergies
• Smoking, alcohol, and drug misuse

During preparing for a buccal fat removal surgery, the patient will be advised by the doctor to:

• Perform several blood tests to examine their health status
• Take certain medications
• Adjust or stop current medications
• Avoid taking aspirin, anti-inflammatory drugs and other medications that can increase the risk of bleeding during the surgery
• Stop smoking

During the procedure

A Bichectomy, or buccal fat surgery, is a quick surgical procedure that is generally considered a safe procedure. A buccal fat removal surgical procedure involves the following steps:

• Anaesthesia – The buccal fat removal surgery can be done either under local anaesthesia or general, depending on the patient’s decision. Usually, for buccal fat removal, local aesthetic is required on the face.
• Incision – The plastic surgeon makes a small incision on the inside of the cheek, thus leaving no visual scars on the face. The surgeon will, then exert pressure on the outside of the cheek to gently remove the fatty deposits through the incision on the inside of the cheek.
• Stitches – Finally, the surgeon will use sutures to close the incision inside the mouth.

On average the procedure will take only about an hour and the patient can go home the same day as the operation.

What is the recovery process of Bichectomy?

The Bichectomy procedure is not very complex, thus it has a relatively rapid recovery. The healthcare team will provide the patient with instructions about the recovery and aftercare process.

The patient will be given:

• A special mouthwash to use several times during the day, to prevent infection and take care of the incisions inside the mouth.
• A liquid diet will be suggested to have for a few days or even weeks after the surgery.
• Medications to aid the healing process and prevent any risk of infections.

After Bichectomy, the patient should:

• Not smoke for at least 48 hours
• Sleep on their back with the head slightly elevated
• Avoid brushing the teeth for 24 hours and subsequently brush them very gently
• Avoid using the tongue to touch the stitches inside the mouth
• Avoid drinking alcohol

These instructions should be followed until the swelling in the face (due to the incisions and stitches) starts to reduce. Ice packs might be also suggested to relieve pain and reduce the swelling on the face. Usually, a full recovery happens after about three weeks.

It will take a few weeks to see visible results of the buccal fat removal surgery when the bruising and swelling fades and the cheeks take their desired shape.

How long does a Bichectomy last?

A buccal fat removal is a permanent procedure and therefore is expected to last forever. However, if a lot of weight is gained the cheeks may start looking bigger or fuller again.

What are the risks of Bichectomy?

Bichectomy is a simple cosmetic surgery for buccal fat removal and the decision to have this surgery should be personal and not be affected by the desire to fit into an ideal image. The patient will have to measure the benefits and risks of having this surgery.

Generally, this procedure is safe, and has benefits on the desired physical appearance and mental health of the patient, but as with every surgical operation it comes with some risks and potential complications, these include:

• Reaction to anaesthesia
• Bleeding
• Infections
• Fluid accumulation
• Pain or numbness
• Swelling of the face
• Slow healing
• Thrombosis
• Cardiac side effects
• Injury to the salivary duct during the surgery
• Damage to facial nerves or loss of sensation
• Poor results such as asymmetry

What is the cost of a Bichectomy?

A buccal fat removal surgery usually costs between £3,000 to £5,000, although the price can vary from clinic to clinic depending on some factors:

• The quality of the clinic and level of the surgeon
• The extent of the surgery
• The type of anaesthesia

As it is cosmetic surgery is not covered by health insurance or by the NHS. Our healthcare team will identify the best fitting clinic for the patient’s case and requests.