Bichectomy
Bichat Pouch Removal - Slimming the face and redefining the contours of the cheeks
Overview
A buccal fat pad reduction is a cosmetic facial surgery procedure that involves reducing the volume of the buccal fat pads, small deep fat deposits located within the cheek tissue. The goal of this reduction is to slim down the middle and lower thirds of the face, enhance the cheekbones, and create a slightly more defined facial contour.
This procedure is primarily intended for patients with a naturally round face, full cheeks despite a stable weight, and a realistic desire for a slimmer appearance. However, it is not always suitable for patients with naturally slender faces, older patients, or those whose faces are likely to become gaunt over time. Weight, age, skin quality, and bone structure must therefore be taken into account before selecting this procedure.
Explanation of the technique
The procedure involves accessing the Bichat fat pads through the inside of the mouth via a small incision made in the cheek mucosa. The surgeon then carefully exposes the deep fat and removes only a portion of it. In practice, the goal is not to remove all the fat, but to perform a measured reduction to preserve the face’s natural appearance. This caution is important because the surrounding structures must be preserved, particularly the Stenon duct and the facial nerve branches.
A buccal fat pad excision differs from cheek liposuction: in this procedure, the surgeon works on a deep fat compartment that is clearly defined anatomically, rather than on superficial fat removed with a cannula. The procedure therefore requires precision and restraint.
Overview of the procedure
Before the procedure, a consultation is held to confirm the need for the procedure, assess the face as a whole, and explain the limitations of the procedure. It is important to disclose any current treatments, medical history, and smoking habits, as smoking can increase the risk of complications and affect the quality of the results.
A buccal fat pad removal is often performed under local anesthesia when done as a standalone procedure; depending on the case, it may also be performed under general anesthesia, particularly if it is combined with another procedure. When performed on its own, it is frequently done on an outpatient basis.
During the procedure, a small incision is made inside each cheek. A portion of the Bichat fat pad is carefully removed, and the mucous membrane is closed with dissolvable sutures. Since no incision is made in the skin, there is no visible scar on the face.
Postoperative Care and Expected Results
After the procedure, swelling and occasional bruising are common. Discomfort inside the mouth may persist for a few days, and it is often more comfortable to stick to soft foods at first. You may experience moderate pain, which can usually be relieved with over-the-counter pain relievers. It is often best to take a few days off from work or reduce your activity level.
The results are not immediate, as swelling initially masks the slimming effect achieved. The face gradually takes on a new shape over the course of several weeks. The goal is a face that is slightly less round, with more defined cheekbones and jawline, without excessive alteration. The result should remain natural; the goal is not to change one’s facial identity, but to improve certain contours when indicated.
FAQ
Frequently Asked Questions About Bichectomy
It is primarily intended for healthy adults with a relatively stable weight, naturally full cheeks, and realistic expectations. People with naturally thin faces are less suitable candidates.
In practice, it is generally best to wait until the face has fully developed; some experts recommend waiting until around age 18 to 20.
No, the incision is usually made inside the mouth.
No. The outcome depends on the patient’s initial facial structure, the quality of the tissue, age, and the amount of tissue removed. If the procedure is not appropriate for the patient, it can result in a face that appears too sunken, especially as the patient ages.
Like any surgical procedure, buccal fat removal carries risks, although they are rare: bleeding, infection, asymmetry, results that are either insufficient or too pronounced, and, more rarely, damage to nearby structures.
>> This page is intended to provide general information. Only a consultation with Dr. Vairinho will allow for an accurate assessment of your situation and the recommendation of an appropriate treatment plan. A personalized quote is provided only during a consultation.
