BISHECTOMY OPERATION

Bishectomy operations involve the removal of a portion of the Bichat fat tissue from
between the cheek muscles by making hidden incisions inside the cheek. This operation is called
Hollywood cheek and aims to create a slight depression and a sexy appearance in the cheek by
removing the excess fat in patients with excessive cheek fullness. The operation can be performed
under local anesthesia in approximately 15 minutes. The patient can be discharged on the same day
and does not require hospitalization.

Who Is a Good Candidate?

A good candidate for bichectomy typically:

• Has full or rounded cheeks that persist despite weight loss
• Is in good overall health
• Has realistic expectations about the outcome
• Is seeking a more refined facial contour
• Does not have overly thin facial structure, as excessive fat removal can cause a gaunt appearance over time

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Surgical Procedure

• Anesthesia: Bichectomy is usually performed under local anesthesia with sedation, though general anesthesia may be used in some cases.
• Incision: Small incisions (approximately 1–1.5 cm) are made inside the mouth, near the upper molars, leaving no visible external scars.
• Fat Removal: The surgeon carefully locates and extracts the buccal fat pad on each side. The amount removed depends on the patient’s facial structure and aesthetic goals.
• Closure: The incisions are closed with dissolvable stitches, and the total surgery typically takes about 30 to 60 minutes.

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Recovery and Post-Operative Care

• Mild swelling, bruising, and soreness are common during the first few days.
• Patients are advised to follow a soft food diet and maintain oral hygiene to prevent infection.
• Antibiotics and pain medications may be prescribed.
• Most patients return to work or social activities within 3–5 days.
• Final results become more apparent as the swelling subsides over several weeks to a few months.

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Risks and Considerations

Like any surgical procedure, bichectomy carries potential risks, including:

• Infection
• Asymmetry
• Damage to facial nerves or salivary ducts (rare)
• Excessive fat removal leading to a hollowed appearance over time

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Results

The results of bichectomy are permanent, as buccal fat does not regenerate. Most patients enjoy a more defined, slimmer, and aesthetically pleasing facial contour, especially in photographs and side profiles.

However, outcomes may vary based on age, skin elasticity, and other anatomical factors. In older patients, significant volume reduction may accelerate facial aging, so proper evaluation is essential before undergoing the surgery.