At our clinic this procedure is not performed on its own; it is planned only in the same operation as rhinoplasty, in suitable patients. See Combined Surgeries.
Buccal fat removal, also known as bichectomy, is a facial contouring procedure designed to reduce the volume of the buccal fat pads located in the lower cheeks. These naturally occurring fat compartments contribute to facial fullness and can create a rounded facial appearance in certain individuals. By selectively reducing buccal fat volume, surgeons can enhance facial definition and improve the visibility of the cheekbones and jawline.
The procedure has become increasingly popular among patients seeking a slimmer and more sculpted facial profile while maintaining natural facial harmony. Careful patient selection remains essential, as not every individual with fuller cheeks is an ideal candidate for buccal fat removal.
Patient Evaluation and Surgical Planning
A comprehensive facial assessment is necessary before considering buccal fat removal. Factors such as facial structure, skin quality, age, soft tissue volume, and overall aesthetic goals must be carefully evaluated. The objective is to achieve balanced facial contouring rather than excessive volume reduction, which may result in a prematurely aged appearance over time.
During consultation, surgeons analyze the relationship between the cheeks, midface, jawline, and chin to determine whether buccal fat removal alone or in combination with other facial procedures may provide the most favorable outcome.
Surgical Technique
Buccal fat removal is typically performed through small incisions placed inside the mouth, leaving no visible external scars. Through these incisions, a controlled amount of buccal fat is carefully removed while preserving surrounding anatomical structures. The procedure is generally completed under local anesthesia with sedation or general anesthesia, depending on patient preferences and accompanying procedures.
Modern surgical techniques emphasize conservative fat removal to maintain long term facial balance and preserve natural facial contours.
Recovery and Results
Recovery is generally straightforward, with most patients experiencing mild swelling and temporary discomfort during the early postoperative period. As swelling gradually resolves, facial definition becomes increasingly apparent. Final results typically emerge over several months as the soft tissues adapt to their new contours.
Patients often notice improved cheek definition, enhanced facial angles, and a more refined overall appearance while maintaining natural facial expressions.
Expert Approach to Buccal Fat Removal
Successful buccal fat removal requires a thorough understanding of facial anatomy and aesthetic proportions. Overaggressive fat removal can compromise facial harmony and accelerate signs of facial aging. In combined surgeries with rhinoplasty, Dr Erdal Erkoç focuses on individualized treatment plans that create elegant, natural appearing facial contours while preserving long term aesthetic balance and facial function.
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
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.
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
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.
