Bichectomy, also known as buccal fat pad removal, is a surgical procedure that involves removing excess fat from the cheeks. The procedure is performed by making small incisions inside the mouth and removing a small amount of fat from the buccal fat pads, which are located on either side of the cheekbones.

Bichectomy, also known as buccal fat removal, is a cosmetic surgery procedure aimed at enhancing facial contours. It involves the removal of buccal fat pads, which are located in the lower cheeks. These fat pads can vary in size, and their removal can create a more sculpted, defined facial appearance, often desired for aesthetic reasons.

This procedure is particularly popular among individuals seeking to diminish the appearance of chubby cheeks, achieving a more chiseled look. The surgery is relatively simple and is performed under local anesthesia.

It typically involves small incisions inside the mouth, ensuring no visible external scars. While generally safe, as with any surgical procedure, bichectomy carries risks and potential complications. It's crucial for candidates to have realistic expectations and to consult with a qualified plastic surgeon.

How Does Bichectomy Work?

Bichectomy is a cosmetic surgical procedure designed to improve facial aesthetics by reducing the size of the buccal fat pads located in the lower cheeks. These fat pads, also called Bichat fat pads, contribute to the fullness of the cheeks. The procedure works as follows:

  1. Consultation and Evaluation: The process typically begins with a consultation with a qualified plastic surgeon. During this consultation, you'll discuss your goals, concerns, and expectations for the surgery. The surgeon will evaluate your facial anatomy, skin elasticity, and the amount of buccal fat present to determine if you are a suitable candidate for bichectomy.
  2. Anesthesia: On the day of the procedure, you will be administered local anesthesia to numb the treatment area. This ensures that you won't feel any pain or discomfort during the surgery.
  3. Incisions: The surgeon makes small incisions on the inside of your mouth, usually near the back molars. These incisions are carefully placed to avoid visible external scarring.
  4. Fat Removal: Through the incisions, the surgeon accesses the buccal fat pads. They gently tease apart the fat from surrounding tissues and remove the desired amount of fat. The surgeon takes care not to over-remove fat to prevent a hollow or gaunt appearance.
  5. Closure: After the buccal fat pads are removed, the incisions are closed with dissolvable sutures or surgical glue. There is no need for stitches to be removed later.
  6. Recovery: You may experience some swelling, bruising, and mild discomfort in the days following the procedure. These side effects are normal and typically subside within a week or two. Your surgeon will provide post-operative care instructions to aid in a smooth recovery.
  7. Results: Over the following weeks and months, as the swelling subsides and the tissues heal, you will begin to notice the improved contour of your cheeks. The results become more apparent, providing a more sculpted and defined facial appearance.

It's important to note that the amount of fat removed and the specific techniques used may vary from patient to patient, depending on their individual goals and facial anatomy. Bichectomy is a relatively straightforward procedure, and while it provides noticeable results, it's essential to choose a skilled and experienced plastic surgeon to minimize risks and achieve the desired outcome. Additionally, it's crucial to have realistic expectations regarding the final appearance, as the procedure is designed to enhance facial contours, not drastically change your overall facial structure.

Who is Suitable Candidate for Bichectomy?

Here are some criteria that can help determine who is a suitable candidate for bichectomy:

  1. Excess Buccal Fat: The most suitable candidates for bichectomy have a significant amount of buccal fat that contributes to overly full or chubby cheeks. This procedure is intended to create a more sculpted and defined facial appearance by reducing the volume of these fat pads.
  2. Good Overall Health: Candidates should be in good physical health and have no underlying medical conditions that could increase the risks associated with surgery. A thorough medical evaluation will be conducted by the plastic surgeon to ensure that you are a suitable candidate.
  3. Realistic Expectations: It's crucial for candidates to have realistic expectations about the results of bichectomy. This procedure is not meant to drastically change your facial structure but to enhance your existing features by reducing cheek fullness. Open and honest communication with your surgeon about your goals is essential.
  4. Stable Weight: Candidates should be at a stable weight and maintain a healthy lifestyle. Significant fluctuations in weight can affect the long-term results of bichectomy.
  5. Non-Smoker: Smoking can increase the risks of complications during and after surgery, so candidates are generally advised to quit smoking for a period before and after the procedure.
  6. Commitment to Recovery: Bichectomy requires a brief recovery period, during which you may experience swelling and discomfort. Suitable candidates should be willing to follow post-operative instructions provided by their surgeon to ensure a smooth and successful recovery.
  7. Realistic Understanding of the Procedure: Candidates should have a clear understanding of how bichectomy works, its potential risks and complications, and what can be achieved in terms of facial enhancement. This understanding helps in making informed decisions about the surgery.
  8. Consultation with a Qualified Surgeon: Ultimately, the best way to determine if you are a suitable candidate for bichectomy is to schedule a consultation with a board-certified plastic surgeon experienced in performing this procedure. During the consultation, the surgeon will assess your individual facial anatomy, discuss your goals, and provide personalized recommendations based on your specific needs.

It's essential to consult with a qualified surgeon who can evaluate your unique situation and provide expert guidance on whether bichectomy is the right choice for you. Keep in mind that bichectomy is a cosmetic procedure, and the decision to undergo it should be made carefully after considering all relevant factors.

Will There Be Visible Scars After Bichectomy?

One of the advantages of bichectomy, also known as buccal fat removal, is that there are typically no visible external scars after the procedure. This is because the surgeon makes small incisions on the inside of the mouth, specifically within the cheek area, near the back molars.

These incisions are strategically placed to ensure they are not visible from the outside. As a result, you won't have any noticeable scars on your face or cheeks.

The incisions are made on the inner side of the cheeks to access and remove the buccal fat pads, which are responsible for the fullness of the lower cheeks. Since the incisions are located inside the mouth, they remain hidden, and there is no need for stitches to be removed, as dissolvable sutures or surgical glue are typically used.

However, it's important to keep in mind that while there are no visible external scars, there will still be internal healing taking place.

During the recovery period, you may experience some mild discomfort, swelling, and possible bruising inside your mouth, but these are temporary and part of the normal healing process. Following your surgeon's post-operative care instructions will help minimize any potential complications and ensure a smooth recovery without any visible scarring.

How Long Do The Results of Bichectomy Last?

The results of bichectomy, also known as buccal fat removal, are generally considered to be permanent. Once the buccal fat pads are surgically removed, they do not grow back. This means that the reduction in cheek fullness achieved through bichectomy should be long-lasting.

However, it's important to note that while the fat pads do not return, the overall appearance of your face can still change over time due to factors such as aging and lifestyle choices. Here are some considerations regarding the long-term results of bichectomy:

  1. Aging: The natural aging process can lead to changes in facial volume and skin elasticity. As you age, your face may naturally lose some fat, and the contours may shift. While the results of bichectomy are permanent, the overall appearance of your face may continue to change as you get older.
  2. Lifestyle Factors: Maintaining a stable weight and adopting a healthy lifestyle can help preserve the results of bichectomy. Significant weight fluctuations can affect the distribution of fat in your face and impact the long-term outcome.
  3. Genetics: Your genetic makeup plays a role in the way your face ages and how fat is distributed. Some individuals naturally have more prominent cheekbones and less buccal fat, while others may be genetically predisposed to fuller cheeks.
  4. Maintenance: To maintain the sculpted and defined appearance achieved through bichectomy, it's important to continue following a healthy lifestyle and skincare routine. Consult with your surgeon for personalized recommendations on post-operative care and maintenance.
  5. Consultation with Your Surgeon: If you have any concerns about the long-term results or notice any changes in your facial appearance over time, it's advisable to schedule follow-up consultations with your plastic surgeon. They can assess your situation and provide guidance on potential options for maintaining or enhancing your facial aesthetics.

While the results of bichectomy are considered permanent in terms of fat reduction in the treated area, it's important to have realistic expectations and understand that your overall facial appearance may evolve over the years. Regular communication with your surgeon and a commitment to a healthy lifestyle can help you maintain the desired look for as long as possible.


Opr. Dr. Cenk MelikoğluOperating Doctor Cenk Melikoğlu was born in Görele, in 1978. In 2002, he graduated from Dokuz Eylül University Faculty of Medicine. Between the years of 2003 and 2010, he did his specialization in İzmir Atatürk Training and Research Hospital, Aesthetic and Plastic Surgery Clinic. In 2015, he worked as a guest lecturer in the American Hospital of Paris. When abroad, he especially focused on the transfer of free vascular lymph nodes for lymphedema treatment, in the field of microsurgery. He participated in numerous training and meetings in this area. There are more than 30 articles in the literature, which were published in national and international journals. Since 2016, he has been working in İzmir Özel Ekol ENT Hospital in Aesthetic Plastic Surgery and Cosmology Clinic. He speaks English well. He is married and has one child. His special interests are; Breast Aesthetics & Dual-Plan Method, Aesthetic nose surgery, Lymphedema surgery, Endoscopic facial stretching, Aesthetic body shaping surgery (abdominal stretching, liposuction, aesthetic breast surgery), Hair transplantation with FUE method, Migraine surgery, Gynecomastia correction, Genital aesthetics (especially penis enlargement), Lymphedema Treatment (Laser Assisted, With Microcannula Lymph Protective Method), Penis Enlargement (Length & Thickness Combined Method), Migraine Surgery (Closed Method with Scopy). He was entitled to receive the "Proficiency Certificate" by being successful in the examination, which was held by the Turkish Plastic Surgery Association in 2010. In 2015, he participated in a scientific competition by Gülhane Military Medical Academy with his study 'Saddle-nose deformity repair with micro-plate-adapted costal cartilage.’ He has won the first place in the field of surgical medicine. In 2018, he worked at Weiss Memorial Hospital in Chicago, USA for three months in April, May and June on advanced techniques on gender reassignment and penis enlargement in men. He is still continuing his academic and scientific studies.
Opr. Dr. Anıl ÖZPAKHe graduated from Samsun Ondokuz Mayıs University Faculty of Medicine in 2011. Between 2013-2019, he received his specialty training in Plastic Reconstructive and Aesthetic Surgery Department at Ankara Dışkapı Training and Research Hospital. He successfully has the Turkish Plastic Reconstructive and Aesthetic Surgery qualification certificate in the 2018 exam. He is a member of the Aesthetic Plastic Surgery Association and the Turkish Plastic Reconstructive Surgery Association and the Turkish Medical Association. He is fluent in English.  Dr. Anıl Özpak is married and has 2 children. Domain Knowledge: Rhinoplasty Eyelid aesthetic Face rejuvenation (face-neck lifting) Otapostatis Breast aesthetics (enlargement, reduction, lifting) Correction of gynecomastia Abdominal stretching Tummy Tuck Arm - Thigh lift Genital aesthetics Lipoedema surgery Liposuction Fat injections Minimal aesthetic applications (filling- neurotoxin) Skin Tumours Facial Traumas Hand Aesthetic surgeries
Opr. Dr. Arif AydınHe graduated from Eskişehir Osmangazi University Faculty of Medicine in 2008. He studied at Kaunas Medical Faculty between the years 2007 and 2008. He completed his specialization on Plastic, Reconstructive and Aesthetic Surgery Department at Afyon Kocatepe University between the years 2009 and 2014. He has 5 original articles published in national and international scientific journals, and 13 verbal and written academic papers presented in national congresses. He continues the academic studies. He received the competence certificate of Turkish Plastic Reconstructive and Aesthetic Surgery after his success in the exam in 2016. He did well in European Plastic Surgery Competence Written Exam that took place in Brussels in 2019. Fields of Interest: Rhinoplasty Neck lift surgery, Face lift Surgery, Otoplasty, Tummy tuck, Liposuction, Breast augmentation / reduction / mastopexy, Gynecomastia, Genital aesthetics, Blepharoplasty, Lipoedema surgery, Penis enlargement (lengthening and thickening surgery), Fat injections 

Frequently Asked Questions

The procedure can be performed by Aesthetic surgeons who are experienced in this field. You should make good research before choosing your surgeon and be sure to describe your desired result well to them. 3 Esthetic Surgeons in EKOL Hospitals perform Bichectomy operations.
Ekol Hospitals experienced esthetic surgeons perform bichectomy operations since many years. The operation itself requires great experience and should be performed under correct hands only. You can completely trust EKOL Hospitals’ Surgeons by this operation.
Buccal fat removal can be done at almost any age. However, keep in mind that many people begin to lose facial fat in their 20s and 30s. If their fat reserves are removed before then, they may end up with a gaunt appearance — a face that looks too thin and possibly unhealthy.
Following your buccal fat extraction surgery, your lower face and mouth will be sore, swollen and tender. Any bruising will be on the inside of your mouth. You may be put on a special diet of foods that are not acidic, and you may be instructed to sleep with your head elevated and to rinse your mouth with an antiseptic mouthwash several times each day. The swelling should dissipate after about two weeks.
You should see preliminary results within a week or two as the swelling subsides, but it may take anywhere from two to four months to see the full results of your buccal fat extraction procedure.
The results of buccal fat extraction are permanent. However, if you gain a marked amount of weight in the future, your cheeks may plump up again.
Although this surgery is usually performed under local anesthesia, general anesthesia can also be used in some cases depending on the patient's condition
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