A More Balanced, Defined Cheek Contour in Harmony with the Face
Bichectomy is a minimally invasive surgical procedure that reduces a selected portion of the buccal fat pads within the cheeks to create a more balanced and defined mid-to-lower facial contour.
Because cheek fullness does not always originate from buccal fat, facial bone structure, cheekbone prominence, subcutaneous fat, jawline and overall facial proportions are evaluated together. The procedure is planned only when buccal fat is considered a meaningful contributor to the facial contour.
What Is Bichectomy?
Bichectomy is a surgical procedure that involves removing a selected portion of the buccal fat pads located deep within the cheeks through small incisions made inside the mouth.
Buccal fat is one of the anatomical structures that contributes to cheek contour between the cheekbone and lower jaw. Its volume varies from person to person and may contribute to a fuller appearance in the mid-to-lower face in some facial types.
The aim of bichectomy is not to make the face as slim as possible. The effect of buccal fat on the overall facial anatomy is evaluated with the goal of creating a more balanced transition between the cheekbones, cheeks and lower face.
Who May Be a Candidate for Bichectomy?
Patients whose cheek fullness is thought to be related to buccal fat may be evaluated for bichectomy after a detailed facial analysis.
Patients with structurally prominent fullness in the cheek area
Patients who feel that the mid-to-lower face appears wider in relation to their overall facial proportions
Patients who would like a more defined transition between the cheekbones and lower face
Patients with suitable facial anatomy whose cheek fullness persists regardless of weight changes
Patients seeking a more balanced and natural transition in facial contour
Patients whose general health is suitable for surgery and who have realistic expectations about the results
Not every full-cheek appearance is caused by buccal fat. Subcutaneous fat, bone structure, muscle volume and overall facial anatomy can create a similar appearance. For this reason, the decision to perform bichectomy should be made after a detailed facial analysis.
How Does Buccal Fat Affect Facial Appearance?
The buccal fat pads are among the deeper anatomical structures of the face. During surgical planning, not only their volume but also their relationship with the surrounding facial structures is evaluated.
Cheek Volume
Buccal fat volume may contribute to fullness, particularly in the mid-to-lower portion of the cheeks.
Cheekbones
The relationship between cheekbone projection and cheek volume influences the overall appearance of the facial contour.
Lower-Face Width
The structure of the jawbone and chewing muscles also contributes to lower-face width and should be evaluated separately from buccal fat.
Skin and Soft Tissues
Skin quality and other soft tissues are important when assessing the contour that may result after reducing fat volume.
Facial Analysis and Planning Before Bichectomy
There is no standard amount of fat removed in bichectomy. The overall facial anatomy is evaluated to create an individualized surgical plan.
Analysis of Facial Proportions
Cheekbones, cheek volume, jawline, lower-face width and right-to-left facial balance are evaluated together.
Identifying the Source of Fullness
It is assessed whether cheek fullness is caused by buccal fat or by other anatomical structures of the face.
Controlled Volume Planning
In suitable patients, the approach is planned to create a balanced contour without reducing facial volume excessively.
How Is Bichectomy Performed?
Bichectomy is performed through the inside of the mouth. The details of the procedure may vary according to the patient’s anatomy and surgical plan.
Intraoral Surgical Access
A small incision is made at an appropriate site on the inner cheek to access the buccal fat pad.
Identification of Buccal Fat
The buccal fat pad is carefully exposed while protecting the surrounding anatomical structures.
Controlled Fat Removal
The amount of fat identified during facial analysis is removed with the aim of avoiding excessive volume loss.
Incision Closure
The intraoral incision is closed with appropriate sutures and postoperative care begins.
How Is a Natural Cheek Contour Achieved?
The primary aim of bichectomy is not to make the face appear as slim as possible, but to preserve anatomical balance between the midface, cheeks and lower face.
The aim is to preserve natural soft-tissue transitions by avoiding excessive reduction of cheek volume.
Planning aims for the cheek contour to remain balanced with the existing cheekbone structure.
The resulting contour is planned to remain harmonious with the jawline and lower-face width.
Can Bichectomy Be Planned with Other Facial Aesthetic Procedures?
The cheek area is closely related to other anatomical regions of the face. Therefore, addressing buccal fat alone may not be sufficient to achieve the desired facial balance in some patients.
When jawline definition is limited, jawline aesthetics may be considered; when muscle structure contributes to lower-face width, other treatments or facial aesthetic procedures may also be evaluated within the same plan.
The procedures that are necessary are determined according to facial anatomy and the patient’s goals. Combined procedures are not required for every patient.
Recovery After Bichectomy
Temporary swelling, tenderness and edema may occur in the cheek area after bichectomy. The details of recovery may vary from person to person.
Because the incision is located inside the mouth, oral hygiene and the care instructions recommended by the surgeon are important parts of the recovery period.
Swelling and tenderness may occur in the cheeks. Diet and oral care are adjusted according to the surgeon’s recommendations.
As swelling gradually decreases, the return to daily activities is planned according to the patient’s recovery.
As swelling subsides, the new cheek contour becomes clearer and facial proportions can be assessed more accurately.
Results and Long-Term Facial Appearance
After bichectomy, the aim is to reduce fullness in the mid-to-lower cheek area in a controlled manner and create facial contours that appear more balanced with the patient’s existing anatomy.
Because of postoperative swelling, the result cannot be assessed in its final form immediately. As swelling subsides and the tissues heal, the facial contour becomes more defined over time.
Facial appearance continues to be influenced by natural aging, weight changes and soft-tissue changes over time. Long-term appearance may therefore vary according to individual anatomy and lifestyle factors.
Frequently Asked Questions About Bichectomy
Will Bichectomy Make My Face Look Too Thin?
The aim of surgical planning is not to make the face as thin as possible. Buccal fat volume and overall facial anatomy are evaluated together to achieve a controlled change in volume.
Is Bichectomy Suitable for Every Full-Cheek Appearance?
No. Cheek fullness may also result from subcutaneous fat, bone structure or muscles rather than buccal fat. The anatomical source of fullness should therefore be evaluated before the procedure.
Can Bichectomy Make the Cheekbones Appear More Defined?
In patients with suitable facial anatomy, reducing cheek volume may contribute to a more defined transition between the cheekbones and lower face. The result varies according to the patient’s existing bone structure.
Are Bichectomy and Jawline Aesthetics the Same Procedure?
No. Bichectomy is a surgical procedure targeting buccal fat in the deeper cheek area. Jawline aesthetics may include different treatments involving the jawbone, chin, soft tissues and the jaw-to-neck transition.
Will My Face Look Hollow After Bichectomy?
Long-term facial appearance depends on several factors, including baseline anatomy, the amount of tissue removed, age and soft-tissue characteristics. Careful patient selection and controlled surgical planning are therefore important.
Will There Be a Visible External Scar After Bichectomy?
Because bichectomy incisions are made inside the mouth, the standard procedure does not create an externally visible skin incision on the face.
When Can I See the Results?
During the early period, facial contour cannot be fully assessed because of swelling. As edema decreases, the change becomes clearer and the contour can be evaluated more accurately as healing progresses.