• Dr. Nicolas Zwillinger, Plastic and Cosmetic Surgery

What is a buccal fat removal?

A bichectomy, or removal of the Bichat fat pads, is a cosmetic surgical procedure that involves removing the Bichat fat pads—clusters of fat located behind the jaw’s chewing muscles.

This procedure helpsto slim and contour the cheeks, sculpting and redefining the facial contours; it may also result in a more refined facial appearance. The face thus appears more harmonious.

 

The benefits of buccal fat removal may include, but are not limited to:

1) Thinner cheeks

2) Improvement in facial appearance,

3) More defined cheekbones, resulting in a more prominent appearance

4) Can help improve self-esteem

5) Can boost self-confidence.

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How is a buccal fat removal procedure performed?

The procedure takes 30 minutes under local anesthesia and is performed on an outpatient basis.

Incisions are made inside the mouth near the back teeth of the upper jaw, allowing the Bichat fat pads to be removed. After the incision is made, the buccal muscle is dissected, exposing the Bichat fat pad.

External pressure is applied to the skin to manipulate the Bichat fat pads (fat deposits) into the incision, and without excessive traction, the exposed tissue is grasped and excised. Absorbable surgical sutures are used to close the wound on each side. 

There are two methods for performing a buccal fat pad removal: via an intraoral approach or via a facial approach during a facelift procedure. In clinical practice, the safest method involves making an intraoral incision.

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The drawbacks of buccal fat removal surgery

  • Temporary facial swelling
  • Difficulty chewing and opening the mouth for a few days
  • There is one absolute contraindication, but other contraindications may vary from patient to patient.

Before the buccal fat pad removal procedure

  • Medical appointments: 1 to 2 cosmetic surgery consultations.
  • Signing of the estimate and informed consent form, and routine taking of medical photographs.
  • Cooling-off period: 15 days between the initial consultation and the procedure.
  • Recommendations: Stop smoking at least one month in advance; stop taking aspirin or anti-inflammatory medications 10 days before the extraction.

All the benefits of buccal fat removal surgery

  • Reshape the cheeks
  • A more defined jawline and much more prominent cheekbones
  • Quick and easy to use
  • Local anesthesia and outpatient surgery.
  • The sutures are absorbable, and the scars are generally inconspicuous, though their visibility may vary from patient to patient.

Removal of Bichat's fat pads

  • A quick and easy process
  • Local anesthesia and outpatient surgery
  • The sutures are absorbable, and the scars are generally inconspicuous, though their visibility may vary from patient to patient.
  • This procedure is generally considered to be relatively painless, but the perception of pain can vary from patient to patient.