Bichectomy removes part of the deep buccal fat pad of the cheek, also called Bichat's fat pad. It is considered by people who want slimmer cheeks and a more defined lower face when fullness comes from this fat pad rather than bone or superficial fat.
It is often performed under local anaesthesia with sedation, sometimes under general anaesthesia. The surgeon makes a small incision inside the mouth near the upper second molar, so no cut shows on the skin, exposes the fat pad, and removes a measured portion while protecting nearby nerves and the salivary duct. Dissolvable stitches close the incision.
Surgery commonly takes thirty to sixty minutes, and many patients resume light activity within a few days. Mild swelling and bruising are expected in the first week, with a soft diet and careful mouth hygiene. The final contour usually becomes clear after three to six months, and results vary between individuals.
The final cost is set after a medical consultant reviews your case and photos.
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It may give the face a slimmer look and clearer definition around the cheekbone and jaw in people whose fullness comes from the buccal fat pad. It does not treat general weight gain or loose skin.
Usually an adult in good general health with clear lower-cheek fullness, stable weight and realistic expectations. It may not suit people with already slim faces or signs of ageing, because fat loss can make the face look hollow over time.
The surgeon reviews your face and medical history. You are usually asked to avoid smoking before and after surgery for a period set by the doctor. Decisions about blood-thinning drugs and supplements rest with the doctor; never stop a prescribed medicine on your own.
A small incision is made inside the mouth, a measured amount of the buccal fat pad is removed, and the wounds are closed with dissolvable stitches. The surgeon aims to keep both sides balanced.
It usually involves mild swelling, bruising and a tight feeling in the cheeks. Soft, cool foods are generally recommended at first, with no hard chewing or strenuous exercise until the surgeon allows it.
Swelling fades gradually and the result is usually clear after several months. The removed fat does not usually return, but weight changes and ageing may still alter the face later.
They include infection, bleeding, a collection of blood or fluid and asymmetry. Injury to a facial nerve or the salivary duct is uncommon but serious and may need further treatment. Removing too much fat can leave the cheeks looking hollow.
The incision is inside the mouth, so no scar is visible on the skin. A small mark inside the mouth usually heals within weeks.
Patients are generally advised to wait several days until the early recovery is stable, but the treating doctor confirms the right timing based on how healing is progressing.
Some temporary stiffness or discomfort when opening the mouth and chewing is common in the first days, and normal function usually returns within a few weeks. Persistent pain or numbness should be reported to the doctor.
