Buccal Fat Removal

Bichectomy (Buccal Fat Removal) in Istanbul

Overview & objectives

Bichectomy reduces fullness in the mid-cheek by removing a carefully selected portion of the buccal fat pad. The goal is not radical fat loss but a subtler contour between cheekbone and jawline so the face appears slimmer at rest and in profile. We plan conservatively and anatomically: a modest reduction can refine the cheeks and visually emphasise the jawline; overly aggressive resections look unnatural, accelerate hollowing with age, and are deliberately avoided. Indication is selective—not every “round face” benefits. Key factors: tissue thickness, skin elasticity, fat distribution, dental bite and mimetic muscle tone.

Who is a candidate?

Best suited for persistent cheek fullness despite normal weight, a clearly defined excess of buccal fat, and good skin quality. Common candidates have a robust midface where sport, diet and weight loss don’t change the round contour. Less suitable: very slim faces, mature skin with laxity, or genetically small buccal pads—these risk an early hollowed look. We also differentiate masseter hypertrophy, zygomatic volume deficits and a possible double chin; sometimes masseter botulinum, submental liposuction or cheekbone shaping are wiser than bichectomy alone.

Method & technique

Tiny intraoral incisions (no external scars). After infiltration and protecting Stensen’s duct (parotid duct), the buccal fat chamber is gently mobilised; only the portion that truly disturbs the contour is removed. Closure with resorbable sutures. Symmetric dosing on both sides is essential because pad volume varies widely. Our approach is conservative: we sculpt, not “empty”, and respect the glide planes between buccinator, masseter and mimetic muscles. We often combine bichectomy with subtle chin/jawline optimisation (e.g., lipo or light fat grafting) to balance mid- and lower face.

Anaesthesia & workflow

Options: local anaesthesia, local + twilight sedation, or general anaesthesia. In many cases, local + sedation is comfortable, safe and outpatient. After antiseptic mouth rinse, the short bilateral procedure takes about 30–60 minutes. We then observe briefly for haemostasis. You leave with a clear aftercare plan, cooling instructions and prescriptions for mouth care and pain control.

Aftercare — practical & thorough

The first 48 hours matter most. Intermittent external cooling reduces swelling and discomfort. Inside the mouth: antiseptic rinses (e.g., chlorhexidine) after meals, gentle brushing with a soft brush, and strict no smoking. Choose soft foods for the first week; avoid sharp or highly spicy meals. Mild bruising and tightness are normal and settle within 7–14 days. Pause sport, heat and sauna for 2–3 weeks; sleep slightly head-elevated. Swelling fluctuates and can be worse in the morning; gentle self-lymphatic massage (after instruction) and walks help. A preview result appears after 3–6 weeks; the final result after 3–6 months once soft tissues reorganise. Minor asymmetry can be fine-tuned later (e.g., micro-fat deposits).

Risks & safety

Possible risks: bleeding, infection, prolonged swelling, asymmetries, and—very rarely—injury to Stensen’s duct or irritation of small sensory nerves. The most common aesthetic issue is over-resection with premature hollowing—mainly in thin skin/low residual volume. We prevent this with conservative indication, sterile tissue-sparing technique and structured aftercare. Realistic expectations, patience with swelling, and willingness to combine treatments (volume/contouring) are key to a timeless, “not-done” result.