Bichectomy (Buccal Fat Removal)

This article was updated on January 22nd, 2024 at 02:20 pm

Buccal Fat Removal is usually performed to give the face a slimmer and sharper contoured appearance. In this surgery, some fatty tissues are removed from the fuller parts of the cheeks, making the lower part of the face more prominent, aiming to achieve sharper and more defined facial features called “Hollywood cheeks”.

Since the second half of the 20th century, it has gained popularity.

Buccal Fat Pad

Buccal Fat is the fatty tissues that accumulate in the cheek part of the face. These fats affect the overall shape and fullness of the face.

Healthy nutrition, regular exercise, facial exercises, adequate water consumption affect the weight loss process and accelerate weight loss from the cheek. This affects the reduction of cheek fat and thinning of the face.

What is Buccal Fat Removal?

Bichectomy (Buccal Fat Removal) is a procedure performed in the field of aesthetic plastic surgery. It is the removal of some of the cheek fat pads by making a small incision on the inside of the cheeks, inside the mouth. Generally, the amount of fat removed is between 1 and 3 cc.

It is performed under local anesthesia and takes about 30 minutes. The aim of the surgery is not to remove excessive amounts of fat from the cheeks, but to make the lower part of the face more prominent and defined.

The fat tissue removed from the cheeks is irreversibly removed and this fat tissue does not come back. However, factors such as weight gain or aging can change the shape and appearance of the face over time. Generally, more pronounced results are seen in people with fuller or rounder facial features.

The degree of difficulty of the surgery may vary depending on factors such as the surgeon’s experience, the patient’s facial structure and general health status. The surgery is performed by plastic surgeons or surgeons specialized in aesthetic surgery.

Possible Advantages and Disadvantages


  • Sharper facial contours
  • Rejuvenation effect
  • Increased self-confidence
  • Lasting results


  • Asymmetry risk
  • Infection
  • Bleeding
  • Risk of damage to facial nerves

Bichectomy surgery can affect the lower part of the face but does not directly affect the jowl area (lower jaw and neck area).

Who is it suitable for?

Bichectomy is not a procedure suitable for everyone. People under 18 years of age are not suitable for buccal fat removal considering that their facial structures are still developing. People with health problems, active smokers and people with reduced skin elasticity are not recommended to have bichectomy surgery as there may be a risk of skin sagging after bichectomy.

It may be more effective especially for people with fuller cheeks. Since the skin is more elastic in young patients, healing may be faster and more effective.

Buccal fat removal is usually planned as a one-time procedure. However, a second bichectomy procedure may rarely be required due to reasons such as asymmetry correction, dissatisfaction with the first surgery, incorrect or inadequate first surgery.

In addition, since it is an operation performed in the mouth, there is always a risk of infection, so it is a situation that people with braces should be careful. Because this risk may increase even more in people with braces. It is important to pay extra attention to oral hygiene before and after the procedure.

Recovery After Buccal Fat Removal

Bichectomy is usually a permanent type of surgery, the fat tissue is removed and the fat cells do not regenerate or come back. However, other fat cells in the body may increase and in case of weight gain, the amount of fat in the face may increase and cause the facial contours to become fuller again.

For this reason, aging and related reasons such as decreased skin elasticity and weight changes can affect permanence.

Since skin elasticity decreases with aging, there may be a risk of sagging in elderly patients. In addition, removal of excess fat tissue can also increase the likelihood of facial sagging because the support under the skin decreases. Therefore, the procedure should be performed in a balanced manner while preserving the natural contours of the face.

Absorbable sutures are usually used during surgery. Such sutures are absorbed by the body over time and usually fall out spontaneously within 1 to 2 weeks. If the surgeon has used sutures that need to be removed, these sutures are usually removed 1 week after surgery.

It is normal to have pain, discomfort and swelling in the face after a bichectomy. This is usually more in the first few days of the operation but decreases over time. Therefore, soft and easily chewable foods should be consumed in the first few days after surgery.

Foods such as pureed vegetables, yogurt, soups, smoothies and puddings should be eaten. It is also important to avoid hot and very cold foods and drinks and to avoid alcohol, caffeine, acidic drinks and smoking.

For the first few days after surgery, teeth should be brushed gently until the incisions and stitches in the mouth have healed. It is very important to maintain oral hygiene by using a soft-bristled toothbrush without direct pressure on the area.

Bichectomy is usually performed as an outpatient procedure under local anesthesia and most patients can return home the same day and do not require hospitalization. In addition, since this procedure is performed inside the mouth, it leaves no visible external scarring.

Famous People Who Have Buccal Fat Removal

Bichectomy surgery is especially popular among celebrities and it is seen that celebrities such as Angelina Jolie, Natalie Portman, Megan Fox, Kim Kardashian have had this procedure.

Non-Surgical Cheek Fat Removal

For those who do not want to undergo bichectomy surgery, alternative options include facial exercises and massages, diet and exercise, dermal fillers, thread suspension techniques, radiofrequency and ultrasound treatments, make-up techniques.

It is possible to remove the fat on the cheek naturally with facial exercises, diet and healthy nutrition. These non-surgical methods generally do not provide permanent results such as bichectomy surgery.

Agassi Cheek Fat Removal

By heating the collagen fibers in the lower layers of the skin with monopolar radiofrequency energy, it creates tightening of these fibers and new collagen production. This makes the skin look firmer and younger.

V Line Non-Surgical Cheek Fat Removal

By thinning the lower part of the face, a V-shaped contour is created. This is usually done with aesthetic treatments such as fillers, thread suspension techniques and radiofrequency, and provides a more defined facial line by thinning the cheeks.

Cheek Fat Removal Exercises

These exercises help to achieve more defined facial contours by toning the facial muscles, usually affecting the cheeks and lower part of the face. Although working the facial muscles does not directly affect the reduction of fat in the cheeks, it makes the face look firmer and more toned. These exercises can usually be easily practiced at home.

Operations Combined with Bichectomy

Such combined surgical procedures are a customized procedure for the patient and should be performed by an experienced plastic surgeon.

Buccal Fat Removal and Chin Lipo

First, a bichectomy is performed. The surgeon carefully removes the buccal fat through a small incision in the cheek. Then, the surgeon moves on to chin liposuction. Small incisions are made under the chin and sometimes in the neck area. A thin cannula (tube) is then inserted under the skin through these incisions and the excess fat tissue is vacuumed out. This procedure aims to make the jawline and the lower part of the face more defined.

Buccal Fat Removal and Neck Lipo

First, the patient’s fat distribution and skin elasticity in the face and neck area are evaluated. First, a buccal fat pad removal procedure is performed. Then the surgeon moves on to neck liposuction. When these procedures are performed together, a firmer and younger appearance is achieved as the neck contour will also improve.

Buccal Fat Removal and Jowl Lipo

Buccal Fat Removal and jowl liposuction (liposuction under the chin) are two procedures that are often performed together in the field of facial aesthetics. The advantages of performing them together are that they provide holistic appearance, aesthetic harmony and one-time surgery.

Buccal Fat Removal and Jawline

While the cheeks are thinned with bichectomy, the jawline is emphasized with jawline procedures. This combination shapes the lower part of the face in a more balanced and aesthetic way. Performing two procedures at the same time reduces the surgical and healing process that would be required if they were performed individually.

Cost of Buccal Fat Removal in Turkey?

In 2024, buccal fat removal in Turkey generally range between a minimum of $1,500 – $2,500.