Buccal Fat Removal (Bichectomy)

Buccal fat removal is a procedure that reduces the buccal fat pads, the deep pockets of fat that give the lower cheeks their fullness. These pads have a normal role in cushioning the face, but in some people they make the cheeks look round or full even when overall weight is healthy, an appearance that diet and exercise rarely change because the fat sits in a fixed deep compartment. During the operation the surgeon removes a carefully judged portion of each pad through the inside of the cheek, slimming the area below the cheekbone and sharpening the transition toward the jaw. The aim is a balanced, natural result that suits the whole face, not an over-hollowed look, which is why the amount removed is tailored to each person.

The procedure is chosen mainly to refine facial contour and to soften a round or full appearance in the lower cheeks. It defines the cheekbones, creates a smoother line toward the jaw and gives the mid-face a more angular, elegant profile. It is well suited to healthy adults who have finished growing, are at a stable weight and feel that their cheeks look fuller than they would like despite an otherwise balanced face. People who want a more natural, less invasive option than a larger lifting operation, yet still wish for a visible change in facial definition, are often good candidates. Those whose fullness is mainly due to overall weight, or who have a naturally slim or long face, may benefit less, since removing the pads could over-hollow the cheeks with age.

A good candidate is an adult in general good health, at a stable weight, a non-smoker or willing to stop well before surgery, and with realistic expectations about a contour change rather than a dramatic transformation. Planning begins with a detailed consultation in which the surgeon assesses the shape of the face, the position of the cheekbones, skin quality and the true source of the fullness, then explains what can and cannot be achieved. Because faces naturally lose some volume with age, the surgeon takes a conservative approach, especially in slimmer or younger patients. Before the procedure, simple health checks confirm fitness, and any blood-thinning medicines or supplements are paused in advance on medical advice. For international patients much of this assessment can begin remotely, with photographs and a health questionnaire reviewed before travel and the final examination completed in person on arrival.

Buccal fat removal is a minimally invasive operation performed from inside the mouth, so there is no external scar. It is usually carried out under local anaesthesia, sometimes with light sedation, which keeps the patient comfortable and awake or lightly drowsy rather than under full general anaesthesia. The surgeon makes a small incision on the inner surface of each cheek, near the back teeth, and gently locates the buccal fat pad through this opening. A measured portion of the pad is then eased out and removed, with the amount judged on each side to create an even, balanced contour. The incisions are closed with stitches that dissolve on their own, so nothing needs to be taken out later. The whole procedure usually takes about 30 to 60 minutes, and because it is a day case the patient can normally go home the same day after a short period of observation.

Recovery is generally quick and comfortable. Most people return to light daily activities within 1 to 2 days, with only mild swelling and occasionally minor bruising, which usually settle within 1 to 2 weeks. Because the stitches are inside the mouth, eating soft foods, keeping the mouth clean with the rinses provided and avoiding very hot or hard foods for the first days helps healing. There is no dressing on the face and no external scar to care for. Planning a trip abroad, it is sensible to stay in the destination city for about 2 to 4 days so the surgeon can confirm that early healing is on track before you fly. Air travel is generally comfortable once that check is done. Afterwards, follow-up continues remotely by message, photo or video, and international patient teams commonly provide interpreters and coordinators so that language is never a barrier.

The change in contour becomes clearer as the early swelling fades over the first weeks, and the final, refined shape of the cheeks usually settles within roughly four to six weeks. Because the buccal fat pads do not grow back once removed, the result is considered permanent and is not undone by ordinary weight changes, although a major weight gain can still add fullness elsewhere in the face. Most people are left with a slimmer, more defined lower and mid-face that looks natural for them. A measured, conservative removal is important here, since the face naturally loses a little volume with age, and a balanced result tends to age more gracefully than an over-hollowed one.