Are your cheeks looking “sweetly” full or too puffy? If you want to get rid of your face’s “chubby cheek” appearance and seek sharper cheekbone definition and an elegant facial oval, Bichectomy Surgery is perfect for you! This operation, offered at our clinic in Istanbul with experienced plastic surgeons and microsurgical techniques, comfortably removes inner cheek fat pads (Bichat fat) to give your face both a refined contour and timeless elegance.

What is Bichectomy Surgery?

Bichectomy, also known medically as “Bichat fat excision,” is an aesthetic surgical procedure that removes excess fullness by extracting fat pads accessed through a small incision inside the cheeks, behind the lip-tooth line.

  • Purpose: To eliminate the “pouch” appearance in cheeks and allow more light to fall on the cheekbones
  • Technique: Fat packets are removed through a 1-1.5 cm incision inside the mouth using microsurgical cannulas or scissors; no external scarring remains
  • Duration: Average 45-60 minutes; a quick and comfortable procedure under sedation or local anesthesia

Why Choose Bichectomy?

  • Sharp Contour: Highlights your cheekbones and clarifies your facial oval.
  • Minimal Scarring: No external scarring is visible thanks to the intraoral incision.
  • Fast Recovery: Most patients can return to social and work life within 1-2 days.
  • Natural Appearance: Preserves the natural anatomy of facial features, creating a “refined version of your face” effect.
  • Single Session Solution: Permanent intervention for localized fat tissue that cannot be eliminated through diet and exercise.
  • Personalized Planning: The volume of fat to be removed is determined with microsurgical precision according to your facial structure.

Who Can Have Bichectomy Surgery?

  • Healthy Individuals Aged 18-45: Those with permanent cheek fullness or “round face” complaints
  • BMI Between 18-25: Those with balanced overall body proportions but excess fat only in the cheek area
  • Those Who Haven’t Achieved Results with Non-Surgical Methods: Those seeking localized refinement but unsatisfied with temporary solutions like fillers or thread lifts
  • Those with Controlled Smoking and Chronic Disease Usage

Note: Pre-evaluation is mandatory for candidates with pregnancy, breastfeeding, serious bleeding disorders, or immune system problems.

Pre-Surgery Preparation Process

1. Free Consultation and Facial Analysis

Facial photographs and ultrasound measurement of fat volume, determining the amount to be removed.

Expectations, procedure steps, and dressing protocol are shared.

2. Medical Evaluation

Blood tests, coagulation profile, and internal medicine/cardiology approval are obtained if necessary.

Blood thinners like aspirin/NSAIDs are discontinued 5 days prior under doctor’s supervision.

3. Anesthesia Planning

The most suitable option is determined from local anesthesia + sedation or mild general anesthesia options.

4. Appointment and Preparation Instructions

Instructions are given for 6-hour fasting on surgery day, comfortable clothing, and oral hygiene.

How is Bichectomy Surgery Performed?

1. Anesthesia and Sterile Preparation

Started in a sterile environment under sedation or mild general anesthesia.

2. Intraoral Incision

Entry through a 1-1.5 cm incision from the inner lip tooth line.

3. Fat Packet Excision

Bichat fat is gently released and extracted using microsurgical hooks or scissors.

4. Contour and Symmetry Control

Mirror check until refinement on both sides of the face is equal.

5. Suturing and Dressing

Closed with absorbable sutures; procedure completed after intraoral dressing.

6. Operation Duration:

45-60 minutes

The Importance of Doctor Selection

Bichectomy is a microscopic procedure that creates a big impact from a small area. Therefore:

  • Plastic Surgeon or Aesthetic Surgery Specialist: Physician with Bichat fat excision certification and experience
  • Microsurgical Competence: Specialist providing precise fat extraction and contour balance in fine incisions
  • Empathetic Communication: Doctor who clearly listens to the process and results, offering transparent guidance
  • Sterile Clinic Standards: Single-use equipment, fully equipped operating room, and comfortable service

What Awaits the Patient on Surgery Day?

1. Morning Preparations & Anesthesia Consultation

Vital measurements, sedation plan, and sterile preparation.

2. Bichectomy Procedure

Comfortable and controlled fat removal procedure for 45-60 minutes.

3. Dressing and Initial Stabilization

Intraoral dressing and transition to service with absorbable sutures.

4. Service Observation

Generally same-day discharge or 1-night stay after 2-4 hours of observation.

5. Home Care Instructions

Oral hygiene, mild cold compress, and soft foods are recommended for the first 48 hours.

Recovery Process

  • 1-3 Days: Mild swelling and pressure sensation inside the lip are normal; comfort is provided with cold compress and prescribed painkillers.
  • 1 Week: Swelling largely subsides; light return to social life is possible.
  • 2-4 Weeks: Inner lip healing is completed, cheek contour becomes prominent.
  • 6 Weeks: Fully settled “refined face” form emerges; annual check-up is recommended.

Frequently Asked Questions

1. Will there be scarring inside the cheek?

Since incisions remain inside the mouth at the lip-tooth line, no external scarring is visible.

2. How long do bruising and swelling last?

Swelling lasts 3-5 days, mild bruising 7-10 days; no need to cover with makeup.

3. Is the procedure painful?

No pain is felt thanks to local anesthesia or sedation; minimal discomfort during recovery.

4. Will my face look too thin?

The amount of fat removed is planned individually; your facial features remain in natural contour without excessive thinning.

5. When can I return to work?

You can comfortably return to office work in 3-5 days, and full social life in 1-2 weeks.