What is a bichectomy?

By | 9 May 2021

Bichectomy, which can also be defined as cheek aesthetics, is a type of aesthetic operation performed by removing cheek fat to give a sharper appearance to the facial features. Hollywood cheek and discectomy are terms that are sometimes used interchangeably as intertwined terms. Bichectomy operation can be considered as a part of Hollywood cheek aesthetic surgeries. Other structures that make up the contours of the face on the Hollywood cheek are also intervened and it is aimed to achieve a higher level of change compared to bichectomy.

Thanks to the discectomy operation, which is also known as the youth triangle, which aims to obtain a face shape with an inverted triangle between the cheekbones and the chin, the disproportionate appearance in the facial lines are eliminated. Facial lines are sharpened with discectomy surgery performed to achieve the golden ratio. In this way, the face of the person gets a more aesthetic, attractive, and youthful appearance.

Bichectomy, a method that is frequently used by those who want to obtain a V-type face, is often preferred by people with square and U types. In vitrectomy surgery, which is also known as cheek thinning surgery, the buccal adipose tissue in the cheeks is thinned with plastic surgery methods. The procedure, which is performed by making an incision of 1 cm from the inside of the cheek, takes about half an hour and since the intervention is performed from the inside of the cheek, there is no incision on the skin surface.

What is a bichectomy?

Bichectomy, one of the aesthetic operations frequently used by those who want to have an ideal facial appearance, is applied to make the facial lines proportional. In some cases, even if the person is at the ideal weight, he may seem overweight due to the fat ratio in his current facial structure.

The adipose tissue in the middle of the cheeks is called buccal adipose tissue. This adipose tissue located between the facial muscles is anatomically located in the lower region of the cheekbones and is thought to contribute to the sucking functions in babies. The size of this fat tissue is one of the main factors affecting the size of the face. The buccal adipose tissue generally tends to decrease with aging.

Buccal adipose tissue is one of the important components of facial aesthetics. After the growth of this tissue, complaints such as rounding of the facial contours, sagging cheeks, or the appearance of a babyface may occur in people. Removal of adipose tissue in the cheeks, in other words, “partial buccal lipectomy” is considered an important surgical intervention for facial features and aesthetics.

Tissue defined as buccal adipose tissue may be excessive due to structural or advancing age. Fat pads in the cheek, which cause the appearance of chubby cheeks, may cause the person to look older or overweight.

With vitrectomy, which is frequently used by those who want to have a triangular and sharp facial appearance, facial features can be thinned by the fat tissue taken from the approximately 1 cm incision on the inside of the cheek. Thanks to the operation that does not cause any surgical scar on the skin surface, the asymmetrical appearance in the cheek area is also removed. It is ensured that the facial features of the person are sharpened and the cheekbones and jawbones become prominent.

Anatomically, the lower facial line is formed by 4 basic structures:

  • Buccal adipose tissue
  • Masseter muscle
  • Lower jawbone
  • Subcutaneous adipose tissue

Thanks to the operation based on the golden ratio between these structures and also known as the youth triangle, the person has a more beautiful and younger appearance. With the discectomy operation performed to have a V-type face, the face gains a more proportional appearance.

The removal of buccal adipose tissue can be performed alone or simultaneously with many other plastic surgery procedures:

The buccal adipose tissue can also be removed during aesthetic surgical procedures that eliminate signs of aging in the face and neck area, called a facelift. With the advancement of age, it is expected that the skin and other structures in your body lose their elasticity. With the face lifting process, the tissues of this area can be made to have a more taut appearance. This aesthetic operation may include removal of excess skin tissue, correction of wrinkles, and stretching of facial tissue.

Nose Aesthetics (Rhinoplasty)
Rhinoplasty operations are one of the most frequently performed surgeries among plastic surgery applications. People can benefit from rhinoplasty applications recommended by physicians if it is detected that they have difficulty breathing through the nose due to aesthetic anxiety or trauma and birth defects.

Rhinoplasty can refer to surgical interventions performed in changing the size and inclination of the nasal structure, flattening the nasal bridge, reshaping the nasal tip, and narrowing the size of the nostrils.

Lip Implants
Lip implants are considered a cosmetic procedure and are used to provide the fullness of the lips. With the help of plastic implants, the lips are permanently supported. Silicone and expanded polytetrafluoroethylene constitute two types of implant materials. This procedure is recommended for people who have a relatively symmetrical lip, enough lip skin to create post-implant tension, and are aware of the current cosmetic problem and post-procedure results.

Botox Injections
Botox are injections produced by clostridium-type bacteria, usually containing botulinum toxin A, causing temporary paralysis of the muscles. Wrinkles caused by paralysis of the muscles can also be eliminated.

Botox injections applied to the area called glabella in the middle of the eyebrows and around the eyes are applications that can also be beneficial in conditions such as overactive bladder, lower extremity spasticity, chronic migraine, and excessive sweating.

Botox temporarily prevents the signals from nerve cells in the area where it is applied, so as a result, contraction of the muscles in this area is prevented. Thus, the appearance of wrinkled skin around the eyes and forehead area can be improved.

Who is a Bichectomy suitable for?

Although bischectomy can be applied to people of all ages and genders, the lower age limit deemed appropriate for the operation is accepted as 25. Before this period, cheek shape and facial features may change, but after the age of 25, the facial features of the person settle and there is no significant change after this age. Bichectomy surgery, or in other words, cheek aesthetics, can be applied to people who have a lot of fat on their cheeks, whose facial features are not prominent, whose cheeks look chubby, who look overweight due to their face, and who have thick facial features.

People who have cheek types that are not suitable for facial features and body structure can also have an aesthetic, sharp, and triangular appearance with a discectomy operation. Facial features are made sharper and more prominent with discectomy performed by targeting the golden ratio. Bichectomy, which can be applied to men as well as women, is performed by removing less buccal adipose tissue due to the low amount of adipose tissue in men compared to women.

Various factors may indicate that the person is a suitable candidate for discectomy surgery:

  • Being physically healthy
  • Have a healthy body weight
  • A round and plump face
  • Having realistic expectations about the cheek appearance after the operation
  • Not using tobacco

Bichectomy surgery may not be suitable for everyone. In various cases, this initiative is not recommended for individuals. At the beginning of these situations are people whose facial features are naturally thin. In these people, if the cheek area is thinned with the discectomy operation, the collapse of the cheeks may occur in these people with aging. It is not recommended to apply discectomy operations within the scope of facial aesthetics in elderly people. Since people will lose cheek fat tissue with aging, vitrectomy may cause other signs of aging, such as jowl, to become apparent over time.

How is a bichectomy done?

Thanks to discectomy, which aims to highlight the cheekbones and chin by thinning the cheeks, the person attains an inverted triangular appearance and sharp facial contours. A part of the buccal adipose tissue in the inner side of the cheeks can be removed with discectomy surgery, which is frequently preferred by people who have fuller cheeks due to structural or aging, as well as those who have disproportionate cheeks and who cannot achieve an ideal appearance despite losing weight.

Before the cheek aesthetic operation, which is applied to give an aesthetic appearance to the facial features of the person, the person should be examined and get answers to all the questions left in his mind from the doctor. In addition, it should be learned how to follow the procedure before and after the operation. During the physical examination, the physician will ask the patient to open and close his mouth and perform the examination of the cheek.

It is extremely important to clearly express what kind of appearance you want to obtain during the examination. In addition, the physician should be informed about the drugs used and the use of blood thinners should be left under the control of the physician before and after the operation.

The person must be hungry before the operation. After checking the suitability of the blood tests for the operation, the person is taken into operation. Local anesthesia is usually used in discectomy surgery, but if you are going to have different plastic surgery operations simultaneously with the discectomy operation, general anesthesia may be applied by your physician. Under local anesthesia, an incision of approximately 1 cm in size is made inside the cheek.

The inner cheek fat tissue is reached and then the predetermined part of this tissue is removed from the cheek tissue. Then the same process is applied to the other cheek. At this point, it is extremely important to make both cheeks symmetrical. In addition, some of the fat tissue taken or some fillers can be added to this area to make the cheekbones look sharp.

The buccal adipose tissue can be reached through the mouth or on the face. Intervention from the face is usually performed during face-lifting procedures. The safe method of procedure accepted for now is known as intraoral access. After surgery, the incision areas are closed with soluble suture materials.

What should be considered before bichectomy surgery?

Before operations performed within the scope of aesthetic surgery such as bichectomy, patients should clearly express their expectations and goals after the operation to their physicians. They need to indicate whether they have any chronic diseases and whether they currently use any medication or food supplements. Physicians should also be informed about harmful habits such as allergies, previous surgeries, and alcohol or tobacco use.

With this information, physicians can create a preliminary idea of ​​possible risks and how the recovery period may be, and thus decide which surgical intervention is the most appropriate for the person. You should not discontinue your regular medications in line with personal decisions unless instructed by your physicians. Physicians may be asked to stop the medications you use before surgery and some examinations. Plastic surgeons also examine your face during the physical examination and take photos for planning the operation.

What should be considered after bichectomy surgery?

After bichectomy surgery, the person does not need to stay in the hospital. After a short rest, the patient is discharged and the process of returning to daily life begins. Depending on the operation, the physician may recommend the use of antibiotics so that the incision in the mouth is not infected. In addition, the physician informs the patient that attention should be paid to oral hygiene for the healing process to be fast. Regular brushing and mouthwash help prevent possible infections, while good oral care is among the factors that accelerate the healing process.

After the removal of buccal adipose tissue, various applications made within the knowledge and suggestions of physicians can contribute to the recovery period:

Continuing pressure bandage applications for at least 120 minutes in the post-op (postoperative) period
To apply cold approximately every 4 hours and for 15 minutes for 72 hours post-op.
Avoiding heavy exercises and various physical activities for the first 5 days – 1-week post-op
In addition to these practices, it is important to eat soft and liquid foods for the period recommended by the physician after the operation and to avoid hard food types that should be chewed.

Although the incision area heals after about a week after the bichectomy operation, it is normal to have edema and swelling in the face and especially in the cheek area for two to three weeks. Scarring is not an issue in bichectomy surgeries where surgical intervention is performed inside the mouth. Cold applications, as recommended by the physician, help keep the swelling at a low level.

Alcohol and smoking should not be consumed during this period. Blood thinners should not be used as they pose a risk of bleeding. Since the postoperative effects of herbal teas are not known for sure, they are not recommended to be consumed. It should be kept in mind that paying attention to the physician’s recommendations during the recovery period will speed up the healing process. Since the fatty tissue in the cheek is removed with bichectomy surgery, the procedure is permanent. If the person gains weight, the cheek area does not accumulate as much fatty tissue as before, so the triangular facial appearance does not disappear.

What are the advantages of bichectomy?

The benefits of bichectomy according to other types of operations can be listed as follows:

  • The procedure time is short and does not require hospitalization.
  • Since it is performed under local anesthesia, post-operative symptoms such as nausea are not observed.
  • Facial features that people with round and chubby facial features cannot achieve with diet, diet, and sports can be achieved in a short time.
  • It provides a more effective and smoother appearance since there is no filling and prosthesis application.
  • Since the fat tissue in the cheek is removed, weight gain does not cause the facial features to return to their former state.
  • The recovery process after the operation is fast. Since there is no incision on the skin surface, it does not cause an aesthetic problem.

What are the disadvantages of bichectomy?

Bichectomy surgery is a surgical procedure that is generally considered safe. However, as in any operation, there is a risk of bleeding and infection in bichectomy. Although rare, an asymmetrical appearance may occur between the cheeks due to the difference in the amount of fat removed.

Other disadvantages and possible complications of bichectomy operation are listed below:

  • Excessive bleeding
  • Infection
  • Body’s response to anesthesia
  • Hematoma
  • Restriction of mouth opening
  • Subcutaneous water collection
  • Salivary gland damage
  • Facial nerve damage

Bichectomy operation, which aims to reconstruct the aesthetic contours of the face by removing the fatty tissue under the cheekbone, is a very popular subject. Aesthetic operations must be performed by specialist hands and inappropriate hygienic environments to prevent the above-mentioned and other complications that may occur during bichectomy operation.

If you are planning to have a bichectomy, make sure that an appropriate environment is provided to eliminate possible complications that may occur during the operation.

We wish you healthy days.



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