Is Cheek Reduction (Bichectomy) Suitable for Every Face Type?

Bichectomy is the surgical removal of the deep fat tissue in the cheek area called the "Bichat fat pads." These fats are structural tissues that do not dissolve with diet or sport. This procedure, carried out through a small incision of about 1 cm from inside the mouth, provides the thinning of the cheeks and the definition of the cheekbone line without leaving any scar on the outside.

Bichectomy gives the most successful results in people who want to make their facial contours look more "contoured" and have the following characteristics:

• Round and Square Facial Contours: People whose cheeks are genetically full and who, no matter how much they lose weight, cannot shed that "baby-faced" fullness in their face are the most suitable candidates.

• Those Whose Cheekbones Do Not Become Prominent: When the cheek fats are too much, the cheekbones are hidden under this fat tissue. Removing the fats brings the bone structure to the fore.

• Those Who Want a "V" Form in Their Face: It creates a dramatic change in people who want the lower-face area to look narrower and the cheekbones wider.

Op. Dr. Ayşe Öznur Akidil emphasises that not every patient is suitable for bichectomy and that wrong patient selection can turn into an aesthetic mistake:

• Already Thin and Long Faces: If the person's cheeks are already sunken or thin, removing these fats can make the patient look sickly and excessively old.

• Advanced Age Group: As we age, the fat tissue in our face naturally decreases. In people over the age of 45-50, removing these fats can accelerate skin sagging.

• Overweight People: In people whose BMI (Body Mass Index) is very high, the small amount of fat removed may not be noticeable from the outside. These patients are advised to first get close to their ideal weight.

• Weak Bone Structure: In people whose cheekbones are very flat, cheek reduction can disrupt the balance of the face. In these cases Op. Dr. Ayşe Öznur Akidil may recommend combining bichectomy with cheekbone filler.

The most critical subject in bichectomy is "time." Cheeks that look very full in the twenties turn into "support mechanisms" that keep the face firm when the forties are reached.

At our clinic that provides aesthetic consultancy in İzmir, we remind our patients of the following truth: The fats in the face are our youth capital. If too much fat is removed at a very young age, the middle part of the face can collapse prematurely in middle age. For this reason the surgeon needs to analyse the amount of fat in the patient's face and the skin quality very well and remove not all of the fat but only as much as needed.

Bichectomy is a comfortable and fast procedure surgically:

• Duration: It takes about 30-45 minutes. It is usually done under local anaesthesia or sedation.

• Pain: Minimal aching is felt during and after the procedure, easily controlled with painkillers.

• Recovery: The sutures inside the mouth dissolve by themselves. Oedema (swelling) in the cheeks for the first 3-5 days is normal. Seeing the full result and the settling of the face takes about 3 to 6 months.

Since it is a procedure done from inside the mouth, hygiene is very important against the risk of infection:

• Soft and lukewarm foods should be consumed for the first 2-3 days.

• Oral hygiene should be provided with the mouthwash recommended by the doctor after each meal.

• Since smoking will delay recovery, it should be paused for at least 1 week.

Although bichectomy looks like a simple procedure, the Bichat fat pads are in a position very close to the facial nerves (facial nerve) and salivary ducts. For this reason procedures done in hands that do not fully master the anatomy can carry risks. Op. Dr. Ayşe Öznur Akidil performs the operation by protecting the sensitive structures in this area with a surgeon's meticulousness. At her clinic in İzmir Bayraklı, by making a design special to each patient's face type, she provides a "non-exaggerated," natural and aesthetic thinning.

Do the fats removed after bichectomy come back? No. The fat pads removed are not produced again by the body. However, in case of excessive weight gain, the fat cells in the other areas of the face can expand.

Does bichectomy make the face sag? When done in the right patient and in the right amount, it does not cause sagging. However, when done in people whose skin is already very loose and whose face is thin, it can create the illusion of sagging.

Does a suture scar remain on the outside? No, the incision is completely inside the mouth. No one understands you have had surgery unless you tell them.

Bichectomy, when done on a suitable face type, is a tremendous procedure that makes the face more characteristic, energetic and attractive. However, the aim is not just to empty the cheeks but to provide the holistic harmony of the face. While dreaming of a "Hollywood Cheek," you should not overlook the limits of your own anatomy and your future need.

Op. Dr. Ayşe Öznur Akidil awaits you in İzmir to bring your facial contours to their most ideal form and to determine whether bichectomy is the right decision for you. For a professional facial analysis and detailed information, you can contact our clinic.