Bichectomy: how is it done? See risks, results and value

Year in, year out, and new aesthetic procedures gain repercussion and fame in the media, for being the darlings of the famous.

In a short time, a legion of people, mainly women, are already looking for clinics and professionals who perform this procedure. It was no different with bichectomy!


What is bichectomy?

Bichectomy, or facial lipoplasty , is a surgical procedure for partial removal of the Bichat ball, which is a fatty tissue. This removal causes the cheeks to become smaller, resulting in a thinner, more elongated face appearance.

Despite being an adipose tissue, Bichat balls do not participate as a source of energy for the body, so they do not respond to weight loss. That is, even if you lose weight and decrease the amount of fat, they will remain there, intact.

The procedure is commonly practiced by the dentist. However, there is considerable controversy as to whether this would be the most suitable professional to carry out the process.

In the resolution of 1950/2010, the Federal Council of Medicine, together with the Federal Council of Dentistry, establish, among other issues, that purely aesthetic procedures in the buco-maxillofacial and cranio-maxillofacial region must be performed by doctors .

However, those functional esthetics in the regions where the dentist (buccomaxillofacial) operates can be performed by the professional, who is trained.

Furthermore, contrary to what many people think, bichectomy is not a recent issue. The main work in the area began in the late 1980s, with the Mexican plastic surgeon Guerrero Santos, in an article published in 1989.

However, the boom took place between 2015 and 2016, and since then it has remained high. Some celebrities who underwent the procedure, such as the singer Buchecha (from the duo Claudinho and Buchecha) and the singer Ludmilla.

Others have not declared that they have already undergone the operation, but there is speculation about, as is the case with Angelina Jolie and Juliana Paes.

Index – in this article you will find the following information:

  1. What is bichectomy?
  2. What are bichat balls?
  3. What is bichectomy for?
  4. How is it done?
  5. Who is it for?
  6. Contraindications
  7. Care before surgery
  8. How is the recovery?
  9. Results of
  10. Does bichectomy age?
  11. Photos: before and after
  12. What are the risks of having a bichectomy?
  13. What the value?
  14. Common questions

What are bichat balls?

Bichat balls, or buccal adipose bodies, are an accumulation of fat that is located in the cheek area.

There is still no consensus on what their real function is in the human body, but it is believed that they have a fundamental role in the breastfeeding process. They would be responsible for preventing the lining of the mouth from touching each other during the baby’s sucking process.

At the same time, they are located close to important structures in the region of the face, such as terminal branches of the facial nerve and blood vessels.

What is bichectomy for?

The main function of the process is the removal of Bichat balls, with the objective that the cheek area is more “thin”, leaving the face as a whole thinner and longer.

In addition to this purpose, surgery is recommended for those who have trauma to the cheek mucosa. This is usually because the cheek is very large and then the patient ends up biting the region, which is evidenced by the appearance of a white and well-marked line inside the mouth.

How is it done?

Bichectomy is a very simple surgery that lasts between 30 minutes and 1 hour to be performed. Surgery must be done under anesthesia, whether local or general, but the use of sedation is not a rule.

And the choice of which anesthesia will be used will always depend on the conditions in which the patient is.

The cut is made in the internal area of ​​the mouth, above the upper second molar, and usually has an extension between 1 and 4 centimeters.

By pressing the outer side of the cheek, the surgeon will make the fat go through the cut. Then, a clamp is used and it is at that moment that the Bichat ball is removed.

After removal, the professional will sew the cut, leaving no external scarring, although the patient is able to feel it internally – as long as the procedure is done properly.

The stitches made for closing the cut can be of the absorbable type and therefore do not need to be removed. In the case of normal stitches, removal should be done 7 days after the procedure.

Who is it for?

Bichectomy surgery is indicated for people who have a very rounded face, very large cheeks, a little defined face volume and, of course, who are bothered by these characteristics.

There are also those that have no definition in the jaw and have a little fat in the jowl and neck, so they end up not having the angle of the jaw.

These two “biotypes” of patients are the ones that will most benefit from the results that the bichectomy can cause.

Can men do?

Despite the fact that bichectomy is more sought after by women, mainly due to its aesthetic appeal, the procedure can also be performed on men and the process is exactly the same, this is because all human beings have Bichat balls.

Thus, as with women, men must also undergo an evaluation by the surgeon so that he can identify whether there is a need or indication for the procedure.


The professional who will perform the surgery should evaluate the shape of the patient’s face to know whether or not to perform the surgery. Normally, faces that are more elongated and that are already “thinner” by nature, do not require surgery.

There are other conditions that can prevent people from undergoing the surgical procedure:

  • People undergoing radiotherapy and chemotherapy;
  • Local or systemic infections;
  • Severe heart diseases;
  • Systemically non-compensated patients;
  • Deficiency of coagulation factors;
  • Severe liver and kidney problems;
  • Difficulty in reaching;
  • Minors;
  • Pregnant women.

In addition, two aspects must be evaluated by the doctor before the surgery is performed:

Masseter muscle hypertrophy

Hypertrophy of the masseter muscle can cause a wider face appearance. If this is the case, it is possible to do another type of procedure.

As this muscle is located behind the cheeks, the bichectomy can give a limited result, so it may not meet the patient’s expectations.

“Cheekbones” evident or large

It is important to note that bichectomy does not “create” cheekbones for those who undergo surgery. What happens is that the procedure can highlight that region.

Care before surgery

When consulting with the doctor, it is normal that he needs to know some information before performing the procedure, such as which medications you are taking.

In addition, it will also inform you about how the bichectomy will be performed, from the incision to the extraction of the bicolor balls.

It is also part of the preoperative order of blood tests – blood glucose, coagulogram and complete blood count – or even physical, all to make sure that the patient’s health allows an operation.

How is the recovery?

Since bichectomy is a very simple procedure, recovery does not have any major complications either.

As soon as the patient leaves the office, it is recommended to make ice packs in the first 2 days so that the face is not too swollen, although the swelling is normal, along with the appearance of bruises and pain.

On the first and second day, the patient’s diet should be mostly liquid, with the inclusion of baby food and foods that do not require a lot of force at the time of chewing.

It is also important to use facial compression bands, which should be used for 3 days, in order to reduce edema and avoid bruising.

The general recommendation is that the rest is done in the first 2 days and the patient does not make much effort in the first 7 days.

In addition, the patient will be able to use medications prescribed by the professional who performed the operation, usually anti-inflammatory and analgesics for pain.

It is worth remembering that great care is needed when brushing teeth so that oral hygiene is maintained, thus preventing infections.

What not to do in the postoperative period?

Many people are in doubt as to what can and cannot be done right after the surgical procedure. Then check here some activities that are contraindicated:

  • Do physical activities, such as gym, crossfit and etc .;
  • Lifting weight in the first days;
  • Talk excessively in the first 48 hours;
  • Eat very hot food for the first 48 hours.

Results of


When it comes to cosmetic procedures, it is always important to keep in mind that no surgery works miracles and that sometimes people have a lot of expectations and end up being frustrated with the result.

Then find out what are the possible results of bichectomy:

  • Thinning of the lower region of the cheekbones and thus, defining the angle of the jaw a little more;
  • Enhancement and definition of cheekbones.

Is the result immediate?

In the first 5 days after the surgery the facial swelling is quite evident. As the days go by, the face returns to the characteristics it already had before the surgery.

The result of the procedure itself is slow and gradual, taking between 3 and 6 months for the face to be properly shaped. However, the first results can be seen in the first month after the procedure.

Does bichectomy age?

With the popularization of bichectomy, an immense discussion was creating a body with regard to its results in the medium and long term.

It is known to the scientific community that Bichat balls are larger in childhood and will decrease as the aging process progresses. Therefore, babies, in general, are much more chubby and in the course of growth they lose this characteristic a little.

Following this logic, some doctors claim that the removal of Bichat balls can accelerate aging, or accentuate the characteristics of this process. This is because this facial fat would also be responsible, then, for supporting the face.

However, this would only happen in patients in whom bichectomy surgery is not indicated – those who already have thin faces and other conditions already explained above.

In general, as the procedure has recently become popular, the results have yet to be evaluated, but the prediction of some doctors is that within a few years many people who have had a bichectomy will be undergoing new aesthetic treatments.

These will be to (re) fill the “hole” left by the absence of Bichat balls, in order to disguise premature aging.

However, there are doctors who disagree that these structures have support functions and therefore would not have any influence on the facial aging process.

Photos: before and after

We have separated some pictures of celebrities so that you can see the possible results that bichectomy surgery can generate. However, it is important to note that some celebrities never spoke about whether or not they underwent the procedure.

However, experts say it is possible to deduce that they performed the bichectomy when comparing recent photos with older ones.