What Is Bichectomy (Cheek Slimming)?

Bichectomy is a surgical procedure in which the Bichat fat pads located in the inner cheek are removed to achieve a slimmer, sharper, and more aesthetically proportioned facial appearance. In recent years, this method—popularized as the “Hollywood cheek”—has been especially preferred by individuals who feel their face appears round or overly full.

In individuals with genetically wide or full cheek structures, the face may appear rounder than it actually is, and facial features may lack definition. Bichectomy reduces this fullness, enhances the inverted triangle appearance in the lower face, and makes the jawline more aesthetic.

Who Is Bichectomy Suitable For?

Bichectomy surgery is an ideal solution for individuals who want to slim their facial features and enhance contours. Individuals who meet the following criteria are considered suitable candidates for this procedure:

People with noticeable fat accumulation in the cheek area: Individuals who are bothered by a full cheek appearance.
Those who want more defined facial features: People who wish to highlight the jawline and cheekbones.
Individuals in good general health: Those without medical conditions that would prevent surgical intervention.
Those aiming for an inverted triangle facial shape: Men and women who desire more feminine or more masculine facial features.

Bichectomy is generally not recommended for individuals with very thin faces, as the face may appear more sunken after the procedure. Surgical evaluation is critical at this point.

Benefits of Bichectomy Surgery

Bichectomy not only provides an aesthetic change but also improves overall facial proportions, giving the individual a more balanced appearance. The main advantages of the surgery include:

Sharper Facial Features

With the removal of cheek fat, the lower part of the face becomes slimmer, and the cheekbones and jawline become more defined.

Permanent Results

The Bichat fat tissue does not regenerate; therefore, the slimming effect achieved is permanent.

An Aesthetic and Youthful Appearance

Reducing full cheeks makes the face look slimmer, younger, and more balanced.

Increased Self-Confidence

As the individual achieves the desired facial contour, they feel more confident in social life.

How Is Bichectomy Surgery Performed?

Bichectomy is a minimally invasive procedure performed through a small incision inside the mouth. No external scars remain.

Stages of the Surgery

The procedure is performed under local anesthesia or sedation.
An incision of approximately 1 cm is made inside the mouth.
The Bichat fat pad is carefully removed.
The incision site is closed with self-dissolving sutures.

The surgery takes an average of 20–30 minutes, and patients can be discharged on the same day.

Risks of Bichectomy Surgery

As with any surgical procedure, bichectomy carries some risks; however, when performed by an experienced surgeon, the complication rate is extremely low.

Swelling and Edema: Edema may occur in the cheeks after the procedure and usually decreases within 2–3 weeks.
Infection: Since the procedure involves the oral cavity, proper oral care significantly reduces the risk of infection.
Nerve Injury: This is a very rare complication; the risk is minimal with surgeons who have a thorough knowledge of facial anatomy.
Excessive slimming: In cases of incorrect patient selection, the face may appear overly sunken.

Recovery Process After Bichectomy

The recovery process after bichectomy is generally comfortable, and return to daily life is quick.

Postoperative Care Considerations

Liquid nutrition should be preferred for the first 2–3 days.
A special antiseptic spray or mouthwash should be used for the intraoral sutures.
Use of a facial compression garment / band helps reduce edema and speeds up healing.
Heavy exercise should be avoided during the first week.
Hot foods and beverages should be avoided for a period of time.

Complete resolution of swelling may take 4–6 weeks, while the final settling of facial contours may take 2–3 months.

When Do Bichectomy Results Become Visible?

Swelling in the cheeks may be observed in the first days after the procedure. The true contours:

Begin to become noticeable in weeks 2–3,
Settle within 1–2 months,
Reach their final appearance by the end of 3 months.

Are Bichectomy Results Permanent?

Yes. The Bichat fat tissues do not regenerate; therefore, the results of the procedure are considered permanent. However, since excessive weight gain can cause overall facial fullness, maintaining an ideal weight is recommended.

Who Is It Not Recommended For?

Individuals with very thin and sunken faces,
Older individuals with low cheek volume,
Those with serious systemic diseases,
Individuals with active intraoral infections.

Conclusion

Bichectomy is an effective, safe, and permanent procedure that reduces excess fat tissue in the cheeks, giving the face a slimmer, younger, and more attractive profile. It is an ideal solution for individuals aiming for the Hollywood cheek appearance, wanting to enhance facial contours, and meeting the appropriate candidate criteria.