What Is Bichectomy?
A bichectomy is a surgical procedure in which the surgeon removes the Bichat fat pads — also known as buccal fat bags — with the goal of gently “slimming” the face. These pads sit on the inside of the cheeks, and their size varies from person to person according to genetics.
Through small incisions inside the mouth, a measured amount of buccal fat is removed — leaving no visible external scars — to create more defined, sculpted cheekbones and a slimmer facial contour. Sometimes called the “Hollywood cheek,” it targets the stubborn fat pads that diet and exercise can’t reach, and because those pads don’t grow back, the results are permanent.
How Is a Bichectomy Performed?
A bichectomy is a quick, minimally invasive procedure that usually takes about an hour. It is performed under local anesthesia: a small incision is made on the inside of the cheek, the buccal fat pads are carefully removed through it, and the incision is closed with dissolvable sutures — so there are no external scars.
Beforehand, you’ll have a consultation to review your goals, facial anatomy, and medical history. Afterward, we schedule a follow-up visit to make sure the incisions are healing well and to check your final contour as the swelling settles.
Benefits
- Slimmer, more sculpted cheeks
- Enhanced cheekbone definition
- No visible external scars (incisions inside the mouth)
- Quick procedure under local anesthesia
- Permanent results
Who Do We Recommend It For?
It’s a technique we recommend for rounded faces with an excess of facial fat but without excess muscle volume. It’s an ideal procedure to combine with submental and cervical (chin & neck) liposuction on fuller faces or those with excess regional volume.
Are You a Candidate?
During your consultation we confirm whether Bichectomy is the right approach for you. Most ideal candidates:
- Have full or rounded cheeks you would like to slim
- Want more defined facial contours
- Are over 18, with fully developed facial features
- Are at a stable, healthy weight and in good general health
- Are non-smokers, or willing to quit before and after surgery
- Have realistic expectations — results are shaped by your natural bone structure
Recovery & What to Expect
Mild swelling is expected for the first days. Most patients return to normal routines within a few days, with final definition emerging over the following weeks.
Post-Operative Care
- During the first 3–4 days, sleep with your head higher than your feet, and apply ice locally during the first 48–72 hours.
- For the first 5 days, avoid foods that require opening your mouth wide and don’t bite directly with your lower front teeth. Also avoid very hard foods or anything that requires continuous chewing.
- Do not rinse your mouth for the first 24 hours, to protect the clots that shield the mucosal wound and to prevent bleeding.
- After 5–6 days, once the swelling has gone down, you can resume your social life. In some cases the swelling may persist for a couple of extra days, especially in fair-skinned patients who also have subcutaneous fat accumulation.
- The final result takes about 3–4 months to fully appear, as the residual tissue swelling resolves — though improvement is already visible by the end of the first month.
Risks & Safety
When performed by an experienced surgeon, a bichectomy is a very safe procedure with a low complication rate. As with any minor surgery, potential risks are uncommon and may include:
- Infection (rare)
- Bleeding (rare)
- Temporary swelling or numbness
Our team follows strict safety and hygiene protocols at every step. If you notice unusual pain, bleeding, numbness, or any sign of infection during your recovery, contact us right away.
Bichectomy FAQs
Are the results permanent?
Yes. The removed buccal fat does not return, so results are long-lasting.
Are there visible scars?
No. Incisions are made inside the mouth, leaving no external scarring.
Will it change with weight gain?
Significant weight changes can affect the face, but the removed fat pads do not regenerate.
Why Choose Golden Cosmetic Center?
Every procedure at Golden Cosmetic Center is guided by one goal: to keep you as safe and comfortable as possible while delivering natural-looking results. Our experienced surgical and medical team combines precision with genuine, personalized care — from your first consultation through your final result.
To support a smooth recovery, we often recommend increasing your protein intake before and after surgery and avoiding restrictive diets while you heal, and we’ll walk you through a simple, personalized preparation plan at your consultation.
At our West Miami practice, your safety and trust always come first — so you can focus on feeling like the best version of yourself.