Bichectomy, also called buccal fat removal, slims the lower cheeks by removing part of the buccal fat pads, two small pockets of fat that sit deep in the cheeks. It is one of the most searched facial procedures by patients planning treatment in Turkey, and also one of the most misunderstood. A rounder face is not always caused by buccal fat, and removing fat from the wrong face can make it look hollow years later. This guide explains who bichectomy suits, how it is done and what recovery really looks like. You can also see the procedure page for bichectomy in Kadıköy, Istanbul.
Short answer: Bichectomy is done through a small incision inside the mouth, so there is no visible scar. It is done in hospital under sedation and takes about half an hour. Swelling settles within 1–2 weeks and most people are back at work on day three; the result starts to show at the end of the first month and is clear by the third month. It suits full, round lower cheeks; it does not suit naturally thin faces.
What Is Bichectomy?
The buccal fat pad lies between the cheekbone and the jaw, under the cheek muscles. In some people it is large enough to make the lower face look round even at a healthy body weight. Bichectomy removes a planned part of this pad to give a slimmer contour between the cheekbone and the jawline. The fat is reached through a short incision on the inside of the cheek, so nothing shows on the skin.
Who Is a Good Candidate?
- Adults with full, round lower cheeks that are out of proportion to their body weight,
- people whose face has looked round for years, not only after recent weight gain,
- people in good general health with realistic expectations.
Who Is It Not Suitable For?
- People with naturally narrow or thin faces, where removing fat can make the cheeks look sunken,
- people who already have age-related volume loss in the mid-face,
- people whose wide lower face comes from a large jaw muscle rather than fat (see the comparison below),
- people with active infection in the mouth or certain conditions affecting facial fat.
Facial fat naturally decreases with age. That is why careful candidate selection matters more in bichectomy than the procedure itself: the face has to look balanced not only next month but in ten years' time.
Is It Buccal Fat, Jaw Muscle or Weight?
A round or wide lower face has different causes, and each needs a different approach.
| Cause | What you notice | What may help |
|---|---|---|
| Large buccal fat pads | Full, soft cheeks below the cheekbone, even at a healthy weight | Bichectomy |
| Enlarged jaw muscle (masseter) | A wide, square angle of the jaw, often with teeth clenching or grinding | Masseter Botox |
| Overall weight gain | Fullness across the whole face and neck | Weight change first; then reassessment |
| Weak jawline or chin | The lower face looks undefined rather than wide | Jawline or chin filler |
If you are unsure which applies to you, an examination usually answers it in minutes. Our guide to jawline filler explains the definition side of the lower face in more detail.
How Is Bichectomy Performed?
We perform bichectomy in hospital under sedation; it takes about half an hour. A short incision is made inside each cheek, the planned amount of fat is removed and the incision is closed. Working in hospital means that rare events, such as bleeding, can be dealt with straight away.
Recovery After Bichectomy
| Period | What to expect |
|---|---|
| First days | Swelling and tenderness in the cheeks; soft or liquid diet; antiseptic mouthwash after meals |
| Day 3 | Most people return to work |
| Weeks 1–2 | Swelling settles; avoid hard foods such as bread crusts and nuts for 10–12 days |
| Weeks 2–3 | Avoid strenuous exercise and contact sports; keep using mouthwash as advised |
| Months 1–3 | The result starts to show at the end of the first month and is clear by the third month |
The stitches dissolve on their own and do not need to be removed. Avoid smoking during recovery, as it slows healing inside the mouth.
Risks and Side Effects
Temporary swelling, discomfort and numbness in the cheeks are common. Less common risks include bleeding or a collection of blood (haematoma), infection, asymmetry, removing too much or too little fat, and injury to the salivary duct or to a branch of the facial nerve that runs nearby. These are rare when the procedure is planned and performed by an experienced surgeon who knows the anatomy of the cheek well.
Bichectomy in Istanbul for International Patients
Bichectomy is performed by Op. Dr. Müge Yalçın, plastic, reconstructive and aesthetic surgeon. Your assessment takes place at our clinic in Caddebostan, Kadıköy, and the procedure itself in hospital. The first check-up is on day two and the stitches dissolve by themselves, so if you are travelling from abroad a stay of three days in Istanbul is enough.
Bichectomy is often planned together with double-chin liposuction, jawline filler or mid-face procedures (a lift or fat injection) to treat the lower face as a whole. Which of these suits you is decided at your consultation.
Frequently Asked Questions
Is bichectomy permanent?
Yes. The removed fat does not grow back. Your face will still change with age and weight, which is why the amount removed is planned with the future in mind.
Will my face look hollow when I am older?
This is the main long-term risk, and it is why bichectomy is not offered to people with naturally thin faces or existing volume loss. In a well-chosen candidate, a measured amount is removed rather than as much as possible.
Is there a scar?
No visible scar. The incision is made inside the mouth and heals within a few weeks.
When will I see the final result?
The cheeks look slimmer once the early swelling settles, but the result starts to show at the end of the first month and is clear by the third month.
Is Bichectomy Right for Your Face?
Request a consultation at our clinic in Caddebostan, Kadıköy, Istanbul. When you submit the form, your details are sent to our team via WhatsApp.
Source: ISAPS – Buccal fat removal. This article is for information only and does not replace a medical consultation.