Overview
Cheek fullness does not consist of a single layer of fat; The deep buccal fat pad, superficial fat tissue, muscles and bone structure together determine the appearance. Bichectomy specifically targets the buccal fat pad and is usually performed through a small incision inside the mouth. The amount of fat on both sides may not be the same. It should be taken into account that the face loses volume with age; Removing too much tissue may cause unwanted collapse in the future. Therefore, a different evaluation is required on a narrow or already low volume face. The procedure does not reduce the entire face, and the effect of the removed tissue should not be seen as a change that is easy to reverse.
What is evaluated?
- Examining the relationship of fullness to buccal fat, superficial fat, masticatory muscle or bone structure.
- Evaluation of existing facial volume, cheek asymmetry and volume loss that may occur with age.
- Discussing oral health, previous cheek procedures and expected thinning.
Approach and options
- If buccal fat contribution is evident, limited and individually planned tissue removal may be considered.
- If the source of fullness is another structure, options for that cause can be discussed separately.
- If it is not deemed appropriate in terms of facial volume or long-term appearance, it may be preferred not to perform the procedure.
Recovery and follow-up
Due to the intraoral incision, oral cleaning and recommended diet are important. If the surgeon deems it appropriate, a special oral care product can be used; The stitches should not be tampered with. As the swelling decreases, the cheek contour is evaluated. If increasing unilateral pain, foul-smelling discharge, or significant redness develops, the surgical team should be consulted.
Risks and limits
- Salivary duct damage.
- Injury to facial nerve branches causing weakness of facial expression.
- Asymmetry in the cheeks, excessive sunkenness or less change than expected.
- Intraoral infection, bleeding and prolonged swelling.
The headings here do not cover all risks. Possible benefits, alternatives and personal risks should be discussed in detail during the examination.
You can ask in the consultation
- Is buccal fat really the source of my cheek fullness?
- How might decreasing facial volume affect my results in the future?
- How will the amount of tissue to be removed from both sides be determined?
Resources
- ASPS – Buccal fat removal ↗
- ASPS – Bichectomy technique ↗
- ASPS – Bichectomy risks ↗
- ASPS – Care after bichectomy ↗
Access to sources: September 2026. The content has been prepared for general information purposes.