Bichectomy in Barcelona
What Is a Bichectomy?
This procedure involves removing the fat pads (Bichat pads) that we all have inside our cheeks in order to achieve a more contoured face. First described in 1732 by Heister, it was later analyzed in 1801 by the French anatomist Xavier Bichat.
The Bichat fat pads are biconvex in shape and are located in the oral cavity, bounded internally by the buccinator muscle, externally by the facial muscles, and posteriorly by the parotid gland.
Even if we lose weight, these fat deposits remain because of their different metabolism. They measure an average of 7 to 8 ml.
Removing them—or“bichectomy”—results in more pronounced cheekbones, a more angular face in that area, and therefore a more slender appearance.
Who is the ideal candidate?
It improves the appearance of the middle third of the face, making the cheekbones and cheeks more defined. Therefore, we do not recommend it for patients with small or poorly defined cheekbones. Therefore, we do not recommend it for patients with small or poorly defined cheekbones.
Surgical Steps
The postoperative period is quite comfortable; it doesn’t hurt, and the swelling from the surgery usually lasts 3 or 4 days. The new contour of the cheek becomes visible after 10 days to two weeks. During this time, you can lead a normal life, avoiding strenuous exercise and smoking.
We have a cranial and facial physical therapy unit to promote better post-surgical recovery.
What Are the Benefits of a Bichectomy?
Youthful Appearance
Facial Harmony
Well-defined cheeks
Treatment Process
We begin with an aesthetic assessment in which we analyze the proportions of your face, your weight, your bone structure, and your habits. Bichectomy is indicated only when it provides a real improvement and does not compromise facial harmony in the medium term. If you decide to proceed, we’ll schedule the surgery in our office under local anesthesia. The procedure takes about 30–45 minutes. Access is intraoral, through the cheek mucosa, leaving no visible scars. The Bichat pad is partially removed, and the incision is closed with absorbable sutures. We’ll provide you with detailed postoperative instructions and a follow-up visit 7 days later.
Recovery time
Inflammation peaks between the second and fourth days and decreases significantly by the end of the first week. We recommend a soft, cold diet for 5–7 days, local cold therapy for the first 24 hours, careful oral hygiene with prescribed mouthwashes, and avoiding strenuous physical activity for 2 weeks. Social reintegration usually occurs 4–7 days later, once the swelling has subsided. The stitches are absorbable. It is common to feel a slight tightness in the cheek for 2–3 weeks, which gradually subsides.
Expected Results
The results become increasingly apparent over time: after 2–3 weeks, the lower-middle part of the face appears more defined, and after 6–12 weeks, the final results are visible. The cheek appears more defined, without affecting the natural expression or smile. Due to the nature of the tissue that is removed, the results are long-lasting, although the face will continue to age naturally. We document the progress and patient satisfaction with comparative photographs taken at 3 and 6 months.
Duration of treatment
The procedure takes about 30–45 minutes in the office. Preliminary planning takes place during an initial visit, which includes taking photographs and obtaining consent forms. The entire treatment process—including preparation, the procedure, and follow-up visits—is typically completed in 8–12 weeks. Follow-up appointments are scheduled at 7 days, 1 month, and 3 months. It is a short procedure, but it requires careful assessment to ensure a harmonious result without overcorrection.
Frequently Asked Questions About Bichectomy
What is a buccal fat removal?
A buccal fat removal procedure involves partially removing the buccal fat pads, located in the cheeks, to contour the lower-middle part of the face. It is a brief procedure, performed intraorally, that slims the cheeks without affecting facial expression. At Clínica Birbe in Barcelona, we only recommend it when it results in a real aesthetic improvement, while avoiding excessive facial slimming.
Who is a good candidate for a buccal fat removal?
People with full cheeks who feel their face looks round even when they are at a healthy weight, and who want a more defined profile. It is not suitable for patients who are very thin or have naturally thin faces, as facial sagging may become more pronounced over time. The evaluation by Dr. Joan Birbe, an ABOMS-certified specialist, ensures responsible prescribing.
How long does recovery take after a buccal fat removal?
The procedure is performed under local anesthesia and takes about 30–45 minutes. Inflammation peaks during the first 3–5 days and decreases significantly within 7–10 days. Most patients return to work within 3–5 days. The final results are visible between 6 and 12 weeks, once the tissues have settled.
Does a buccal fat removal leave a scar?
It leaves no visible scar. The incision is made inside the mouth, in the cheek lining, and is closed with a dissolvable suture that disappears on its own. The scar is hidden and does not affect your smile or facial expressions. Meticulous technique and aseptic practices are key to rapid and discreet healing.
Dr. Joan Birbe: Bichectomy Using the ABOMS Criteria
A buccal fat removal procedure is only beneficial if the face requires it and if the correct amount of tissue is removed. Dr. Birbe, who is ABOMS-certified, first analyzes the patient’s overall facial proportions and rules out surgery when it is not appropriate for the patient. When indicated, the procedure is performed under local anesthesia or sedation, intraorally, and with controlled extraction to prevent premature aging.
Why Have Your Bichectomy at Clínica Birbe?
Bichectomy is a minor surgical procedure. Doing it right means knowing how to say no and, when you do, taking back just the right amount.
• Preliminary facial analysis using clinical photographs to confirm the indication.
• An intraoral technique with no external scars and absorbable sutures.
• Optional conscious sedation for greater comfort during the procedure.
• Bichat fat was removed conservatively to prevent a gaunt appearance in the future.
• Postoperative follow-up with checkups to monitor the reduction of swelling.
→ Schedule your consultation at Clínica Birbe Barcelona and find out if buccal fat removal is right for you.
Testimonials
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- Phone: +34 93 212 47 37
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