Buccal Fat Removal (Bichectomy) CENTER FOR FACIAL PLASTIC SURGERY AT ENT SPECIALISTS
Buccal Fat Removal (Bichectomy)
Buccal fat removal or Bichectomy is a cosmetic surgical procedure that involves the removal
of buccal fat, that is located in the cheeks. These fat pads contribute to the fullness of the
lower cheeks, and their removal, complete or partial, is intended to achieve a more
sculpted and contoured facial appearance. The procedure is often sought by patients
looking to enhance cheek definition or achieve a slimmer overall face.
Here are key aspects of buccal fat removal:
1. Procedure Overview:
- Incisions: Small incisions are made on the insides of the cheeks, within the mouth,
when it is performed as a standalone procedure. More commonly, the buccal fat
pads are removed or repositioned at the time of deep-plane facelift surgery using
the same facelift incision.
- Fat Removal: The buccal fat pads are carefully identified and removed. Conservative
removal is key, as facial hollowing is a sign of aging and skeletonizing the face should
be avoided. However, in younger patients with very round faces, buccal fat removal
can dramatically improve facial contours. In older patients that undergo facelift
surgery, minimal fat excision combined with fat resuspension is the procedure of
choice.
2. Candidates:
- Full Cheeks: Patients with naturally fuller or rounder cheeks may consider buccal fat
removal.
- Facial Contouring: Those seeking improved facial contouring and cheek definition.
3. Results:
- Cheek Contouring: The procedure is designed to create a more sculpted
appearance, enhancing cheekbone and jaw definition.
- Slimmer Face: Removal of buccal fat pads contributes to a slimmer appearance in
the lower face.
4. Recovery:
- Initial Swelling: Some swelling is expected, with the peak occurring in the first few
days.
- Healing Time: Full recovery may take a few weeks to months.
5. Longevity of Results:
- Permanent Change: The results of buccal fat removal are considered permanent and
difficult to reverse, for which reason careful patient selection is key. Not every
round-face patient is a good candidate for the procedure and careful balancing of
improved facial contours and premature aging is crucial.
BEFORE THE SURGERY
From the time of your first consultation (whether on-line or in person) till the day of surgery you will have the opportunity to discuss with Dr Georgescu and his staff all your questions and concerns related to the surgical procedure, the preparation and the recovery. Make sure you fulfill all your financial obligations at least 2 weeks prior to surgery. Stop all anticoagulants (Eliquis, Pradaxa, Plavix, Coumadin, Warfarin), anti- inflammatory medication (Aspirin, Ibuprofen, Naproxen, Diclofenac, Indomethacin) and all vitamins and supplements (except for Calcium and Vit. D) two weeks prior to surgery, but only with the approval of your primary care doctor or cardiologist. Smokers need to stop smoking or vaping at least 4 months prior to surgery. Nicotine patches or gum are accepted. Make sure you fill your prescriptions before surgery, as you will not be able go to the pharmacy immediately after surgery. You need to make arrangements for someone to bring you to the surgery center and take you back home, as you will not be able to drive the day of surgery. You also need someone to stay with you for at least the first night after surgery.
THE DAY OF SURGERY
Do not eat or drink anything past 10:00 PM the night before! If you need to take your blood pressure or anxiety medication, do so with a sip of water when you wake up. Make sure you arrive at the surgery center at the time indicated (our staff will call you the day prior with the exact time you need to be there). Our surgery center staff will greet you and make sure all the consent forms have been signed. Your companion can either wait in our comfortable waiting area, where there is coffee, water and snacks, or can return back home and we will call as soon as the surgery is over. You will be then taken to your room where our nurses will place an IV and EKG electrodes. A urine pregnancy test is performed on all pre-menopausal women. Then, you will meet in person our anesthesiologist who will explain the anesthesia procedure. Most surgeries are done under general anesthesia. Dr Georgescu will come and read to you the consent form and answer any last-minute questions you may have. He will then do the skin markings and may take some additional photographs. The bed will then be wheeled into the operating room where the time out will be performed before you go to sleep. The anesthesiologist will then give you IV medication that will allow you to fall asleep. At the end of surgery, you will be taken to the recovery room where you will wake up with no pain. We typically use ice-packs in recovery for 20 minutes to decrease swelling. After approximately 30 min you will be discharged to go home with your companion. We will bring you to the car in a wheelchair. You will be given Dr Georgescu’s personal cell number to call at any time if you have questions or concerns and Dr Georgescu will call you the night of surgery to make sure you are doing well and following the instructions.
RECOVERY & RESULTS
Most patients take between 3 and 5 days off after buccal fat removal surgery. Bruising
and swelling typically go away in about 2-3 weeks. Antibiotic and pain medication may
be prescribed for a few days. You will need to apply ice packs 20 min / hour while awake
for 2 days. Starting on the 3 rd day you switch to warm compresses twice a day 10 min
each till the bruising is completely gone.
Strenuous activity, such as golfing, swimming, tennis and weightlifting should be avoided
for 3 weeks. Walking is allowed the day after surgery. Light running and biking can be
resumed after 1 week.
You will need to come back to the office the following day to ensure that you are healing
well. You will also be seen on days 7 and 14 followed by 1 month, 3 months and 6
months. However, Dr Georgescu is available to see you at any time if you have questions
or concerns.
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2122 NW 62nd ST, Ste 229 Fort Lauderdale, FL 33309
