Buccal fat removal - Bichectomy


If you want to make your cheeks smaller, buccal fat removal, also called bichectomy, may be the right choice for you. This non-invasive procedure can reduce the cheeks and define facial angles. Prepare to display defined cheek hollows in a very Bella Hadid style!

You will look as if you were puckering your lips or blowing a whistle in a flattering, very sophisticated manner. Also, you will get a more balanced facial appearance.

Indeed, it is the way to go if you want a chiseled and slender look, which can boost confidence and self-esteem.

So keep reading to find out everything about this relatively small yet very effective cosmetic procedure.

Let’s talk about the buccal fat pad

The buccal fat pad is a rounded mass of fatty tissue responsible for your cheek’s appearance. It is located between facial muscles, in the hollow area beneath your cheekbone, and front of your ears.

This area is susceptible to accumulating fatty tissue. Hence, it is responsible for the appearance of “chipmunk cheeks,” which could result from weight gain, genetics, or simply ageing.

The size of your buccal fat pads can greatly impact your face shape. For example, if you have large buccal fat pads, your face could look too round or full.

This excess fatty tissue may also cause jowls or drooping skin on the neck and jawline. Hence, the impact of overly full cheekbones goes beyond the mid-face area.

What Is Buccal Fat Removal?

Buccal fat removal is a cosmetic surgery procedure recommended for people who, despite heavy diet and exercise, cannot get rid of their chubby cheeks.

Also known as bichectomycheek reduction surgery, buccal lipectomy, and Hollywood Cheeks, the procedure creates a more contoured facial appearance by removing excess fat pads (buccal fat pads) from the cheek area.

It is an effective and safe procedure that aims to improve your cheekbones’ contours by strategically reducing the fat volume in the hollow part of your cheeks.

In men, the reduction of facial cheek volume translates into a chiseled jawline and cheeks. On the other hand, women aim for a delicately sculpted and slender facial contour.

Also, surgery that removes the buccal fat can help improve the facial appearance by eliminating any asymmetry. It is important to note that the size of the buccal fat pads can differ on each side of the cheeks in the same patient.

Benefits of Buccal Fat Removal

Some of the main benefits are:

  • Improved facial contouring
  • Rejuvenated, harmonious facial shape
  • No scarring
  • Subtle changes
  • Quick recovery

Buccal fat removal - Bichectomy - Before After

Who is a Good Candidate for Buccal Fat Removal?

Bichectomy is designed for those who are looking to reshape their face and jawline. However, this surgery is not recommended for patients with a lot of excess fat.

The ideal candidate:

  • is aged between their mid-20s to 40s.
  • wants to get rid of puffy or chubby cheeks.
  • wants to achieve a more sculpted appearance.
  • maintains a stable, healthy weight (within 30% of his/her ideal weight).

You are unlikely to be a candidate if you:

  • have a narrow face and no fullness in the cheeks. The procedure may give you sunken cheeks as you age!
  • are an older patient, and the ageing process has already caused volume loss in the cheeks and midface area. The procedure could emphasize jowls and other signs of facial aging.
  • have hemifacial atrophy (Parry-Romberg syndrome). This rare genetic disorder causes the skin on one side of the face to shrink, including the buccal fat pad.

Whichever your case, during your first consultation, the surgeon will review your medical history and assess the anatomy of your cheeks.

Then, based on the clinical findings and your expectations, he will decide if you are an ideal candidate for this procedure. Also, he will elaborate on realistic goals and a treatment plan specially tailored for you!


The procedure is relatively straightforward. It is usually performed in the doctor’s office as a day case procedure.

You will be under local anaesthesia and sedation if you feel anxious. You won’t feel any pain or discomfort.

The surgeon makes small incisions on the inside of the cheeks (approximately 15 mm) —so there are no visible scars, and you get minimal downtime.

Then, he will apply place pressure on the outside of your cheek to expose the buccal fat pad. During the procedure, the excess fat pads are removed, and the wounds sutured.

The entire process is relatively quick, taking around an hour to complete. If you’re having more procedures done, though, you will have surgery in an operation room under general anaesthesia instead.

Buccal fat removal - Bichectomy procedure


Typically, it takes about three weeks for the mouth tissues to recover from surgery. Although, most patients can return to all their regular activities within 5-7 days after surgery.

We strongly advise stopping smoking at least two weeks prior to your bichectomy and two weeks after the procedure to optimize your healing process. Smoking can significantly impair your post-operative recovery and increases the risk of complications.

A soft, cold-food or liquid diet is recommended for the first week following surgery to prevent dislodging the stitches or irritating the tissue at the incision sites. Then, you can progress to soft foods before returning to your regular diet.

Make sure you follow the instructions from your surgeon and take any medication or special mouthwash as prescribed to prevent infection.

Minimal discomfort is expected, and bruising is uncommon. The swelling usually peaks on the 3rd day and then subsides in the following days. However, it may persist for up to 6 weeks following surgery.

You should avoid strenuous exercise and bend over on the first days. Also, sleeping in an elevated upper body position can help control post-operative swelling and protect your incisions.

You will have to wait nearly three months before the areas are completely healed and see the final results. It takes time for your cheeks to settle into their new shape.


If the entire buccal fat pad is removed, it is permanent. Once the fat is removed from your cheeks, it does not come back.

If your surgeon removes it partially, or other fat removal methods have been used in the lower cheek, the buccal fat may return if you put on weight.

Important fluctuations in weight may affect the appearance of the results over time!

The same applies to the natural ageing process. It can cause volume loss, fine lines, wrinkles, and sagging skin.


Buccal fat removal is a relatively safe procedure, but it is important to note that all surgery carries some risk.

Most side-effects following surgical procedures, such as discomfort, swelling, and bruising, are temporary and subside within weeks.

Complications may include:

  • Anaesthetic risks (if general anaesthesia is used).
  • Haematoma (blood accumulation).
  • Seroma (fluid accumulation).
  • Damage to nerves or salivary glands.
  • Facial asymmetry.

One of the risks of buccal fat reduction is removing too much.

During the ageing process, the fat pad can shrink. Thus, an experienced surgeon will take a conservative approach when removing the fat in younger patients to maintain a natural appearance when they are older.

Risks and complications are rare in the hands of a plastic surgeon with expertise in facial aesthetics.


Buccal fat removal reduces cheek volume and should make the cheekbones and jawline more prominent. However, if you do not have a good cheekbone projection to start with, removal or reduction of buccal fat may not give you the high, prominent cheekbones you desire.

Thus, a consultation with an expert in plastic surgery is vital so that your cheekbone structure is analyzed to determine whether bichectomy alone will give you the results you want. The good news is that it can be combined with other surgical or non-surgical procedures to provide an enhanced effect, including cheek implants, fat transfer, and dermal fillers.

Other facial plastic procedures that you can combine are:

How Much Does a Buccal Fat Removal Cost?

The price of a Buccal Fat Removal surgery is 1,320 euros (approximate cost).

Since we know that cost is important, we welcome you to visit our facilities for a free, no-obligation visit. You’ll have time to consult with the plastic surgeon, ask questions, and talk about any concerns. We’ll identify the best solution and the best price for you.

Why Choose Doctor Jesús Benito for Your Bichectomy in Spain?

We’re so glad you asked! With over 20 years of experience, Doctor Jesús Benito is one of the best board certified plastic surgeons in Europe. He’s a global authority in plastic, reconstructive, and cosmetic surgery and he’s pioneered many new techniques and surgical processes.

Doctor Jesús Benito is a member of many international plastic surgery organizations, has won numerous awards, and is dedicated to his patients. His world-class medical center in Spain is sought out for its excellence and state-of-the-art procedures. A highly trained team supports Doctor Benito and provides superb care for every patient.

Doctor Jesus Benito - Plastic Surgeon

Doctor Jesús Benito

Specialist in plastic and cosmetic surgery.

  • Secretary of the ISAPS (International Society of Aesthetic Plastic Surgery).
  • Former president of the Spanish Association of Aesthetic Plastic Surgery (AECEP).
  • 2013 Gold Medal (Forum Europa)

More information about the medical team.

Bibliography & Publications:

Complications associated with bichectomy surgery: a literature review.  Alcantara MT, Ribeiro NR, Abreu DF. Minerva Stomatol. 2020 Nov

Photobiomodulation in the Postoperative of Bichectomy Surgeries: Case Series. Bernal Rodriguez CG, Kraul LF, Cardoso TW, Eduardo CP, Aranha ACC, de Freitas PM. Photomed Laser Surg. 2018

Do you want more information about buccal fat removal?

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    Dr Benito and Dr Salvador - Antiaging Group Barcelona

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