Bichectomy in Paris is a cosmetic surgery procedure that is increasingly in demand, particularly among younger patients who wish to refine and sculpt the contours of their face. This simple procedure redefines the contours of the face by removing fat deposits from the cheeks, known as Bichat balls.
Dr. Delobaux, a plastic surgeon in Paris, will guide you through this process to achieve a harmonious and natural result that respects the balance of your facial anatomy.
What is a buccal fat removal?
Definition of Bichat's fat pads
Bichat's fat pads are fatty structures found in everyone to a greater or lesser extent. They are named after the famous French physician Marie François Xavier Bichat, who first described them. These fatty deposits are located in the cheek, behind the jaw's masticatory muscles, and extend upward into the temporal region.
These fat pads can vary in size from person to person. They are what give the cheeks either a sunken or a round appearance. As a result, a slim person may have a round face if their Bichat fat pads are very prominent. In babies, the Bichat fat pads are particularly well-developed because they support the sucking motion, giving the cheeks their characteristic âbaby faceâ appearance.
As we age, the Bichat fat pads shrink, giving the cheeks a slightly more sunken appearance.
Principle and Purpose of Bichectomy
A buccal fat pad removal, or bichectomy, is a cosmetic surgical procedure that involves removing part of the fatty tissue located within the cheek. It is referred to as a reduction rather than a removal because the buccal fat pads extend to the temple region, where they are preserved.
The area in question, located in the cheek, has little or no useful physiological function. Reducing it results in less rounded cheeks and creates a slight hollow. This reverses the curvature of the face at the cheeks, highlighting the cheekbones and jawline. The face then appears more harmonious and dynamic, with more prominent and better-defined features.
In women, the procedure adds elegance, refinement, and femininity to the face. The goal here is to achieve the âmodelâ look. For men, the removal of the Bichat pads is intended to refine the face, making it more angular and masculine, with a more defined jawline and more prominent cheekbones.
Who is a good candidate for a buccal fat pad removal?
This facial surgery procedure is performed on both men and women. Since the size of the Bichat fat pads varies from person to person, it is not limited to people who are overweight.
Cosmetic surgery to remove Bichatâs fat pads is generally considered once the patient has reached physical and emotional maturity. It is advisableto wait until at least age 18 before considering this type of procedure, to ensure that facial growth is complete and that the decision is not made lightly.
Good to know: This procedure is not recommended for overweight patients whose goal is to lose weight, as weight loss can affect the size of the Bichat balls.
What are our different buccal fat pad removal techniques?
There are two methods for performing abuccal fat pad removal: via an intraoral approach or via a facial approachduringa facelift. In clinical practice, the safest and most commonly used method involves making an intraoral incision.
Reducing the Bichat pads allows for a more pronounced sculpting of the lower third of the face than cheek liposuction. This is because liposuction cannot remove fat from deep within the tissue.
What are the steps to take before your buccal fat removal?
First appointment with Dr. Delobaux
The first step is the preliminary consultation, during which your surgeon will explain the steps involved in the procedure, as well as its benefits and risks. After analyzing your face, Dr. Delobaux will guide you in choosing the best treatment.
As with any surgical procedure, this initial consultation is necessary to conduct a comprehensive evaluation and detailed analysis of the face.
At the end of your first consultation, Dr. Delobaux will provide you with an information sheet summarizing the benefits and potential complications associated with this surgery. A 15-day cooling-off period is required between the first consultation and the procedure.
Medical Preparation
In the weeks leading up to the procedure, you should avoid certain medications, such as aspirin or anti-inflammatory drugs, because they can increase the risk of bleeding. You must stop taking these medications at least 10 days before the procedure.
As is generally recommended for various cosmetic surgery procedures, it is advisable to stop smoking at least one month before and one month after the operation. Smoking can indeed impair healing and increase the risk of postoperative complications.
Anesthesia Consultation
You must have a consultation with the anesthesiologist at least 48 hours before the procedure. This consultation is intended to assess your overall health and determine the type of anesthesia that is appropriate for you.
What is the procedure for your buccal fat removal?
A buccal fat pad removal can be performed under short-term general anesthesia lasting 30 to 45 minutes, under sedation, or under local anesthesia alone. It is an outpatient procedure, meaning patients do not need to stay overnight at the clinic. Patients can go home the same day as the procedure without a bandage.
Schedule ofâCheek Reduction Surgery:
- An incision is made on the inside of the cheek, near the upper jaw, at the site of the upper wisdom teeth. It measures between 1 cm and 1.5 cm. Therefore, there is no visible scar on the face.
- Exposure of the Bichat fat pad: After the incision is made, the buccal muscle is dissected, and the Bichat fat pad is exposed. External pressure is applied to the skin to manipulate the Bichat fat pads within the incision. The Bichat fat pad is brought out through the incision, and the exposed portion is gently removed.
- Partial removal of the ball: only the portion that protrudes on its own should be removed, so as not to remove too much. Doing so could result in a face that appears too sunken.
- Closing the incision: The incision inside the cheek is then closed with absorbable stitches, which will naturally dissolve in saliva within 7 to 15 days.
What are the aftereffects of a buccal fat pad removal?
Pain and Discomfort
- After the procedure: pain is very mild or even nonexistent. A buccal fat pad removal is relatively painless because the fatty tissue has few nerve endings and is not prone to inflammation.
- Swelling, bruising, and ecchymoses: Postoperative complications very rarely involve significant swelling or bruising. However, swelling of the cheeks may occur for one to two weeks, similar to what is seen after wisdom tooth surgery. This swelling resolves completely within 10 to 15 days. Bruises may appear; they resolve on their own within a few days.
- Applying ice to the area minimizes the risk of swelling.
- Difficulty chewing and opening the mouth: these symptoms last a few days.
Care and Hygiene
No nursing care is required after the procedure. No stitches need to be removed, since the sutures are absorbable. Since the incision is made inside the mouth, it is essential that you maintain excellent oral hygiene to ensure proper healing. It is recommended that you use mouthwash regularly to keep the surgical site clean.
It is recommended that you avoid foods that are too hot or too spicy for one week, so as not to irritate the scar.
Resumption of Operations
You can resume your daily activities as early as the day after the procedure. However, depending on the swelling in your cheeks, it is recommended that you return to work 3 to 5 days after the procedure. The recovery period is generally 4 days.
Physical activities may be resumed after 15 days, which is the time needed to allow for optimal healing.
Good to know: Since this procedure is purely cosmetic, it is not possible to issue a sick leave certificate.
Medical Follow-up
Regular follow-up appointments will be scheduled with Dr. Delobaux to ensure optimal monitoring of your progress. A follow-up appointment is typically scheduled one week after the procedure, followed by appointments at 1 month, 3 months, 6 months, and one year.
Results and Duration
The results of a buccal fat pad removal are not immediate. Although the fat is completely removed right away, postoperative swelling may cause the cheeks to swell and temporarily restore volume. The final result becomes apparent once the swelling has completely subsided, which takes between 3 and 6 weeks.
That's when you really start to appreciate the results. Finally, the skin tightens and the underlying tissues are reshaped. The results become permanent within 3 to 6 months.
Sustainability of the Results
The effects of a Bichat fat pad removal are irreversible, and the results are permanent. This is because fatty tissue cannot regenerate: once the fat is removed, it is gone for good. Once removed, the Bichat fat pads do not grow back.
However, the remaining fat cells (adipocytes) retain the ability to store fat; this is why the effects of a bichectomy will be diminished in the event of significant weight gain.
Risks and Complications
It is important to know that this surgery, like any surgical procedure, may involve risks. The main risks include:
- Transient facial edema
- Bruises
- Infections (rare with good oral hygiene)
- Facial asymmetry (rare)
- Partial facial paralysis (very rare)
- Injury to the Sténon salivary duct near the incision (very rare).
Prices for Bichectomy in Paris
Since this surgical procedure is performed solely for cosmetic purposes, the health insurance fund does not cover the reduction of Bichatâs fat pads.
The cost of a buccal fat pad removal varies mainly depending on the type of anesthesia chosen (local, local with sedation, or general). The price for buccal fat pad removal surgery can therefore vary, generally ranging from 2,000 to 3,000 euros, excluding clinic and anesthesia fees.
You will receive a detailed, personalized quote during your consultation with Dr. Delobaux.
