Facial Contour: Subtle Harmony

Bichectomy, or buccal fat pad reduction, is a procedure designed to slim the lower cheeks by removing targeted fat from this anatomical structure. While the term "Bichectomy" is widely used internationally, it can be somewhat misleading. The entire buccal fat pad is not removed; rather, fat is selectively reduced in its lower portion at the level of the molar teeth to create a more defined facial contour. In medical English, this procedure is properly referred to as "buccal fat reduction." The buccal fat pad (corpus adiposum buccae) was named after the 18th-century French anatomist Marie François Xavier Bichat. It is located between the buccinator muscle and the masseter muscle, with Stensen's duct (the parotid duct that drains saliva into the oral cavity) running in close proximity. The surgery focuses specifically on the lower segment of this adipose tissue to slim the lower cheek area. Bichectomy is frequently combined with submental and jawline liposuction or a facelift. When performed alongside liposuction, the approach is intraoral—via a small incision in the mucosal lining inside the mouth—leaving no visible external scars. During a facelift, buccal fat reduction can be performed externally once the deep facial structures are accessed. Although the procedure itself takes only a few minutes, it requires exceptional precision and complete patient immobility. For this reason, it is typically performed under conscious sedation or general anesthesia to ensure maximum comfort and safety for both the patient and the surgeon.