Bichectomy (Buccal Fat Removal)

Bichectomy removes the buccal fat pads — discrete pockets of fat within the cheeks — through small incisions inside the mouth, creating a slimmer, more defined facial contour. The procedure is suited to patients with naturally prominent or full cheeks that do not reduce with weight loss, as the buccal fat pad is anatomically distinct from the general subcutaneous fat layer. At Art Ethic the operation leaves no external scars, takes up to two hours, and requires only about a week of recovery before returning to normal activities.

Bichectomy — buccal fat pad removal — targets a specific anatomical structure: the corpus adiposum buccae, a well-encapsulated fat body that sits within the cheek between the masseter and buccinator muscles. Unlike general facial fat, the buccal fat pad is not meaningfully reduced by dieting or weight loss — its size is largely determined by genetics. Patients with constitutionally prominent buccal fat pads present with a round, full midface appearance that persists regardless of overall body weight. At Art Ethic Beauty Clinic, doc. MUDr. Martin Molitor, Ph.D., MBA performs bichectomy under local or general anaesthesia in up to two hours. The approach is entirely intraoral: a small incision is made inside the mouth in the buccal mucosa (inner cheek lining) on each side. Through this access, the surgeon identifies and delivers the buccal fat pad — a lobulated structure of soft, bright yellow adipose tissue — and removes the planned volume. The incision is closed with absorbable sutures and heals without any external scarring. The procedure is performed bilaterally (both cheeks) to achieve a symmetrical result. The amount removed on each side may differ slightly if the patient has pre-existing asymmetry. The resulting facial change is a reduction in cheek fullness that emphasises the cheekbones and creates a more angular midface profile — the degree of change depends on the natural size of the fat pad. Post-operative recovery involves approximately one week at home; a liquid and soft diet for the first few days is advisable while the intraoral incisions heal. Swelling is typically noticeable for one to two weeks and may make the result appear exaggerated initially — the final slimmed contour emerges at three to four weeks as swelling fully resolves. Full activity resumes at three to four weeks. Bichectomy is most appropriate for patients under 35–40 years of age whose facial fat distribution is stable. In patients over 40, the face naturally loses volume with age — removing the buccal fat pad in this group risks an overly gaunt appearance in later years, which the surgeon discusses honestly at consultation.