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Bichectomy: Reduction of Bichat's Fat Pad

Bichat's fat pad, quite literally, is a globule of fat in the face, contributing to the volume in the foremost part of the cheeks. More often than not, it is of a normal size and doesn't cause any discomfort. However, in overweight individuals or even in lean people, Bichat's fat pad can represent an undue bulk, rendering the cheeks and face less appealing. In such instances, a bichectomy is recommended, with the aim to slim down the cheeks, particularly the front part.

Dr. Zamarian conducts bichectomy in Londrina, in a swift procedure that lasts approximately forty minutes, and the recovery process is rather smooth.

From What Age?

Post the age of fifteen, the face is fully developed, thus permitting bichectomy. Nonetheless, a comprehensive medical assessment is vital to determine if this surgery is indeed appropriate for your case. Dr. Zamarian will perform a thorough examination of your face and suggest the best course of treatment for you.

What Outcome Should You Expect?

Bichectomy aspires to reduce the surplus fat in the front part of the cheek, leading to a face with a leaner and more youthful appearance. This surgery assists in reducing the round-faced appearance and has been increasingly popular, owing to the success it has achieved among international singers and models.


The Consultation

During the medical consultation for a buccal fat pad removal, some details are observed by the plastic surgeon and explained to the patient: the amount of fat in the Bichat's fat pad, the presence or absence of hypertrophy of the masseter muscle, the thickness of the facial skin, the presence or absence of facial sagging, whether there's excess fat in the neck, among others. This complete assessment of the face and neck is essential to ensure an excellent result, as it depends on an accurate recommendation by the surgeon.

Details that are evaluated during the consultation:

Bichat's Fat Pad

The thickness of this fat, its location on the face, its influence on the volume increase of the cheeks, and other details related to the Bichat's fat are assessed during the consultation with Dr. Zamarian, in Londrina. The plastic surgeon needs to ascertain whether the cheek enlargement is really caused by the Bichat's fat pad, in order to achieve success with the surgery.


The hypertrophy of this muscle can increase the volume of the cheeks, especially at its posterior part, and its treatment consists in the application of botulinum toxin.

Malar Region

The evaluation of the bony prominence of the cheeks is also equally important. Cases in which buccal fat pad removal is indicated, but with little prominent malar region, may require supplementary treatment of malar filling with calcium hydroxyapatite or hyaluronic acid, depending on each case.

Skin Sagging

Often, what seems sagged or prominent on the cheeks might be caused by the natural ageing of the face, particularly in patients aged fifty to sixty years old. Thus, a face lift can raise the deep tissues that have sagged, including lifting the Bichat's fat pads, on each side of the face.

Submental Fat (Double Chin)

Reducing the cheeks can accentuate fat present in other areas, such as the submental area (double chin). Therefore, a person with excess Bichat's fat pad may need submental liposuction if there's an excess of fat in this area. Dr. Zamarian will evaluate your face and neck and indicate the treatment that will meet your needs.

Nose and Chin

A face may appear rounder if the nose and chin have little projection. Therefore, to achieve the expected result from buccal fat removal, it's important to evaluate whether a rhinoplasty, nose filler or mentoplasty is needed to complement the treatment and achieve a more harmonious face.

Oral Cavity

Dr. Zamarian will examine the oral cavity of the candidate for buccal fat removal, with the aim of identifying the structures that guide the surgical incision, as well as look for any disease or condition that may compromise the safety of the procedure.


Dr. Zamarian requests the following pre-operative tests to perform the buccal fat removal:

The Anaesthesia

The buccal fat removal is performed by Dr. Zamarian under general anaesthesia, which provides comfort and safety to the procedure that lasts about forty minutes.

The Surgery

The buccal fat removal is performed by Dr. Walter Zamarian Jr., starting with the marking between the parotid duct and the bite line, in the oral cavity. Then, a solution with adrenaline is infiltrated to reduce the possibility of bleeding during and after the procedure. An incision is made and the muscle is spread until Bichat's fat pad is exposed. It is gently pulled, fully or partially removed, and its stump cauterized. Suturing is performed with absorbable threads, and the procedure is repeated on the other side, comparing the amount of fat removed from both sides.

In Dr. Zamarian's experience, buccal fat removal often allows for discharge on the same day, most of the time, provided the patient has completed the recovery period from the anaesthesia.


The incisions from the buccal fat removal are inside the mouth, not causing any visible external scars. This is another factor that is making the procedure quite sought after.

Post-Operative Period

After buccal fat removal surgery in Londrina, patients may experience some swelling, especially in the first three days. However, it is not a painful surgery.

The main care to be taken by the patient includes:

Swelling mainly occurs in the first three days. The first post-operative photos are taken two months after surgery, when the swelling is expected to have decreased by about 90%. We consider the final result after six to twelve months, as with any surgery involving the face.

Treatment of Buccal Fat Removal Sequelae

Dr. Zamarian has received some patients who underwent buccal fat removal with professionals from other areas and, unfortunately, did not get satisfactory results. The two main causes of dissatisfaction among these patients are:

For cases of asymmetry, it is sometimes necessary to remove more of Bichat's fat pad on one or both sides to improve this difference. There may still be a small residual difference, whether due to asymmetry of other facial tissues of the patient, or due to internal scars resulting from the previous treatment. The goal, in this case, is to improve as much as possible, so that the asymmetry stops interfering with simple daily activities.

In cases where there was excessive removal of Bichat's fat pad, the treatment may include the need for a fat graft to improve the unattractive depression resulting from the previous procedure. Like any fat graft, there is a certain absorption, which can be greater or lesser, depending on each patient, and in cases of greater absorption, more than one session of fat grafting may be needed.

Do you want to improve the appearance of a round face?

To learn more about buccal fat removal and other types of plastic surgery that Dr. Walter Zamarian Jr. performs in Londrina - PR, please, get in touch with Zamarian Clinic and schedule a consultation.

Are you ready for this new change? Call now and schedule a consultation!

Schedule your appointment for a buccal fat pad removal in
Brazil with Dr. Walter Zamarian Jr.


Cosmetic plastic surgeon in Brazil

Rua João Wyclif, 111, Sala 1702
Londrina - PR
CEP 86050-450


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