procedure that removes all or most of the fat pads located on the bottom edges of the cheeks, also known as “cellulose-adipose ball of bichat”.

This treatment, which has become known as a “bichectomia” (in Portuguese), refers to the surgical procedure where the total fatty tissue that exists in the cheeks are partially or even entirely removed. This procedure was discovered by the anatomist Bichat. Its purpose is to sink this region, the cheeks, transforming the round face into narrower, more hollowed sides, leading towards a more ‘triangular’ look. It serves to de-characterize round faces, known as “moon face”.

Angelina Jolie; one of the current symbols of beauty of the female face, who is recognized by her extensive media exposure, is admired by her full lips (which today can safely be done with fat grafts), and contoured face, with high cheekbones and sculptured cheekbones. This look can be achieved through the procedure of cellulose-adipose ball of bichat.

This procedure is performed exclusively by plastic surgeons, and although it requires tremendous sophistication and knowledge of the anatomy of the face, it is less invasive. As it is only a small area, the method is done without blood loss and virtually no complications, when it is masterfully executed.

The surgery is done inside of the mouth, with an incision of about one centimeter, combined with superior arched dentistry. Through this access, the surgeon identifies and extracts “the balls of bichat.” It is a surgical procedure that lasts only a few minutes, excluding the preparation and sterilization. This is not a procedure in which the surgeon can predict the final outcome due to the specific amount of fat found in the area. If there is an abundant amount of fat, it results in a greater effect.  If not, the patient will obtain facial refinement, but perhaps less than what he/she had expected.

For further information, and if interested in gaining knowledge upon facial liposculpture, in the form of the work published in 1988 (“The importance of Redefining Facial Contours through Liposculpture”), demonstrating the importance of redefining facial contours through this procedure. This practice has been done since 1985. It is a complementary procedure which will only be indicated afterwards, and the result will only be attained during the final part of the procedure. The definite result of the “bichectomia” will only appear 60-90 days after the surgery.

The postoperative period is simple, painless and only requires regular proper hygiene, with the patient taking a soft diet for the first four days.

This procedure has been performed by plastic surgeons for years, but usually is associated with facial rejuvenation surgery and through the external side of the cheeks. Appearing recently, this procedure is done from within the inside of the mouth. Among the reasons for the high demand are the convenience of access, lower costs and applicability in younger patients, who are often dissatisfied with the rounded contour of their faces.