BICHECTOMY (Removal of Bichat’s balls)

What are Bichat’s balls or pouches?

Bichat’s balls are pockets of adipose tissue or fat located in the cheeks, all people present them in greater or lesser volume. Sometimes, they can give the impression of a full, round, poorly defined face. With its extraction we achieve a more marked cheekbone, stylize more the middle and lower part of the face.

These bags do not have a specific function, so they can be removed without any repercussions and improve the appearance of the face.

They are anatomically located between the masseter and buccinator muscles, therefore it is possible to extract them from inside the oral cavity, through a small incision in the oral mucosa.

The procedure is performed under local anesthesia and is painless for the patient, and very little discomfort. Once the adipose pouch of Bichat is located, it usually comes out without any resistance. It is therefore a simple procedure that can be performed in the office, under local anesthesia (no general anesthesia or sedation is required, nor is it necessary to go to the operating room for this procedure).

The duration of the procedure ranges from 30-60 minutes, depending on the case. Once completed, the wound is closed in the mucosa with a resorbable stitch (it falls off by itself) and leaves no visible scar.

In the first postoperative week the face is not usually observed little change, this is because the procedure generates swelling in the area, and despite having removed the fatty bags, the resulting facial volume is similar or even in some cases look slightly more voluminous. With the passage of weeks the edema or swelling disappears and a thinning of the area, greater definition of the cheekbone and facial harmonization is appreciated. The final result is seen after one and a half to two months, and is usually very satisfactory for patients.

Which patients are ideal for this procedure?

Patients with excess volume in the middle third and pre-pituitary area (they usually present round faces, without cheekbone definition, zygoma, etc.).


To which patients do we contraindicate this procedure?

Thin patients, with volume deficit in cheekbones, and lack of facial structure and support. In this case, it would be more advisable to reposition the volume in the area of the zygoma, eyebrows, etc.

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