Bichectomy: technical systematization applied in 27 consecutive cases

Abstract

Despite buccal fat removal having been performed for a long time, its popularity has increased only in recent years, leading to a rise in the demand for bichectomy in plastic surgery clinics. Buccal fat pad removal is still considered controversial, even when properly indicated, especially with the lack of a systematized surgical technique to make it safe and reproducible. Methods: The intraoral bichectomy described herein was systematically applied in 27 consecutive patients from January 5, 2016 to December 15, 2016. Results: The mean patient age was 32 years; 15% were men, and 85% were women. Isolated buccal fat pad removal was performed in six patients (22%) and in combination with other procedures in 21 patients (78%). The main procedure combined was neck liposuction (55%), and most patients were operated under general anesthesia (93%). No permanent or significant complications occurred, and there were only two minor complications, i.e., inferior mandibular neuropathy and significant swelling, which improved without treatment during the following weeks. Conclusions: Buccal fat removal can be performed in a predictable, fast, and safe manner, leading to volumetric reduction of the lower third of the face, enhancing facial shape. When applied in a safe surgical environment, following all surgical security standards and considering the complex anatomical boundaries of the cheek, our technique can yield secure and satisfactory outcomes both for surgeons and patients.

Comparison of Bichectomy Techniques Through a Clinical Case and 6-Month Follow-up

“…On the other hand, it remains a more accessible technique for professionals and patients due to the low cost of the materials used. [1][2][3][4]17,18 Another method that has been gaining ground, especially among the community of dental surgeons, is laser bichectomy. The equipment used is high power, as it has a photothermal interaction.…”

“…Captured and imprisoned by the tweezers, delicate rotational movements were made in the search Six Months of Bichectomy Follow-up of the excision of a portion of the buccal extension of the BB without breaking its fibrous capsule, avoiding greater difficulties for the equitable removal of fatty volume. 1,3,5,6,17,18 (Figure 2C). When feeling resistance to traction, it was decided to separate the remaining adipose link, thus removing 1.5 mL/2.1 g of fat on the right side (Figures 2D and 2H).…”

“…They should be superficial, just enough for a blunt-tipped instrument to detach the buccinator muscle fibers and seize the fat pad. 3,7,10,11,16,18 LASER is the acronym for light amplification by stimulated emission of radiation, and the one used to perform the bichectomy is the high power or also named surgical. The laser, for its monochromaticity, coherence and collimation, has a specific relationship with the tissues, presenting an absorbing chromophore.…”

Clinical Therapeutic Usage of Bichat Ball in Dentistry-A Review

“…Oroantral communication is a relatively common complication in dentistry, as well as the search for patients for bichectomy surgery, is common. Thus, professionals need to have a good knowledge about the BFP and its various purposes of use, since even if the procedure for accessing it is simple, the professional requires a good anatomical knowledge and surgical techniques, since the fat ball is located in a region very close to the terminal branches of the facial nerve, facial artery, facial vein and parotid duct [4].…”