Buccal Fat Pad and Bichectomy: What It Is, What It’s For, and Who Should Consider It
The buccal fat pad, also known as the buccal fat body, is an anatomical structure composed of deep fat located in the cheek area. Although it is widely discussed in the aesthetic field, many people still do not fully understand its real function and when bichectomy—the surgery to remove it—is actually indicated.
In this article, you will clearly understand what the buccal fat pad is, its role in the face, and the key considerations before undergoing this procedure.
What Is the Buccal Fat Pad?
The buccal fat pad is a deep fat structure positioned between the facial muscles, particularly near the buccinator muscle and the posterior region of the maxilla.
Unlike superficial fat, it has an important structural function and is located in a delicate area, close to critical structures such as branches of the facial nerve.
This structure was described by the French anatomist Xavier Bichat and has since played a significant role in facial anatomy.
What Is the Function of the Buccal Fat Pad?
The buccal fat pad is not just “excess fat”—it serves important functions in the body:
- Assists in suction, especially essential in infants
- Facilitates smooth muscle movement during chewing
- Contributes to volume and contour of the lower third of the face
In other words, it is a functional structure, not just an aesthetic one.
What Is Bichectomy?
Bichectomy is a surgical procedure that involves the partial removal of the buccal fat pad for aesthetic purposes.
The main goals of the procedure include:
- Slimming the face
- Enhancing jawline definition
- Highlighting the cheekbone (malar) area
When properly indicated, bichectomy can provide a more defined and harmonious facial appearance.
Risks and Important Considerations
Although it is considered a relatively simple procedure, bichectomy requires careful planning and proper patient selection.
Excessive removal of fat can lead to:
- Premature aging
- A hollow or sunken facial appearance over time
- Loss of facial harmony
This happens because natural aging already involves a loss of facial volume. Removing too much fat can accelerate this process.
Current Trend: A More Conservative Approach
Today, the trend in facial aesthetics is increasingly conservative.
Many experts believe that, in several cases, preserving facial volume is more beneficial than removing important structures.
The current focus is on:
- Maintaining natural results
- Avoiding overcorrection
- Preserving facial structure over time
Who Are the Best Candidates?
Bichectomy is not suitable for everyone. The best candidates are typically:
- Individuals with rounder faces
- Patients with excess volume in the mid and lower thirds of the face
- Younger individuals with increased fat volume in this area
In these cases, the procedure can create a more balanced and refined facial contour.
Who Should Avoid Bichectomy?
Certain profiles should avoid this procedure due to a higher risk of unfavorable outcomes:
- Very thin individuals
- Patients with long or narrow faces
- Individuals with existing facial volume loss
- Patients over 40–45 years old (in many cases)
In these situations, fat removal may worsen facial appearance rather than improve it.
How Is the Procedure Performed?
Bichectomy is performed through a small incision inside the mouth, which means there are no visible external scars.
The procedure must be done with extreme care, as the area is close to important structures such as the facial nerve.
Additionally, the fat removal should be partial and conservative to ensure a natural and safe result.
Conclusion
The buccal fat pad is a fundamental facial structure with important functions beyond aesthetics. While bichectomy can provide benefits in well-selected cases, it should not be seen as a simple or universally appropriate procedure.
Individual evaluation is essential to avoid artificial results or premature aging.
Today, the trend is clear: less is more. Preserving facial volume, whenever possible, is often the best approach to maintain facial harmony and long-term beauty.
