Bichectomy

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Bichectomy

The face has a complex anatomy. Among its multiple and delicate structures there are several fat compartments that function as protective cushions. Among these compartments, there is one that extends almost along the entire lateral surface of the face, in a deep plane, from the temple to close to the jaw, receiving the name Ball or Bag of Bichat (in honor of the French anatomist who first described it). In the “hollow” region of the oral cavity (cheek region) it is where it is thickest and, when in large volume, can give a more rounded appearance to the face (with an important genetic component).

WHAT IS IT?

Bichectomy is the name given to the surgical removal of part of this fat compartment, aiming to modify/refine the facial contour.

IS IT RIGHT FOR ME?

Whether or not to recommend the procedure depends on an in-person assessment. In principle, men and women could benefit, and it is not recommended for patients under 16-18 years of age or outside the ideal weight.

HOW IS IT PERFORMED?

As the fat compartment to be reached is in a deep plane (below noble structures in the facial region), access through a small incision in the oral cavity facilitates its identification and manipulation, minimizing risks.

The risks are those common to any surgical procedure (bleeding, infection) in addition to those related to local peculiarities. The access region in the oral cavity is close to the ostium of the parotid duct (where saliva – secreted by the parotid gland – reaches the mouth) and the buccal branches of the facial nerve (responsible for moving part of the mouth's muscles), which could favor inadvertent damage to these structures. Another important point, when it comes to the oral cavity, is the care related to protecting the airway, which is vulnerable to liquids or fragments that could move later in the mouth, particularly in patients with a reduced level of consciousness (under the effect of anesthetics) . Hence the importance of the procedure being carried out by trained professionals and in an appropriate environment.

HOW LONG DOES IT TAKE?

It varies depending on the surgeon's experience, type of anesthesia used and complications. In general, it is usually a quick procedure.

HOW LONG IS THE RECOVERY TIME?

Pain is usually not important. Edema and bruises can last from a few days to a few weeks, varying from case to case.

IF A PERSON GET FAT, CAN THEY GET BACK?

With an increase in body fat, there may be a change in facial contour due to accumulation in other regions susceptible to changes in volume, but unlikely due to recurrence of the portion removed from the Bichat Ball.

HOW MUCH?

The price depends on the surgeon's and team's fees, hospital stay and materials, and is therefore quite variable. The Code of Medical Ethics prohibits this type of disclosure. It is worth warning: training and infrastructure involve costs; be wary of surprisingly low prices.