Buccal fat removal (bichectomía) in Bogotá: facial contour refinement

What buccal fat removal is and what it corrects

The Bichat fat pads are accumulations of fat located between the chewing muscles, deep in the cheek. Buccal fat removal consists of taking out a portion of this fat through a small incision inside the mouth, at the level of the upper molars.

The aim is to reduce volume in the middle and lower areas of the face. What usually changes is:

• The sensation of rounded or very full cheeks.
• The definition of the contour between the cheekbone and the jaw.
• The overall proportion of the lower third of the face.

It is important to understand what it does not do: it does not correct skin laxity, it does not treat superficial fat and it does not change bone structure. Nor does it replace a weight-loss process. If your face is round because of the shape of the bone or because of subcutaneous fat, another alternative may suit what you are looking for better, and the doctor will tell you frankly during the consultation.

In addition, Bichat fat tends to decrease naturally with age, so in some people excessive removal can accentuate an aged appearance later on. For that reason it is removed conservatively and in measured amounts.

Who it is for and who it is not for

Buccal fat removal can be an option if you have prominent cheeks due to deep volume and want a more defined face without visible scars. It is usually considered in adults with stable weight and good general health.

A good candidate is usually someone who:

• Has had a full, rounded midface for years.
• Maintains a stable weight and has realistic expectations.
• Understands that the change is subtle and gradual.

On the other hand, surgery should be reconsidered or postponed when:

• The face is already thin or tends toward marked thinness.
• The person is at an age when natural facial volume loss is already evident.
• There are uncontrolled diseases, clotting problems or active infections in the mouth.
• A drastic change or looking like someone else is expected.
• There is pregnancy or breastfeeding.

In some cases, facial contour is better achieved by combining approaches or with a different one, such as chin augmentation (mentoplastia) for the chin or treatment of submental fat (lipopapada). That decision is made after examining you, not before.

How the surgery is done with Dr. Sandro Florez

Evaluation

During the consultation, Dr. Sandro Florez examines your face at rest and in movement, palpates the cheek area, reviews your medical history and talks with you about what you expect. If buccal fat removal is not the most appropriate option, he will explain why and propose other alternatives.

Surgery

It is an outpatient procedure, generally short, usually lasting less than an hour. Once anesthesia has been administered, a small incision is made in the lining of the mouth, the fat pad is located and the planned portion is carefully removed. The incision is then closed with stitches that are usually absorbable. The procedure is performed symmetrically on both sides.

Afterward

When it is over, you receive written instructions about diet, oral hygiene and warning signs. You return home the same day, accompanied. Follow-up visits are scheduled to review your progress and answer questions.

Tests, preparation and anesthesia

Before surgery, a medical review is done to confirm that the procedure is safe for you. Depending on your age and history, lab tests may be requested and, if needed, an additional evaluation.

To prepare, the following is generally recommended:

• Report medications, supplements and allergies.
• Stop, only if the doctor indicates, drugs that affect clotting, such as certain anti-inflammatories or supplements.
• Avoid smoking in the weeks before, because it hinders healing.
• Keep your mouth in good condition; if there are active infections or cavities, it is best to treat them beforehand.
• Arrange for a companion and soft foods for the first few days.

Anesthesia is usually local, sometimes with sedation, depending on the case and a joint decision with the medical team. All anesthesia carries risks, and they are discussed openly with you during the preoperative consultation. On the day of surgery, arrive fasting if so instructed, wearing comfortable clothing and no makeup.

Recovery and postoperative care

Recovery from buccal fat removal is usually manageable, although each person responds differently. In general, during the first few days there is swelling in the cheeks, a feeling of tightness and some discomfort when opening the mouth or chewing.

Usual guidelines include:

• A soft, cold diet during the first few days, as instructed.
• Gentle mouth rinses or oral hygiene, as explained to you.
• Sleeping with your head elevated and applying local cold in the first hours, if the doctor authorizes it.
• Avoiding intense exercise and exertion for a prudent period.
• Taking only the prescribed medications.

Many people return to office activities within a few days, but swelling can take several weeks to go down completely. Contact us immediately if you notice fever, increasing pain, bad odor, persistent bleeding, or swelling that grows on one side only. Possible risks include infection, hematoma, asymmetry, injury to nearby structures and a result different from what was expected. Following the instructions and attending follow-up visits helps detect any complication in time.

Results: what to expect and when

The result of buccal fat removal is not visible on the first day. At first, swelling hides the change, and the contour gradually becomes defined over several weeks and even a few months.

What is usually seen over time is a somewhat more streamlined face, with better cheekbone definition. The change is generally subtle and natural, not a complete transformation.

• First weeks: swelling decreasing and changes barely noticeable.
• One to three months: the contour is seen more clearly.
• Later: the final result settles.

The fat that is removed does not form again, but your face will continue to change with age, weight and lifestyle. A significant weight gain can alter the appearance of the cheeks because of superficial fat. No procedure offers certainty about the result, and there is a possibility that a later adjustment may be desired, although this is not usual. If you want to complement your facial profile, you can also look into options such as facial masculinization or feminization.

Why have surgery with a physician and surgeon in Bogotá

Although buccal fat removal is a brief procedure, it is real surgery involving delicate anatomy: branches of the facial nerve and the duct of the parotid gland pass near the Bichat fat pad. That is why it matters who performs it and where.

Choosing a physician and surgeon in Bogotá allows you, among other things, to:

• Have a complete clinical evaluation before deciding.
• Have the indication based on your anatomy and not on a trend.
• Have an environment prepared to handle any eventuality.
• Access in-person follow-up visits after the procedure.

If you live outside the city, you can review the information for patients from outside Bogotá to organize your trip and follow-up visits. We recommend always verifying the degree and medical license of whoever operates on you, asking where the surgery will take place and being wary of promises of exact results. An honest consultation includes discussing limits and risks.

How much does buccal fat removal cost in Bogotá

The cost of buccal fat removal is not the same for everyone, which is why we do not publish figures on this page. The cost is defined after the evaluation, once your specific case is known.

It usually depends on:

• The type of anesthesia and whether sedation is required.
• The place where the procedure is performed and its operating room fees.
• The complexity of the case and whether it is combined with other procedures.
• Preoperative tests and follow-up visits.
• The necessary medications and supplies.

Be wary of very low prices that do not detail what they include, who operates and where. During the consultation you will receive a clear estimate and can resolve all your questions before deciding. You can book your evaluation and, if needed, compare with other alternatives among our treatments.