Visage Clinic: Dr. Marc DuPéré
101-133 Hazelton Avenue
Yorkville, ON M5R 0A6
Phone: (416) 929-9800
Fax: (416) 368-3113
Toll Free: 1 (855) 8 VISAGE
Monday-Friday: 8:00 a.m.–5:00 p.m.

Visage Clinic: Dr. Marc DuPéré
114-13311 Yonge Street
Richmond Hill, ON L4E 3L6
Phone: (905) 773-9675
Fax: (416) 368-3113
Toll Free: 1 (855) 8 VISAGE
Monday–Friday: 8:00 a.m.–5:00 p.m.

Go Away Buccal Fat Pad of Bichat!

buccal fat pad removal, buccal fat pad, Toronto buccal fat pad, buccal fat pad Toronto, Bichectomy, Bichatectomy

Dr. Marie François Xavier Bichat was an anatomist and biologist who, in the late 1700s, described this unique and complex facial pocket of fat. In fact, the buccal fat pad (also known as “fat pad of Bichat“) has 6 facial components, some superficial and some deep into the musculoskeletal facial structures; the most important one for our discussion here is the buccal fat pad over the mid-cheek, between the buccinator and master muscles, the one the plastic surgeon will excise when slimming down one’s face. The other important ones are the superficial and deep temporal extensions which should not be excised, since it would age the patient.

Journal of oral and maxillofacial surgery, Jun 2012 – K. Khiabani

by Dra. Heloíse D. T. Manfrim

The removal of the buccal fat pad of Bichat, a procedure that’s also called “bichatectomy” or “bichectomy” will often convert a chubby round face into a slimmer, more harmonious face. In many cases, it will also give a man or woman a more angular look, something praised nowadays in the modeling industry.

The best candidate for buccal fat pad removal here in Toronto will be a male or female with a full and round face where reduction off the middle third of the face will be beneficial, allowing to obtain a stronger “cheekbone look” (zygoma) and an angular model-like mid-face. The overall effect will be a rejuvenation of the face by allowing the upper cheekbones to be more prominent, creating the desired slight shadow in the buccal fat area and resulting in the praised “angular” look.

The end results will therefore be, in the ideal patients:

1.  Thinner cheeks

2.  Nice improvement in the overall facial appearance, better harmony and a more youthful face

3.  Cheeks will be more defined resulting in more defined cheek bones (zygomas)

4.  Gain in self-esteem

5.  Better confidence

Journal of Oral and Maxillofacial Surgery, K. Khiabani

The procedure is done often under general anesthesia while another procedure is being done or under local anesthesia with IV sedation. The incision in inside the mouth, horizontal in the occlusal plane, behind the parotid duct. Closure is usually done with dissolving sutures and most will have disappeared by the tenth day. Most patients can resume work within 10 to 14 days, or earlier if able to camouflage the slight bruises with make-up. The final results should show within 6 to 12 weeks while all the swelling have disappeared.

There is a theoretical risk of over-resection and making other parts of the face look older, so the plastic surgeon must use proper surgical judgment as to when to stop. For reference, I like to remove something similar to, and no more than, the size of a flat dry apricot or half a marshmallow.

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Dr. Marc DuPere’s patient, Left buccal fat pad

buccal fat pad removal, buccal fat pad, Toronto buccal fat pad, buccal fat pad Toronto, Bichectomy, Bichatectomy

Dr. Marc DuPere’s patient, Left and right buccal fat pads

Complications that I discuss with patients include over-resection, under-resection, minor bleeding and bruising, nerve and muscle injury, infection, asymmetry, injury to the parotid duct and sialocoele (enclosed cyst of saliva) and buccal mucosal scarring (usually innocuous).

Cost varies depending on the type of anesthesia chosen by the patient.

Some professionals feel that the buccal fat pad removal will age the patients 50 years later, as many of us will get more gaunt in the cheek areas as we get much older. This can be corrected, should it occur, with fat grafting or our fillers such as Restylane® and JUVÉDERM®.

The question therefore is: Do you want to look your best now or when you are ninety years old?

Dr. Marc DuPéré

34 Responses to Go Away Buccal Fat Pad of Bichat!

  • Annah Khounlivong says:

    Hello my name is Annah I just want to know how much for buccal fat removal?
    Regards,
    Annah Khounlivong

    • Dr. Marc DuPéré says:

      Good evening, has anyone from my office answered you? Let me know. You can also email us directly at: infoATvisageclinic.com

  • Gustavo Espinosa says:

    Hi,
    My daughter is 16, she wants to have a bichectomy, is it possible at that age? what is the process and cost?

    • Dr. Marc DuPéré says:

      Thank you for your question. 16 is on the young side for aesthetic surgery as facial fat may still vary (increase or decreased) in the next 2-3 years… but I would be happy to meet you and your daughter for an assessment and discussion of options. I will email you more details now. Kind regards, Dr. D.

    • Dr. Marc DuPéré says:

      Hi Luis! I will email you some information right away! Best regards, Dr. DuPere

    • Dr. Marc DuPéré says:

      Good evening, has anyone from my office answered you? Let me know. You can also email us directly at: infoATvisageclinic.com

  • JJ says:

    I had buccal fat pad removal in the state during double jaw surgery. Not only are the results asymmetrical but my right cheek had collapsed and looks very odd.
    Can this procedure be reversed permanently? Can you graft fat back to the buccal corridor which was lipectomied? Will this be a permanent solution I’m curious about the options. Can a temporary solution be to reverse buccal fat removal through fillers? And then if I see it looks good have fat grafted there for a permanent solution.
    Thanks, for your adcvice.

    • Dr. Marc DuPéré says:

      Good morning and thank you for your message.
      Permanent reversal can be done with fat grafting. As you may know, some fat will survive and some not and sometimes a second “touch-up” procedure might be required.
      Temporary fix are quite efficient – the use of juvederm, restylane – and you should likely give it a try first.
      We do offer SKYPE or FaceTime consultation if interested.
      Kind regards,
      Dr. D.

    • Dr. Marc DuPéré says:

      Good evening, has anyone from my office answered you? Let me know. You can also email us directly at: infoATvisageclinic.com

    • Dr. Marc DuPéré says:

      Good evening, prices vary slightly if this is done under pure local anesthesia versus general anesthesia. My assistants will be emailing both prices. Dr. D.

    • Dr. Marc DuPéré says:

      Hi Samuel, yes, buccal fat pad removal can be done on a 65-year old person. Give my office a call and I will be able to assess and recommend. 416-929-9800. I look forward to meeting you! Dr. D.

    • Dr. Marc DuPéré says:

      Good morning! My assistants will be emailing you this morning details about our technique for buccal fat pad removal. Please call us for a consultation – 416-929-9800. I look forward to meeting you! Dr. D.

    • Dr. Marc DuPéré says:

      Good morning and thank you for participating in my blog! 42 is a great age for buccal fat pad removal! My assistants will be emailing you details later today! I look forward to meeting you! Feel free to call us for a consultation appointment – 416-929-9800. Kindest regards, Dr. DuPere

    • Dr. Marc DuPéré says:

      Thank you for participating in our blog. My assistants will be emailing you details shortly. Dr. D.

    • Dr. Marc DuPéré says:

      HI. Thank you for your enquiry. My assistants will be emailing you today with information. I look forward to meeting you. Dr. D.

  • Arika says:

    Hi, I’m 18 and interested in the bucal fat pad removal, with a little more removal than average if it’s safe as I wish to look older and have more hollowed cheeks. Also, I have great cheekbones and overall bone structure like models usually have, so when I push the fat down from under my eyes and really suck my cheeks in, my face looks more sculpted and defined and lips softer and bigger. Will bucal fat pad removal help achieve all that, especially when combined with another facial fat reduction technique like cool sculpting or airsculpt or ulratherapy or even microliposuction? Can all that be performed with dimple creation and a slight upper bullhorn lift (and soften outline of the upper lip unless it’s not recommended) ? I’ve been saving up a lot so what would the price for all of this put together be?

    • Dr. Marc DuPéré says:

      Hi Arika, I will be happy to meet and discuss all your options. And yes, all could be done at the same time. We can also discuss jaw angle augmentation for an even more-sculpted angular look, yet still very feminine. My assistants will be emailing you shortly. Dr. D.

    • Dr. Marc DuPéré says:

      Hi Sarah! My assistants will be sending you details via emails and costs for the buccal fat pad removal under local anesthesia only versus a general anesthesia (or deep IV sedation). I look forward to meeting you! Dr. D.

    • Dr. Marc DuPéré says:

      Hi, my office will be in touch shortly. Prices will vary slightly depending if you decide to do it under local anesthesia versus deep sedation or general anesthesia. I look forward to meeting you. Dr. D.

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