Bichectomy in a 25-Year-Old Female Patient: Case Report and Brief Review of the Surgical Technique

Abstract

Bichectomy is an elective and increasingly popular surgical procedure in plastic and maxillofacial surgery aimed at improving facial contour by partially removing the buccal fat pads. These anatomical structures, located between the buccinator and masseter muscles, play a critical role in midfacial volume and round facial appearance. Initially recognized for their role in infant suckling, the buccal fat pads are now appreciated for their aesthetic relevance and potential use in oral reconstructive surgery and regenerative medicine. This case report presents a 25-year-old healthy female patient who sought cosmetic enhancement of her midface. Clinical examination revealed bilateral cheek fullness and favorable skeletal support, without generalized adiposity or skin laxity. She met the established anatomical criteria for bichectomy. The surgery was performed under local anesthesia using an intraoral approach and standard technique. It was an outpatient procedure, completed without complications, and resulted in a favorable aesthetic outcome. The report includes a brief review of the buccal fat pad’s 3D anatomy, vascularization, and interindividual variability. It also discusses its role as a rich source of mesenchymal stem cells. Key surgical considerations such as patient selection, anatomical landmarks, and complication avoidance are addressed. When properly indicated and executed, bichectomy is a safe and effective technique for achieving facial balance and contour refinement.