My Advice Regarding Bichectomy (Removal of Bichat Balls)

It should be performed wisely. One should not view the removal of the Bichat ball as a miracle surgery for slimming the face.
If you are overweight, lose a few pounds first before considering a bichectomy.
Your cosmetic surgeon should be able to advise you in this regard. If the indication is justified by naturally full cheeks or a face that is too round, the removal of the Bichat ball is an effective and elegant procedure.
I would limit it to individuals under 50 years old due to the risk of future facial hollowing from aging.

The Risk

Theoretically, two anatomical structures are nearby and could be harmed: the parotid salivary duct and the facial nerve. The real risk lies in not adhering to proper case selection. This is illustrated by a testimony from a patient who wrote to me on a forum. I would like to clarify that I do not know this patient, have never seen her, and certainly have not operated on her.

“Good evening Mr. Ouakil, I had a bichectomy three weeks ago to refine my face, and the post-operative result worries me greatly as I now have sagging cheeks, loose skin, and flat cheekbones.
This gives me a tired appearance and makes me look older… which was not the case before. I am really concerned and do not know what to do to remedy this.
The surgeon removed all of the Bichat ball when I wanted a partial reduction. I am a 26-year-old woman and I would like to regain my full cheeks, possibly through fat injection into the Bichat pouch…
Thank you for any response you can provide, looking forward to a future consultation.
Best regards,
Cendrine A. ”

Warning

Think carefully and consider seeking multiple opinions.
Do not give in to trends, and do not make any decisions in haste, as they can potentially lead to regrets and unsolvable problems.
What is true for bichectomy is also true for all cosmetic surgery.
Bichectomy is a very simple and beautiful facial cosmetic surgery procedure if the indication is well established.
I have often performed it in conjunction with rhinoplasty.

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