What is a bichectomy and why doctors fear its ‘trivialization’ driven by celebrities | Long live you


Social media is full of photos of before and after celebrities who allegedly underwent bichectomy.

The look of ultra-sculpted cheekbones has been in fashion for years, but selfies and the culture of influencers on social media have given an unprecedented boost to this surgery, known and practiced for decades.

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We are talking about bichectomy, or removal of Bichat balls (bags of fatty tissue that we all have on the cheeks).

“It has been in fashion for 20 to 25 year olds for a few years,” said Ainhoa ​​Placer, of the Spanish Society of Plastic, Reconstructive and Aesthetic Surgery, to BBC News Mundo.

It is a trend noticed by experts from several countries, although it is difficult to obtain numbers.

The aesthetic purpose of this procedure is to refine the face and mark the apples more.

Although it is a relatively simple and not very invasive surgery, some experts warn that there is a certain “trivialization” of its use and that the operation is more complex than many aesthetic medicine clinics want to show.

In addition, many experts question the aesthetic procedure if the patient does not have an excessively rounded face: in the short term it can be effective to mark the cheekbones more, but in the long term it can cause an appearance of premature aging.

“Personally, I am not very supportive of this surgery,” said Placer.

Find out more about the bichectomy surgery that fell on women

Do you know why we have these bags of fat on our cheeks?

Bichat balls are bags of adipose tissue that are found in a deep layer of the face, under the cheekbones and between the masseter and buccinator muscles.

They act as a kind of cushion or buffer between facial muscles that, among other things, participate in chewing movements (and breastfeeding in newborns).

These bags are named after the French anatomist who identified them in the late 18th century, Xavier Bichat.

Size and volume vary from person to person due to genetic reasons, and can give the face a rounded appearance that has nothing to do with being overweight.

Although they do not perform a structural function on our face, their location is closely linked to a delicate area of ​​the face, close to several endings of the facial nerve, the parotid duct, through which saliva circulates from the parotid gland to the mouth, and the main vessels blood from the face.

Specialists in dental and reconstructive surgery have used Bichat balls for decades as another resource in their repertoire of surgical techniques.

But the interest in recent years in removing it is purely aesthetic and, according to Placer, comes mainly from young women, who do not necessarily have disproportionately large cheeks or excessively rounded faces.

The removal is done through an incision of one or two centimeters in length inside the mouth, at the level of the upper molars, in an operation that, depending on the surgeon’s experience, can take less than an hour and is usually performed under local anesthesia. .

The aesthetic clinics that promote this surgery highlight that it is a fast, minimally invasive procedure, with easy post-operative, permanent results and without external scars.

They sell an aesthetic dream: to transform easily and quickly (and relatively affordable, around US $ 1,500 depending on the country), a rounded and undefined face into a thinner and more stylized face, with accentuated cheekbones.

It may be very tempting, but “it is not as simple as it looks”.

This is the message of an information campaign that the Brazilian Society of Plastic Surgery promoted on social networks in 2019, specifically to prevent problems associated with bichectomies.

In addition to the possible complications associated with any surgery, such as bleeding or infection, the main risks of a low-quality bichectomy are possible injuries to the facial nerve or accidental section of the salivary duct.

A serious injury to the facial nerve, for example, can lead to irreversible loss of movement of the face.

That is why the associations of Plastic, Reconstructive and Aesthetic Surgery professionals from various countries insist that it is essential to look for a qualified and well-trained specialist to perform these operations.

Although the removal of Bichat balls can be effective for those looking for more defined cheekbones and facial contours, many experts warn that, in the long run, it may have an unwanted effect on another aesthetic dream: delay aging.

On the face there are many compartments of fat, located in different layers, some more superficial than others.

With age, there is a loss of facial fat, which is precisely one of the main signs of aging. That is why Placer says that bichectomy “is harmful in the long run, because you are already anticipating the aging process yourself”.

The Brazilian Society of Plastic Surgery makes a similar warning, arguing that bichectomy can generate important anatomical distortions that can worsen with aging.

Image of the campaign carried out on Facebook by the Brazilian Society of Plastic Surgery in 2019 – Photo: SBCP

“You are removing a fat that you will like in the future, because that is what we do against aging: fill in,” warned Placer.

That is why it is not very favorable for the removal of bichat balls on a face considered “normal”, that is not “super round”.


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