Buccal fat removal in Medellín

Buccal fat removal takes out part of the buccal fat pads, sometimes called Bichat's fat pads. You may also see it called “cheek reduction,” “cheek fat removal” or “buccal lipectomy,” and in Colombia it's known as “bichectomía.” According to the American Society of Plastic Surgeons (ASPS), it's a natural pad of fat that sits in the hollow area of your cheek. Its size varies from person to person, and it can be different on each side of the face. That's why each case is evaluated individually.

It's usually done from inside the mouth, through an incision on the inner side of the cheek, so there's no visible scar. The ASPS explains that this fat is sometimes removed during a facelift, with no incision in the mouth. What calls for the most care is how much fat to remove: in an ASPS article, a plastic surgeon warns that taking out too much raises the risk of a hollow-looking face over the years. It isn't decided from a photo on social media: your surgeon decides after examining you at your in-person consultation.

According to the ASPS, you may be a good candidate if you're in good health with a stable weight, don't smoke, have realistic expectations and are bothered by very full cheeks. It's also best to do it for yourself, not for someone else or to match an ideal image. The ASPS also notes that it isn't usually done on thin, narrow faces, because the face can look more gaunt with age. If your skin has already lost firmness, a surgeon explains in another ASPS article that it may need to be combined with a facelift.

A round face isn't always caused by the buccal fat pads. Depending on your case:

• If the fullness is under your chin, we consider chin liposuction.
• If the width of your face comes from a very active masseter (the muscle you chew with), a surgeon quoted by the ASPS explains that they treat it with Botox instead of removing fat.
• If you want to define your cheekbones or jawline without surgery, there's hyaluronic acid filler, which is temporary and lasts 6 to 18 months depending on the area.
• If there's sagging in your cheeks and jawline, we consider a facelift.

At your consultation we look at where the fullness comes from and what makes sense for you. If a nonsurgical treatment is the right fit, Dr. Valeria Enciso, aesthetic physician, evaluates you.

Every surgery has risks, and this one does too. The ASPS lists, among others:

• Anesthesia risks.
• Bleeding, hematoma or fluid buildup (seroma).
• Infection or poor healing of the incisions.
• Asymmetry.
• Injury to a salivary duct.
• Injury to branches of the facial nerve, with temporary or permanent weakness of facial muscles.
• Numbness or other changes in sensation, persistent pain or prolonged swelling.
• Deep vein thrombosis and heart and lung complications.
• A result different from what you expected or with minimal change, and the possibility of revision surgery.

Before you decide, we go over each one with you, and you sign an informed consent form.

It's done in the licensed operating rooms at Q2, never in a doctor's office. Before surgery, in general:

• You get your pre-op tests, which are required.
• You stop smoking.
• You go over the medications you take with your specialist: the ASPS warns that aspirin, anti-inflammatory drugs and herbal supplements can increase bleeding. We tell you what to stop taking and what to bring.
• If you're traveling to Medellín from another city, come with an adult who can stay with you for the first few days.

For the first few days there's swelling and you eat soft foods. According to the ASPS, you may be given special mouth rinses to lower the risk of infection. As the ASPS explains, the stitches inside your mouth are usually dissolvable, though each surgeon works differently. Avoid touching them with your tongue until your surgeon says it's OK. You leave with clear instructions and come back for your follow-up visits until you're cleared.