Bichectomy, this cosmetic surgery that removes fat from the cheeks

Bella Hadid, Mary-Kate Olsen, Lea Michele, Zoe Kravitz, Miley Cyrus or Anya Taylor-Joy… They would all have a bichectomy. An aesthetic trend that appeals to more than just celebrities, it’s just as popular on social media, where before/after photos of makeovers garner millions of views and go viral, sparking more and more interest among netizens in search of a face. Behind this barbaric name is an equally invasive cosmetic surgery that “consists of removing Bichat’s balls, small fat balls located on the outside of each nasolabial fold, just above the corner of the lips,” explains Dr. Kathryn Bergeret-Galli, a plastic surgeon. . surgeon and president of the French Society of Aesthetic Plastic Surgeons (SOFCEP). More specifically, during local anesthesia, “by making a small incision, we penetrate inside the mouth and remove excess fat. This makes it possible to slightly refine the inner lower part of the cheek,” the doctor describes.

If the operation is being talked about a lot at the moment, it is not recent. It was originally developed more than 30 years ago to meet the needs of overly square and “overstuffed” faces, reports Catherine Bergeret-Gally.

Contour effect

These Bichat balls, which naturally create a round cheek shape, have long been prized in some cultures, especially in the Orient and Eastern Europe, where they are considered a sign of youth. On the contrary, the red carpets in Hollywood are dominated by Kim Kardashian’s “contoured” look: accentuated cheekbones, accentuated jawline and hollow cheeks. The aesthetic became more prominent after the advent of social media detention and video conferencing, as it would have a reputation for making it more photogenic. On TikTok, makeup tips and facial massage techniques compete in originality in an attempt to reduce them without going through the scalpel box.

And for good reason. at a time when the rules of beauty follow one another at the speed of light, and when aesthetic ideals are turned upside down, it seems that volume is of less interest and that physical thinness reigns again. “In the United States, fashion effects are often explosive. Plastic surgeons in France rather try to avoid excesses and promote natural results, notes Dr. Berger-Galli. We explain to young women that this surgery is not necessarily necessary and that they may regret it when they are older. And then we must not forget that the fullness of the cheek is generally a standard of beauty that is still very much present in Europe.

The expert notes the difference between men’s and women’s views. “Along with requests for rejuvenation, there are many requests for slimming women with square faces or overweight women. These profiles have a reputation for ‘aging badly’ as they tend to widen and ‘get heavy’. On the contrary, having massive features in men embodies the popular cultural image of abundance,” analyzes the doctor.

Invasive surgery

Contrary to what the cheesy videos on social media suggest, getting an “Instagram” face with a bichectomy is far from a trivial act. The decision deserves attention. “First, because it is irreversible. if we remove Bichat’s balls, they cannot be “repelled,” warns Dr. Bergeret-Galli. And then, because the operation is uncomfortable and painful; not forgetting the risks involved. “Besides a little bleeding, there can be especially paresis. Indeed, there is a small branch of the facial nerve located just in front of Bichat’s ball, and numbness can be felt at this level for some time. Finally, the doctor notes that the result will never be perfectly symmetrical and that it can emphasize the difference in thickness between the two cheeks.

So Dr. Bergeret-Galli agrees to use it only under certain conditions. “If a woman is overweight, has a very large face with a square frame, the use of bichectomy can be justified. If not, there is no interest in implementing it,” he says. Worse, surgery may even be counterproductive as you age. “After age 50, tissues weaken and migrate downward, fat masses shift or melt away, and some excessive muscle contractions (when you smile or laugh, editor’s note) to create facial cavities. Therefore, it is possible that the patient will ask us to re-inject fat into this area after a few years to restore the fullness of the cheeks,” he adds.

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With or without facelift

The conversion also involves some financial investment. A bichectomy by a plastic surgeon qualified by the National Board of Physicians requires between 3,000 and 4,000 euros. In some cases, it can also be performed along with another facial surgery. Most plastic surgeons tend to remove some of these fat globules during a cervical facelift, says Dr. Bergeret-Galli. “When you open the fascia, this fat pad is immediately invaded. So, at the same time as we’re realigning the tissues, tightening the skin, and removing excess skin, we’re also removing some of this excess fat. This gives this face a more oval look. In this case, bicectomy is included in the total cost of the procedure (about 10,000 euros).