Facial profiling

Bichectomy for facial contouring

Bichectomy is a procedure of precise selection. It is not about “slimming the face”, but removing volume only when anatomically indicated, preserving your facial structure in the long term.

What is Bichectomy?

The bichectomy is a surgical procedure that consists of the partial and controlled reduction of Bichat pockets, deep fat deposits located on the cheeks, which are do not decrease with diet or exercise.

Its objective is not to create an extreme face or to follow viral fashions, but rather to define the middle third of the face when there is a real excess of volume that breaks the facial harmony.

In valuation, the following is determined whether removing fat improves your structure or if, on the contrary, doing so could age your face prematurely.

Bichectomy: what changes and what doesn't change

Bichectomy can define the cheeks and highlight cheekbones, but it does not change the bone structure, replace a weak chin or correct sagging.

It is not a universal or automatic procedure. In many patients, fat removal would be a mistake, and saying so is part of responsible medical practice.

What does a Bichectomy usually include?

The surgical plan is tailored to each patient. Depending on the facial anatomy, a bichectomy may focus on:

Mouth volume adjustment
Partial reduction of the deep fat responsible for the fullness in the lower cheek.

Facial contour definition
Better visual projection of cheekbones and cleaner transition to the jawline.

Correction of visible asymmetries
When one cheek has more volume than the other.

Intraoral approach
Incision inside the mouth, without visible external scars.

Important: we do not work with “packages” or standard solutions. The volume to be removed is defined exclusively after medical assessment.

Who is it for?

It could be for you if...

You feel excess volume in your cheeks despite being at your ideal weight.
You have good bone structure and skin elasticity.
Looking for facial definition without exaggeration.
You have realistic expectations and understand that less can be more.

Alternatives should be evaluated if...

Your face is naturally elongated or very thin.
You have significant facial flaccidity.
You are looking to “slim the whole face” (bichectomy only acts on a specific area).
The volume comes from the masseter muscle (bruxism), where the indicated treatment is usually botulinum toxin, not surgery.

Bichectomy Assessment: how we define your plan

Assessment is the key step. Here we do not improvise or promise a result without prior analysis.

Objective and priorities

What you want to improve and what is reasonable in your case.

Facial analysis

Relationship between cheekbones, cheeks, jaw and chin. No single area is evaluated in isolation.

Anatomy and tissue quality

Skin type, structural support and aging projection.

Recommended range

How much volume should be removed - and how much should be retained - to avoid future subsidence.

Surgical logistics

Hospital location, type of anesthesia and aftercare.

“A clear plan, with aligned expectations, defined next steps and space to resolve doubts.”

Before and after bichectomy photos

The procedure, explained in simple terms

Approach from inside the mouth, without external scars.
Outpatient procedure performed in a certified operating room.
Reduction biased and conservative of the fat bag.
The amount to be withdrawn is decided by medical criteria, not by fashion.

Preparation (before surgery)

Discontinue aspirin, vitamin E and supplements according to medical indication.

Recovery and follow-up

Days 1-3
Visible swelling (feeling of “full cheeks”). Liquid and cold diet.

Days 4-7
Inflammation in decline. Transition to soft diet. Light activities.

Subsequent weeks
Facial definition becomes progressive as the swelling goes down.

The medical follow-up allows to adjust care and resolve doubts as the patient's evolution progresses.

Risks and considerations

Like any surgical procedure, bichectomy carries risks, including prolonged swelling, temporary asymmetry or discomfort when opening the mouth.

Our approach is conservative and selective. We prefer to remove less volume and preserve the facial structure, avoiding premature aging that occurs with aggressive extractions.

These points are explained individually during the appraisal.

Medical Philosophy

Medical tourism in Puerto Vallarta + coordination

If you are coming from another city or country, you can start with a virtual consultation and organize your process with the support of a patient coordinator.

What it does include:

- Flow orientation: steps, agenda and logistical recommendations.
- Support to reach assessment with clarity.

What it does not include:

Flights and direct hotel reservations (we give you the freedom to choose according to your budget).

Frequently Asked Questions

Does bichectomy leave visible scars?

No. The incision is made inside the mouth, so there are no visible external scars. Healing occurs in the mucosa and is controlled with hygiene and follow-up.

Does bichectomy “age” the face?

It can occur if it is poorly indicated or if excessive volume is removed. That is why the key is patient selection and a conservative approach: remove only what is necessary and preserve structure for the long term.

When will the results be seen?

The change is progressive. Initially there is swelling and the face may look “fuller”. Definition is seen as the swelling goes down and the tissues settle. The evaluation will explain what to expect in your case.

Is the recovery painful?

It is usually more of a nuisance than a severe pain. The most common is a sensation of inflammation, tension when opening the mouth and sensitivity. Control is indicated with analgesics and local care.

What diet should I follow next?

Generally a cold food/liquid phase is indicated at the beginning and then a soft diet. The objective is to protect the intraoral incision and maintain proper hygiene. The exact indications are adjusted on a case by case basis.

Can it be combined with other procedures?

Yes, but it is not combined “per package”. In some patients it makes more sense to accompany it with profiling procedures (e.g. jowl/chin) if the anatomy justifies it. This is defined in assessment to maintain harmony and avoid excesses.

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