Bichectomy (Buccal Fat Removal): Everything You Need to Know in 2025

In recent years, bichectomy has gained popularity thanks to social media exposure and the fact that many celebrities have chosen the procedure to refine their facial features. However, behind this viral trend lies a great deal of misinformation. At Clínica Viena, we believe that cosmetic treatments must be performed with responsibility, anatomical expertise, and a long-term focus on health and facial harmony.

Not all patients are ideal candidates for bichectomy, and in many cases, removing the buccal fat pads without proper evaluation can result in a prematurely aged, sunken, or unbalanced appearance. That’s why we only perform this procedure in carefully selected cases—following a personalized assessment and always under the care of a maxillofacial surgeon, the only specialist fully qualified to carry out this type of intervention.

What Is Bichectomy (Buccal Fat Removal) Really?

Bichectomy, also known as buccal fat removal, is a minimally invasive cosmetic procedure that involves partially or completely removing the buccal fat pads—pockets of fat located in the lower part of the cheeks, between the masseter and buccinator muscles. These fat pads serve no essential function in adulthood, and in certain patients, they can create a round or bulky facial appearance even at a healthy body weight.

The goal of bichectomy is to sculpt the mid and lower third of the face by enhancing cheekbone definition and creating a slimmer, more contoured facial profile. However, when performed without proper anatomical evaluation, it may remove structural support that maintains facial youthfulness—potentially leading to a sunken, aged, or sagging appearance over time.

At Clínica Viena, we approach buccal fat removal with a comprehensive and responsible evaluation. We assess tissue thickness, cheekbone projection, jaw structure, and subcutaneous fat levels before recommending the procedure—because a slim face is not always a harmonious one.

Who Is a Good Candidate for Bichectomy (Buccal Fat Removal)?

Bichectomy is not a one-size-fits-all treatment—and promoting it as such is a medical disservice. At Clínica Viena, we only recommend buccal fat removal when a patient meets specific anatomical and functional criteria that ensure a balanced, long-lasting, and healthy outcome.

A good candidate for bichectomy usually meets the following conditions:

✅ A round or overly full face, particularly in the cheek area, that doesn’t improve despite having a healthy body weight.
✅ Between 20 and 35 years of age, when the skin still has good firmness and elasticity—reducing the risk of post-op sagging.
✅ Well-defined bone structure, especially in the cheekbone and jawline area, to help preserve a youthful look after fat removal.
✅ Overall good health and realistic expectations about the procedure.

We do not perform bichectomy on patients with naturally thin faces, flat cheekbones, or early signs of skin laxity. In such cases, removing buccal fat could worsen facial aging, making patients look more tired or older over time.

Before approving any case, our specialists conduct a thorough facial evaluation to ensure the procedure will truly benefit the patient and preserve long-term facial harmony.

What Happens If Bichectomy (Buccal Fat Removal) Is Done Incorrectly?

When bichectomy is poorly indicated or poorly performed, it can lead to aesthetic and functional complications—some of which may be irreversible. Although it’s considered a minor procedure from a surgical standpoint, it should never be underestimated.

Short-Term Complications:

Facial asymmetry
Prolonged swelling
Poor healing or internal scarring (fibrosis)
Discomfort while chewing if nearby structures are affected

Long-Term Consequences:

Premature facial aging: Removing deep fat pads reduces internal support, which can lead to sunken cheeks, sagging, and a tired or aged appearance—especially in thin patients or those with low facial volume.
Loss of facial harmony: Buccal fat plays a structural role. Its removal can create imbalance in facial proportions over time.

Why Should a Maxillofacial Surgeon Perform the Procedure?

Only a specialist with advanced surgical training and in-depth knowledge of facial anatomy can properly evaluate whether you’re a true candidate for buccal fat removal, determine how much fat can be safely removed, and carry out the procedure with precision to avoid complications.

At Clínica Viena, all bichectomy evaluations are conducted exclusively by certified maxillofacial surgeons, who will honestly assess whether this procedure is right for you—or not.

Before and After Bichectomy (Buccal Fat Removal)

Subtle but Powerful Results

A well-performed bichectomy can deliver subtle yet highly effective results. The goal is not to completely transform the face, but to highlight the natural angles and create a more defined appearance, especially in the cheek area.

When Are the Results Visible?

The results are not immediate. Although swelling decreases significantly within the first few weeks, the final outcome usually becomes visible between two and three months after the procedure, once the skin has fully adapted to the new contour and all internal inflammation has subsided.

Real, Natural-Looking Results

At Clínica Viena, we only perform buccal fat removal on patients who are truly good candidates—after a detailed evaluation confirms that the procedure will enhance their appearance without compromising facial harmony. The outcome we aim for is natural, never exaggerated or artificial.

How Is the Treatment Complemented?

When properly indicated, bichectomy is often enhanced with other procedures such as:

Sculptra, to restore volume in key areas and prevent premature aging
Radiesse, to stimulate collagen production and define the jawline
Botox, to soften expression lines and improve overall facial shape
Lip enhancement, for patients who want greater balance in the lower third of the face

All complementary treatments are performed by a specialized maxillofacial surgeon, ensuring a safe, personalized, and well-integrated approach.

Step-by-Step: How Is Bichectomy (Buccal Fat Removal) Performed?

Bichectomy is an outpatient surgical procedure that is fast, precise, and has a relatively manageable recovery time—as long as the post-op guidelines are followed correctly.

Procedure Duration

The procedure lasts approximately 30 to 45 minutes and is performed in the clinic under strict biosecurity protocols. It is a bilateral surgery, meaning one buccal fat pad is removed from each cheek through a small incision inside the mouth. This approach leaves no visible scars.

Type of Anesthesia

The procedure is typically done under local anesthesia, so you’ll be awake but won’t feel pain. For patients with dental anxiety, it can also be performed under conscious sedation, always under professional medical supervision.

Recovery Time

Recovery is usually quick. You may experience swelling and mild discomfort when chewing during the first 48 to 72 hours. Most patients can return to normal activities after 7 days.

The initial results become noticeable between 4 to 6 weeks, with the final outcome stabilizing around 2 to 3 months post-procedure.

Post-Operative Recommendations

Use a facial compression band during the first few days to reduce swelling
Avoid hard, spicy, or hot foods during the first week
Do not engage in intense physical activity for at least 7 days
Follow your surgeon’s instructions and attend your post-op follow-up

This procedure should always be performed by a specialist with surgical expertise—such as a maxillofacial surgeon—to ensure safety, precision, and a naturally aesthetic result.

Post-Bichectomy Compression Garment: Is It Really Necessary?

Yes—wearing a facial compression garment after bichectomy (buccal fat removal) is a key part of the recovery process. While some clinics may not include it, at Clínica Viena we consider it essential to help ensure controlled healing, facial symmetry, and reduced inflammation.

What Is the Purpose of the Compression Garment?

The facial garment helps to:

Control swelling during the first few days
Gently shape the tissues as they adapt to the new facial contour
Prevent fluid retention and reduce the risk of bruising or irregularities

How Long Should You Wear It?

We recommend:

Wearing it continuously for the first 3 to 5 days, especially during the initial 48 hours
After that, use it at night for another 4 to 7 days, depending on your surgeon’s instructions

Important Guidelines During Recovery

Do not overtighten it; it should apply firm but comfortable pressure without causing pain or restricting circulation

Maintain proper hygiene: clean the garment as instructed to prevent infection

Do not stop wearing it early for aesthetic or comfort reasons, as this may affect the final symmetry of your face

Bichectomy (Buccal Fat Removal) Cost in 2025

At Clínica Viena, we understand that cost is an important factor when considering an aesthetic procedure. However, we also believe that quality and safety should never be compromised. That’s why we offer a treatment experience that prioritizes not just the visual outcome, but also professionalism, surgical precision, and attentive post-operative care.

Bichectomy Price Comparison: Colombia vs. USA

Country	Average Price	What’s Included
Colombia	1,800,000 COP (approx. $460 USD)	Facial evaluation by a maxillofacial surgeon, in-office procedure with local anesthesia, post-operative compression garment, one follow-up visit, and WhatsApp recovery support.
United States	$2,000 – $5,000 USD	Usually includes the procedure only; follow-ups, compression garment, and surgeon specialization may be billed separately.

Why Choose Colombia for Bichectomy?
Medellín has become one of Latin America’s top destinations for medical tourism, offering world-class healthcare at a fraction of the cost compared to the U.S. At Clínica Viena, patients benefit from advanced surgical techniques, highly qualified specialists, and personalized care in a safe, modern environment. Choosing Colombia means accessing high-quality aesthetic treatments—like bichectomy (buccal fat removal)—with full support before, during, and after your procedure.

Complementary Treatments to Enhance Facial Harmony

When done correctly, bichectomy can subtly improve facial contours. However, the most impactful results don’t come from simply removing volume—they come from achieving a balanced, harmonious face. That’s why at Clínica Viena, we often combine this procedure with strategic aesthetic treatments designed to restore proportions without exaggerating features.

Sculptra to Restore Volume Where It’s Needed

After the age of 30, many patients begin to lose volume in key areas such as the cheeks or temples, leading to a slimmer or prematurely aged appearance.
Sculptra stimulates natural collagen production, gradually restoring volume without creating an artificial “filled” look. It’s ideal for replenishing areas that may have lost support after bichectomy or over time.

Botox to Define the Jawline

In some cases, a wide jaw isn’t caused by fat, but by muscle tension or bruxism.
Injecting Botox into the masseter muscle relaxes the area, naturally slimming the lower face without surgery. It’s an excellent complementary option when buccal fat is not the main cause of facial roundness.

Lip and Cheek Enhancement with Radiesse

Radiesse not only adds volume—it also firms the skin, stimulates collagen, and sculpts facial contours. We use it strategically to enhance the cheekbones or define the profile. It can also be used in the lips to add shape and projection without looking overdone.

Thoughtful, Balanced Facial Design

At Clínica Viena, we believe that less is more. We don’t aim for extreme transformations or artificial results, but rather to highlight your best features while respecting your natural identity.
Each treatment is tailored to your unique facial structure, always prioritizing balance, projection, and a natural outcome.

Patient Testimonials – Clínica Viena

Patient from USA sharing her experience with veneers in Colombia at Clínica Viena

“I’m very happy with my results. The doctor and the entire team made me feel super comfortable, and I’m leaving truly satisfied.”

Odalis, USA

Veneers in Colombia testimonial from Martha, patient from Puerto Rico

“I was looking for a way to rejuvenate my smile with high-quality, guaranteed work in a clean, professional clinic—and I found it at Clínica Viena. The doctor is truly amazing. You absolutely have to come here!”

Martha, Puerto Rico

Patient from Aruba smiles after receiving veneers in Colombia at Clínica Viena

“I came to Clínica Viena for a smile design, and I had an amazing experience. I loved the result! The care was exceptional—these girls are wonderful and incredibly talented.”

Karen, Aruba

Estefanía from Canada shares her veneers in Colombia testimonial

“I found Clínica Viena on social media and came a few months ago for orthodontic treatment. I returned because I wanted to perfect my smile with a smile design—and I absolutely loved the result. It exceeded my expectations. All the doctors were incredibly kind and attentive.”

Estefania, Canada

Top Specialist for Your Bichectomy

Dr. Santiago Palacio – Oral and Maxillofacial Surgeon

Dr. Santiago Palacio is an oral and maxillofacial surgeon, graduated with honors from the University of Antioquia as the top of his class. He has over six years of experience in oral surgery, facial aesthetics, maxillofacial trauma management, and advanced implantology. His approach combines surgical precision with deeply human-centered care—ideal for patients requiring functional or cosmetic facial procedures.

He has worked at renowned institutions such as Oralmaax, Oralis, and Clínica Las Vegas, and has completed advanced training in facial cosmetic surgery, surgical laser techniques, and reconstructive procedures.
Currently practicing at Clínica Viena, he performs procedures such as wisdom tooth extractions, dental implants, bichectomy, facial harmonization, and complex maxillofacial surgeries.

Why Choose Clínica Viena for Your Bichectomy?

At Clínica Viena, we are proud to have a team of highly trained professionals dedicated to providing top-tier dental and facial care in the region of Antioquia.

Our commitment to quality and excellence is reflected in the strong academic background of our specialists and in our strict adherence to local health and safety regulations. We focus on delivering treatments that combine professionalism, trust, and outstanding results—always tailored to the unique needs of each patient.

Habilitados por la Secretaria Seccional de Salud de Antioquia

Miembro de la American Dental Association

Miembro del Colegio Odontológico Colombiano

Frequently Asked Questions about Bichectomy (Buccal Fat Removal)

Does bichectomy hurt?

Bichectomy is performed under local anesthesia, so you shouldn’t feel pain during the procedure. Some patients report mild pressure or discomfort, but it is generally well tolerated.
After surgery, you may experience swelling and slight soreness, which can be managed easily with mild painkillers and cold compresses.

When are the results of bichectomy visible?

Can the fat come back after bichectomy?

Is bichectomy reversible?

No. Bichectomy is an irreversible procedure, which is why it should only be recommended in well-selected cases.
If too much fat is removed or the patient already has low facial volume, it may lead to unwanted aesthetic consequences, such as a hollow or aged appearance.
That’s why at Clínica Viena, we conduct a thorough evaluation before recommending the procedure.

Our Location: El Poblado – Medellín

Our clinic is located in the heart of Medellín’s prestigious Milla de Oro, within the exclusive El Poblado district—an area known for its convenience, accessibility, and upscale atmosphere.

Surrounded by green spaces and high-end accommodations, we offer a comfortable and welcoming experience from the moment you arrive. Thanks to the proximity to major public transportation routes, visiting us is easy and stress-free. We welcome you into a calm and professional environment, designed to provide the highest standard of care for your smile.