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Cheek reduction surgery (Bichectomy or buccal fat extraction) in Paris for a more chiseled face

Ablation de la boule de bichat (bichectomie) avant après

A Bichectomy, or surgical removal of the Bichat balls, is the favorite procedure amongst the stars.

What is the Bichat ball?

Described in 1802 by Xavier Bichat, the Bichat ball is a cluster of adipocytes (fatty cells) forming an adipose tissue (fatty tissue) delimited and located at the level of the cheek. In other words, it’s a ball of fat. It is located at cheek level in the masticatory space, stretching from the temporal fossa to the median part of the cheek under the cheekbone and maintains contact with the temporal muscle, the coronoid process, the buccinator muscle, and Stensen’s duct). It has an average weight of 9 grams and a volume of 10cm3. It is vascularized by the facial artery and the superficial temporal artery.

Boule de bichat ou bichectomie
Bichat ball surgical removal operation

Why should I have a Bichectomy?

The removal of the Bichat ball will widen the cheek just under the cheekbone and will help define the facial features, bring out the cheekbone and avoid the appearance of a round, puffy face. A line will be drawn between the tragus (the middle part of the outer ear) and the mouth commissure (the corner of the mouth).

How is a Bichectomy performed?

A consultation with your cosmetic surgeon in Paris, Dr. Masson, is necessary to establish whether a surgical procedure is actually warranted and if a benefit will be drawn from the operation. The operation is performed on an outpatient basis at the clinic with the patient being able to leave the same evening. Anesthesia is either local or general depending on the degree of stress and sensitivity of the patient. On average, the operation lasts for 30 to 45 minutes. An incision is made on each side of the mouth just below the salivary canal opposite the 2nd molar at the level of the mucosa and extends over a length of 5 mm to 1 cm depending on the size of the Bichat ball. It will be invisible because it is located in the mouth. The Bichat ball is dissected and carefully removed. A suture is made using absorbable threads.

What are the postoperative effects?

Swelling occurs for a few days. The procedure itself is not particularly painful. You need to make sure that you maintain good oral hygiene after the operation and use mouthwash several times a day. In general, you can resume normal activities after 48 hours. There are no sutures to remove and the result of the Bichectomy can begin to be seen after four to six weeks, becoming final at three months when the tissues have completely healed.

What are the potential complications?

Complications are very rare if the original operating indication is correct and the surgeon is accustomed to, and trained in, the procedure. Otherwise, there can be a hematoma which will subside, a lesion of the facial nerve if it is very close to the bichat ball but which is avoided by careful dissection and, finally, a lesion of the Stensen’s duct (extremely rare because it is directly visible inside the mouth, so there is no reason to damage it during the procedure).

How much does a Bichectomy cost?

In all cases, an estimate will be submitted for consultation by the cosmetic surgeon, mentioning all the costs related to the procedure (clinic, surgical fees, etc.) but, on average, the price of a bichectomy in Paris starts from 3800 euros. The cost may be higher if general anesthesia is required.

Is there a risk of accelerated aging?

No, provided you do not remove the entire Bichat ball and the operating indication is correct.

Does the result of the operation look natural?

Yes, absolutely, especially because the scars are located inside the mouth and are not visible.

What do the results look like?

Bichectomy before and after (bichectomia before and after or surgical removal of Bichat balls) by Dr. Masson.

Ablation de la boule de bichat (bichectomie) avant après
Result before and after surgical removal of Bichat ball or bichectomy or bichectomia


Dr Vincent Masson is a plastic surgeon with a post-graduate diploma in plastic, reconstructive and aesthetic surgery and a gold medal in surgery from the Paris Hospitals. He is a former senior registrar and attaché at the Hôpital Saint Louis.

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