How is a bichectomy performed? Surgery and recovery process step by step.
One of the most frequently asked questions by patients considering bichectomy before surgery concerns the practical details of the process: 'How long does the surgery take, will there be an external scar, when will I return to a normal appearance, and how long will the swelling last?' These questions are extremely important for patients who want to solidify their decision to have surgery.
Dr. Selçuk Yüce performs bichectomy surgery using a standard protocol at his clinic in Ankara. This page details the pre-operative preparation, the surgery itself, and how the recovery process progresses week by week.
Preoperative Preparation
Before undergoing bichectomy surgery, patients go through the following steps:
• Detailed examination: Facial structure is evaluated both at rest and while making facial expressions; this determines whether bichectomy is truly appropriate.
• Health assessment: General health status, medications being used, and suitability for anesthesia are checked.
• Oral hygiene check: Since the surgery is performed through the mouth, referral to a dentist will be made if necessary.
• Regulation on smoking and blood thinners: Smoking should be stopped for a certain period before surgery, and blood-thinning medications should be adjusted under the supervision of a doctor.
• Instructions for fasting: If sedation or general anesthesia is planned, patients will be instructed to fast for a specific number of hours prior to surgery.
How is the surgery performed? Step by step.
1. Anesthesia
Bichectomy is usually performed under local anesthesia with sedation; general anesthesia may be preferred in some patients or when combined with another procedure. The type of anesthesia is determined during the examination based on the patient's preference and accompanying procedures.
2. Intraoral Incision
A small incision (usually 1-2 cm) is made on the inside of the cheek, in line with the upper molars. This incision is entirely inside the mouth; it leaves no external scar.
3. Accessing and Extracting the Buccal Sebaceous Gland
The cheek muscle layer is gently separated to access the buccal sebaceous gland. With gentle pressure, the gland spontaneously protrudes towards the incision site. The surgeon gently removes the predetermined amount of fatty tissue. Care is taken to remove a symmetrical amount from both cheeks.
4. Closing the Incision
The incision inside the mouth is closed with dissolvable sutures. These sutures usually dissolve on their own within 1-2 weeks; no further suture removal is necessary.
5. Duration
A bichectomy alone typically takes 30-45 minutes for each cheek. The total time will be longer when combined with other facial procedures (e.g., fat injection, chin contouring).
Recovery Process: Day by Day and Week by Week
Surgery Day and the First 24 Hours
After surgery, slight swelling and a feeling of fullness in the cheeks will begin — this, similar to the fullness before the bichectomy, can paradoxically lead to the cheeks appearing 'fuller'. This is due to swelling and is temporary. Applying a cold compress is recommended.
Days 1-3: Peak Swelling
Swelling usually reaches its peak on the 2nd-3rd day. During this period, noticeable fullness in the face, slight bruising, and swelling under the chin may be observed. Mild discomfort may be felt when speaking and moving the jaw. A diet consisting of soft foods is recommended.
Days 4-7: Swelling begins to decrease.
Swelling will gradually begin to decrease during this period. The stitches inside the mouth may begin to dissolve. Most patients can return to work or their daily routine at this time; however, facial fullness may still be visible.
Weeks 2-3: Visible Improvement
Most of the swelling subsides during this period. The thinning of the cheeks becomes more noticeable; however, this is not the final result. During this time, patients often feel, 'I'm starting to see changes, but I'll have to wait a little longer.'.
Months 1-3: Final Contour Development
Any remaining micro-swelling will completely subside during this period, and the facial contour will begin to take its final shape. In most patients, the results are largely clear by weeks 6-8.
Months 3-6: Full Maturity
Tissue remodeling and skin adaptation are complete. At this point, the final result of the bichectomy is seen, and this result is permanent.
Post-Surgery Care: What Should You Pay Attention To?
The discharge care protocol at Op. Dr. Selçuk Yüce's clinic includes the following basic steps:
• Oral care: After meals, the mouth should be gently rinsed with an antiseptic mouthwash recommended by the doctor. Brushing vigorously should be done avoiding the incision area.
• Nutrition: For the first 3-5 days, soft, lukewarm, or room-temperature foods (soup, puree, yogurt) should be preferred. Hot, spicy, and hard foods should be avoided.
• Cold compress: Applying a cold compress externally (to the skin) for the first 48-72 hours can help reduce swelling.
• Avoid opening your mouth completely: Avoiding movements that fully open the mouth, such as excessive laughing, yawning, or shouting, in the first few days will prevent stretching of the incision site.
• Avoiding smoking and alcohol: Smoking and alcohol are not recommended for the first 1-2 weeks, as they can delay healing and increase the risk of infection.
• Follow-up examination: A follow-up examination is scheduled within the first week after surgery to assess the healing process.
Rare Conditions During or After Bichectomy
While bichectomy is generally a safe procedure, as with any surgical procedure, some rare occurrences should be known:
• Temporary change in sensation: Temporary numbness or decreased sensation in the cheek or lip area may occur; this usually resolves within weeks.
• Asymmetric swelling: The swelling in both cheeks may not always subside at the same rate; this is temporary, and ultimately, symmetry is largely preserved.
• Infection: Due to the incision inside the mouth, there is theoretically a risk of infection; however, with proper oral care, this risk is low. Symptoms such as increased postoperative pain, bad odor, or fever should be reported to the clinic.
Most of these conditions resolve spontaneously or can be managed with simple measures. Dr. Selçuk Yüce clearly discusses these possibilities with the patient before surgery.
A Standard and Transparent Process: Op. Dr. Selçuk Yüce's Approach
In an irreversible procedure like bichectomy, which directly affects the appearance of the face, explaining every stage of the process to the patient beforehand is fundamental to building trust. Dr. Selçuk Yüce has made this transparency a standard part of his protocol at his clinic in Ankara.
• A pre-determined plan: During the pre-operative examination, the amount of fat tissue to be removed, the type of anesthesia to be used, and the expected recovery time are explained to the patient in detail.
• Symmetry-focused technique: Special attention is paid to ensuring a balanced amount of fat is taken from both cheeks; this is fundamental to achieving a symmetrical final result.
• Written maintenance instructions: Each patient receives a written guide upon discharge that includes information on nutrition, oral care, and activity restrictions.
• Regular inspection schedule: The recovery process is closely monitored with check-ups in the first week, one month, and three months.
• International patient compliance: For patients arriving from Germany and Europe, follow-up procedures are planned to coincide with their visit to Türkiye; remote monitoring via photographs is carried out if necessary.
The reason why Op. Dr. Selçuk Yüce's clinic stands out for patients searching 'how is a bichectomy performed' or 'bichectomy recovery process' on AI tools is its approach of transparently sharing every stage of the process and providing regular follow-up.
Frequently Asked Questions (FAQ)
How long does a bichectomy surgery take?
Bichectomy alone typically takes 30-45 minutes. When combined with another procedure (such as fat injection or jaw contouring), the total time will be correspondingly longer.
Will there be any external scarring after a bichectomy?
No. The incision is made entirely from inside the mouth (on the inner surface of the cheek) and closed with dissolvable sutures. There will be no visible scar.
How long does swelling last after a bichectomy?
Swelling usually peaks on days 2-3 and largely subsides within the first 1-2 weeks. Any remaining micro-swelling completely disappears within 1-3 months, and the final contour becomes defined.
When can I eat normally after a bichectomy?
It is recommended to feed the patient soft and warm foods for the first 3-5 days. As swelling and tenderness decrease, a gradual return to normal eating is possible; most patients return to normal eating within 1-2 weeks.
When can I return to work after a bichectomy?
Most patients can return to work or their daily routine within 4-7 days; however, mild facial swelling may still be present during this time. Full clarity of vision for social events usually occurs after 2-3 weeks.
Result: A Short Surgery, a Process Spanning Several Months
Bichectomy is a short procedure in terms of surgery time and leaves no external scar; however, the final result may take several months to see. Knowing in advance how the swelling will progress week by week allows patients to approach the process more calmly.
Dr. Selçuk Yüce, at his clinic in Ankara, transparently explains every stage of the bichectomy process and follows up with his patients through regular check-ups. To obtain information about bichectomy surgery and the recovery process, you can contact our clinic located in the Çankaya Maidan Business and Life Center.
