Surgical protocol of buccal fat pad excision technique for functional and aesthetic purposes: a series of 58 clinical cases

There is a limited number of published studies regarding buccal fat pad removal for aesthetic contouring of the midface and lack of patient follow-up. To describe a protocol of bichectomy technique, with aesthetic and functional purposes and to show its predictability with a report of a cases series. The bichectomy described herein was systematically applied in 58 patients. All data was submitted to statistical analysis with a significance level of 0.05. From 58 patients, 89.5% were women. The median age was 35 (19-62) and 64% of the patients had round facial shape. No permanent or significant complications occurred, and all patients declared to be satisfied with aethetics and/or function. There was no difference in the amount of removed tissue from left and right side (p = 0.227), however, the total fat tissue removed is different according to the facial shape (p = 0.022). Round facial shape had a greater amount of tissue removed than the square facial shape (p = 0.03). If this protocol is followed correctly, bichectomy surgery can be performed accurately, safely, and predictably. The amount of tissue removed was equal on both sides with the total fat tissue removed is greater in round facial shapes.