Buccal Fat Removal (Bichectomy) in Istanbul, Turkey
- Surgery: About 1 hour
- Hospital stay: Day case
- In Istanbul: ~5 days
- Socially presentable: ~1–2 weeks
Indicative ranges for buccal fat removal on its own. When it is part of a larger facial plan, that operation's ranges apply. Your plan, recovery and clearance to travel are individual.
What the Buccal Fat Pad Is
The buccal fat pad is a discrete, encapsulated body of fat that sits deep in the cheek, between the muscles of chewing, below and slightly behind the cheekbone. It is not the fat you can pinch; that is subcutaneous fat, and it is not what this operation removes. The pad has a fixed shape and a fixed position, it does not grow or shrink much with weight change, and its size varies naturally from person to person.
In a face with a large pad, that fullness sits exactly where a shadow would otherwise define the cheekbone — which is the whole basis of the operation.
What Removing It Does
Removing part of the pad lets the deep cheek fall inward slightly, which opens a shadow beneath the cheekbone and makes the bone read as more defined. The change is subtle in most faces, obvious in a few, and it is a change in shadow rather than in structure: the bone is not touched, nothing is lifted, and the skin is not tightened.
The result appears gradually as the swelling settles, and it lasts — the pad that is removed does not grow back.
What It Cannot Do
Buccal fat removal treats the deep cheek. It does not slim the jawline, it does not treat a double chin, it does not tighten skin, and it does nothing for jowls — the four things patients most often send me a photograph of when they ask for it.
Fat under the chin is a different compartment entirely and is treated with chin liposuction or, where the neck has also loosened, with a deep neck lift. A heavy lower face that has descended is a lift problem, not a fat problem, and the operation for it is a deep plane facelift. Removing buccal fat from a face whose real complaint is any of these leaves the complaint untouched and takes volume out of the one part of the cheek that was still full.
Who It Genuinely Suits
The operation suits a young adult with a genuinely large buccal pad, a full lower cheek that has been there since childhood rather than arrived with weight, good skin quality, cheekbones that are already reasonably defined, and a face that is not losing volume. In that face the change is proportionate and it ages well.
It also suits, occasionally, a face with a clear asymmetry between the two cheeks where the pads differ in size.
That is a narrower group than the search volume for this operation suggests — and it is the reason the section below exists.
Why I Decline It More Often Than I Perform It
Faces lose fat as they age. The deep compartments empty first, the cheek hollows, the midface falls, and the shadow that looked sculptural in a young face looks tired later. A great deal of my facelift practice consists of putting volume back into faces that have lost it, with fat grafting — including, sometimes, into cheeks that were hollowed surgically years earlier.
So when someone with a face that is already thinning, or a face that is beginning to descend rather than one that is genuinely full, asks me to remove buccal fat, I say no and explain why. The same applies to anyone asking for it because of a photograph of a very thin celebrity face, and to anyone who wants it to fix a jawline. Saying no costs me an operation; saying yes would cost you volume you cannot get back without another operation. I would rather have the first conversation.
Does It Age the Face?
It can, and honestly answering this question is the reason this page reads differently from most. Taking volume out of a cheek that will go on losing volume makes the later face gaunter than it would otherwise have been, and the effect shows up in years rather than months. That is not an argument against the operation in the face it suits — a genuinely large pad remains large — but it is a real consideration in every face that is borderline, and “borderline” describes most of the people who ask for it.
This is also why I remove part of the pad rather than all of it, and why conservative is the only sensible setting.
Can It Be Reversed?
Not directly. The pad that is removed does not grow back and cannot be put back. What can be done, if a cheek has been hollowed too far, is to replace the volume with fat grafting — which is a different operation, with its own variability in how much of the graft survives, and it does not restore the original anatomy. Treat the removal as permanent when you decide, because in practical terms it is.
How I Perform It
The operation is done through a small incision inside the cheek, so there is no external scar. The capsule is opened, part of the pad is delivered and removed under direct vision, and the incision is closed with dissolving sutures. The parotid duct, which opens into the mouth in the same region, and the branches of the facial nerve that run nearby are the reason this is done under vision and with care rather than quickly.
How much is removed is decided on your face, not by a standard amount, and I remove less rather than more. On its own the operation is a day case under local anaesthesia; inside a larger facial operation it is performed under the same general anaesthetic. What the day looks like is on your surgery timeline.
With Other Procedures
Where buccal fat removal genuinely fits a plan, it is usually a small part of it: alongside a lip lift or chin liposuction in a younger face, or — much less often — inside a facial rejuvenation plan where one cheek is heavier than the other. I do not add it to a facelift as a matter of course, and in most facelift patients I am adding volume rather than removing it. The logic of what I combine, and where I stop, is on combining facial procedures.
Results
The result is a shadow, not a transformation: a cheek that reads as defined rather than full, in a face that still looks like yours. It settles gradually as swelling resolves, and the early appearance is not the result. Every case in my results gallery lists the full combination of procedures performed, so that nothing there is attributed to the wrong operation.
Recovery
Swelling in the cheeks is the main feature of the early period and makes the face look fuller, not slimmer, before it looks slimmer — which surprises people who expected an immediate change. Eating is uncomfortable at first, soft food and mouth rinses are the rule while the incisions heal inside the cheek, and bruising is usually mild. Most patients are back to normal appearance sooner than after any other operation on this site. The general rhythm of facial recovery is in the facelift recovery guide.
Risks, Plainly
The risks are over-removal, which shows as hollow cheeks and is the one that cannot be undone; asymmetry between the two sides; injury to the parotid duct or to a branch of the facial nerve, which is uncommon but is the reason for operating under direct vision; bleeding and haematoma in the cheek; infection of the intraoral wound; prolonged swelling; and the general risks of anaesthesia. Late volume loss with ageing, described above, is not a complication but it is a consequence, and it belongs in the same list when you are deciding.
What Decides the Cost
The cost follows whether the operation is performed on its own under local anaesthesia as a day case, or inside a larger facial operation under general anaesthesia, and what else is planned with it. After I have reviewed your photographs you receive an itemised quote — and if my assessment is that you should not have this operation, you will receive that instead, with the reasoning. How quotes are built and compared safely is on the cost page.
Frequently Asked Questions
What is buccal fat removal?
Buccal fat removal, or bichectomy, removes part of the buccal fat pad — a discrete body of fat deep in the cheek, below and behind the cheekbone — through a small incision inside the mouth. It opens a shadow beneath the cheekbone so the bone reads as more defined. It is not the fat you can pinch, and no external scar is involved.
Does buccal fat removal age you?
It can. Faces lose deep fat as they age, and removing volume from a cheek that will go on emptying makes the later face gaunter than it would have been. In a face with a genuinely large pad that is not the outcome — but in a borderline face it is a real risk, and most of the people who ask for this operation are borderline. That is why I decline it more often than I perform it.
Is buccal fat removal permanent? Does the fat come back?
The pad that is removed does not grow back, so the change is permanent in practical terms. Weight change and ageing alter the face around it, but the removed fat does not return.
Can buccal fat removal be reversed?
Not directly. If a cheek has been hollowed too far, the volume can be replaced with fat grafting — a different operation, with its own variability in how much of the graft survives, and it does not restore the original anatomy. Decide as though it is permanent, because it is.
Will buccal fat removal slim my jawline or my double chin?
No. The buccal pad sits deep in the cheek, not along the jaw or under the chin. Fat under the chin is treated with chin liposuction, or with a deep neck lift where the neck has also loosened, and a heavy lower face that has descended needs a lift rather than fat removal.
Am I a good candidate for buccal fat removal?
If you are a young adult with a genuinely full lower cheek that has been there since childhood, good skin quality and a face that is not losing volume, possibly. If your face is already thinning, if you are chasing a photograph of a very thin face, or if what bothers you is your jawline, I will tell you the operation is not the answer.
Is there a scar?
Not on the outside. The incision is inside the cheek and is closed with dissolving sutures. The trade-off is that the healing is intraoral, so soft food and mouth rinses are the rule in the early days.
Does it hurt, and how long is the recovery?
Discomfort is mild and mostly related to eating and to swelling in the cheeks. The cheeks look fuller before they look slimmer, which surprises people. Most patients return to normal appearance sooner than after any other facial operation I perform; the indicative ranges are in the summary at the top of this page.
Can buccal fat removal be combined with other procedures?
Yes, where it genuinely fits the plan — most often with a lip lift or chin liposuction in a younger face. I do not add it to a facelift as a matter of course; in facelift patients I am usually adding volume rather than removing it.
How much does buccal fat removal cost in Turkey?
It depends on whether the operation is performed on its own as a day case under local anaesthesia or inside a larger operation under general anaesthesia, and on what else is planned. After I have reviewed your photographs you receive an itemised quote — or my reasoning for declining, if that is my assessment.
Start Your Assessment
Send a photograph straight on and one from each side, with your face relaxed. Over WhatsApp or through the form — you will receive my honest assessment of whether your cheek fullness is buccal fat at all, and whether removing it would suit your face now and as it ages, before anything is arranged.
Request a personal review See before & after results
Every enquiry is reviewed personally by Dr. Yilmaz; scheduling is handled by the patient coordination team.
About Dr. Muhsin Yilmaz
Written and medically reviewed by Muhsin Yilmaz, MD, FEBOPRAS — Plastic, Reconstructive and Aesthetic Surgeon. Last reviewed: September 2026.
Dr. Muhsin Yilmaz is a double board-certified plastic surgeon, holding the FEBOPRAS diploma of the European Board of Plastic, Reconstructive and Aesthetic Surgery and the certification of the Turkish Board of Plastic, Reconstructive and Aesthetic Surgery, and practises in Istanbul, Türkiye. His practice is focused on facial and neck rejuvenation, centred on the deep plane facelift — around 150 facelift operations per year, performed at Acıbadem Kartal Hospital. He is a member of TSPRAS and ISAPS, and is registered with the Turkish Ministry of Health for international health tourism. Read his full profile.
References
- Zhang HM, Yan YP, Qi KM, Wang JQ, Liu ZF. Anatomical structure of the buccal fat pad and its clinical adaptations. Plast Reconstr Surg. 2002;109(7):2509–2518. PMID 12045584
- Rohrich RJ, Pessa JE. The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg. 2007;119(7):2219–2227. doi:10.1097/01.prs.0000265403.66886.54
- Stuzin JM, Baker TJ, Gordon HL. The relationship of the superficial and deep facial fascias: relevance to rhytidectomy and aging. Plast Reconstr Surg. 1992;89(3):441–449. doi:10.1097/00006534-199203000-00007