What are Bichat balls and why their removal is in fashion

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What are Bichat balls and why their removal is in fashion




The aesthetic objective of the bichectomy is to refine the face and mark the cheekbones more.


© Getty Images
The aesthetic objective of the bichectomy is to refine the face and mark the cheekbones more.


Social networks are full of before and after photos of celebrities allegedly operated on Bichat balls.

He look of ultra-sculpted cheekbones has been in vogue for years, but the rise of selfies, the fashion of influencers and the growth of social networks have given this surgery, known and practiced for decades, an unprecedented boost in recent years.

We talk about the bichectomía, or extraction of the Bichat balls, bags of fatty tissue that we all have on our cheeks.

“For a few years it has been very fashionable among young women of 20, 25 years,” confirmed to BBC Mundo the Spanish doctor Ainhoa ​​Placer, permanent member of the Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE).

It is a trend that specialists from many countries have noticed, although it is difficult to obtain concrete figures.

The aesthetic objective of this procedure is to refine the face and mark the cheekbones more.



The rise of selfies, the trend of influencers and the growth of social networks have fueled the interest in bichectomies to redefine the cheekbones.


© Getty Images
The rise of selfies, the trend of influencers and the growth of social networks have fueled the interest in bichectomies to redefine the cheekbones.


Although it is a relatively simple and minimally invasive surgery, some experts warn that there is a certain “trivialization” in its use, and that the operation is more complex than many aesthetic medicine clinics want to show.

In addition, many specialists question it as an aesthetic procedure if patients do not have an excessively rounded face: in the short term it can be effective to mark the cheekbones more, but in the long run it can cause an appearance of premature aging.

“I personally am not very much in favor of performing this surgery,” Dr. Placer told BBC Mundo.

In this article we explain why, but first, do you know why we have these pockets of fat on our cheeks?

Shock absorbers

Bichat balls are adipose tissue bags found in a deep layer of the face, under the cheekbones and between the masseter and buccinator muscles.

They act as a kind of cushion or cushion between those facial muscles that, among other things, participate in the movements of chewing – and breastfeeding in newborns.

These bags are named after the French anatomist who identified them in the late 17th century, Xavier Bichat.


Portrait of the French anatomist Francois Xavier Bichat (1771-1802), by Pierre Maximilien Delafontaine.


© Public domain
Portrait of the French anatomist Francois Xavier Bichat (1771-1802), by Pierre Maximilien Delafontaine.


Their size and volume vary from person to person due to genetic reasons, and they can give the face a rounded appearance, which has nothing to do with being overweight.

Although they do not fulfill a structural function in our face, their location is closely linked to a delicate area of ​​the face, near various endings of the Facial nerve, the parotid duct, through which saliva circulates from the parotid gland to the mouth, and blood vessels important of the face.

Dental and reconstructive surgery specialists have been using Bichat balls for decades as a resource more within his repertoire of surgical techniques.

But the interest in recent years in its removal is purely aesthetic, and according to Dr. Placer it comes mostly from young women, who do not necessarily have disproportionately large cheeks or excessively rounded faces.

“It is not so simple”

The removal is done through an incision of one or two cm long inside the mouth, at the height of the upper molars, in an operation that, depending on the surgeon’s expertise, can take less than an hour and is usually performed with Local anesthesia.

The beauty clinics that promote this surgery highlight that it is a fast, minimally invasive procedure, with an easy postoperative period, permanent results and no external scars.

They sell an aesthetic dream: to transform in an easy and fast way – and relatively affordable, around US $ 1,500 depending on the country, a rounded and undefined face into a thinner and more stylized face, with accentuated cheekbones.

It can be very tempting, but “it’s not as simple as it seems“.


Image of the information campaign carried out on Facebook by the Brazilian Society of Plastic Surgery in 2019.


© SBCP
Image of the information campaign carried out on Facebook by the Brazilian Society of Plastic Surgery in 2019.


That is the message of an information campaign that the Brazilian Society of Plastic Surgery carried out on social networks in 2019, specifically to prevent problems associated with bichectomies.

Beyond the possible complications associated with any surgery, such as bleeding or infection, the main risks of a poor quality bichectomy are the possible facial nerve injury o la accidental section of the saliva duct.

A severe injury to the facial nerve, for example, can lead to irreversible loss of movement in the face.

That is why the associations of professionals in Plastic, Reconstructive and Aesthetic Surgery in various countries insist that it is essential to put yourself in the hands of a qualified and well-trained medical specialist to perform these extractions.

Premature aging

While removal of Bichat balls can be effective for those seeking a more defined cheekbone and facial contour, many specialists warn that in the long term, you can have unwanted effect about another aesthetic dream: delaying aging.

In the face there are many fat compartments, located in different layers, some more superficial than others.


Over time, bichectomy can give the face an older appearance, compared to chronological age, many specialists warn.


© Getty Images
Over time, bichectomy can give the face an older appearance, compared to chronological age, many specialists warn.


With age there is a loss of facial fat, which is precisely one of the main reasons for aging, which is why Dr. Placer believes that bichectomy “is harmful in the long run, because you yourself are already anticipating the aging process.”

From the Brazilian Society of Plastic Surgery they make a similar warning: “bichectomy can generate important anatomical distortions that with aging would worsen, giving the face a more aged appearance compared to chronological age”.

“You are removing a fat that in the future you will like, because that’s what we do against aging: fill“Dr. Placer told BBC Mundo.

That is why this specialist is not very in favor of removing Bichat balls on a “normal” face, other than “super round”.

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