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Buccal fat removal (bichectomy) in Istanbul
For adults whose cheeks look full despite a stable weight. This page covers who tends to benefit, what recovery involves and what is still unknown about the long term.
- Operation time Short; confirmed at your examination
- Hospital stay None; you go home the same day
- Time in Istanbul Around 7 days; less only if your surgeon agrees
- Back to work A few days to a week
What is buccal fat removal?
Buccal fat removal (bichectomy) takes out part of the buccal fat pad, a deep pocket of fat in the cheek between the chewing muscle and the cheek muscle. This can make the hollow beneath the cheekbones more visible and the lower face look slimmer. It is usually done under local anaesthesia through a small incision inside the mouth, and you go home the same day. Most people resume their routine within a week; the final shape takes a few months to show.
What it can do
- Reduce cheek fullness caused by the buccal fat pad
- Make the cheekbones and the hollow beneath them more visible
- Be combined with a facelift or chin liposuction
What it cannot do
- Slim a face whose width comes from the chewing muscle or fat under the skin
- Be undone: removed fat cannot be put back
- Tell you how your face will age, as long-term studies are lacking
Is it right for you?
Choosing the right face matters more than the technique. The buccal fat pad grows markedly between the ages of 10 and 20, then slowly shrinks over the next 30 years.
Usually a good fit if
- Your cheeks look full although your weight is stable
- You have well-defined cheekbones that the fullness hides
- You are healthy, do not smoke and have realistic expectations
- You are 18 or older
Better to wait or consider alternatives if
- Your face is already slim or narrow, so it could look hollow with age
- You expect to lose a lot of weight, for example after weight-loss surgery
- Your cheeks have already started to lose volume with age
- You have an active infection in your mouth or teeth
Techniques
The fat pad is usually reached from inside the mouth, or through a facelift incision. A non-surgical option also exists.
Intraoral bichectomy
A cut of about 1.5 cm is made inside the cheek, positioned in relation to the salivary duct. A portion of the fat pad, typically around 3–5 ml, is eased out, and the cut is closed with dissolving stitches.
Best for
Most people having buccal fat removal on its own.
Removal during a facelift
During a planned facelift, the fat pad can be reached through the facelift incision instead.
Best for
People also planning a facelift.
Non-surgical cheek slimming
A device that applies heat to the cheek fat from inside the mouth is also offered at the practice. No peer-reviewed studies of its effect or side effects were found, so it is not presented as an equal alternative.
Best for
Discussing at consultation if you would rather avoid surgery.
Op. Dr. Bilgehan İlker
Specialist in plastic, reconstructive and aesthetic surgery
- Specialist training: Dokuz Eylül University
- Medical degree: Trakya University
- Health tourism authorization: ST-2657
- Dr. İlker speaks English and Turkish.
How Dr. İlker approaches buccal fat removal
Op. Dr. Bilgehan İlker is a specialist in plastic, reconstructive and aesthetic surgery, trained at Dokuz Eylül University. Her own pages sum up the operation as “cheeks in, cheekbones out”, and advise changing what your face needs rather than following a trend, since trends change faster than faces.
She does not usually recommend it for people living with obesity or expecting a large weight change, such as after weight-loss surgery, because later weight loss can leave the face looking hollow.
- Your face before the trend Cheekbones, fat distribution, age and weight history are assessed before anything is suggested.
- Home the same day Dr. İlker describes it as an outpatient operation through a small cut inside the cheek.
- A clean mouth Good oral hygiene before surgery lowers the risk of infection, and you leave with clear rinsing and eating instructions.
The operation, step by step
What usually happens on the day of surgery.
-
Examination
Face shape, cheekbones, fat distribution, weight history and general health are reviewed.
-
Anaesthesia
Local anaesthetic numbs the inner cheek; general anaesthesia is used when procedures are combined.
-
A small incision
With the salivary duct identified, a cut of about 1.5 cm is made inside the cheek.
-
Removing part of the fat pad
A measured portion is eased out, aiming for a natural contour rather than the largest possible amount.
-
Closing and going home
Dissolving stitches close the cut, and you go home the same day.
Your days in Istanbul
Plan time for an unhurried examination before surgery and a check-up afterwards. ASPS advises waiting 7–10 days after facial procedures before flying; after a short local procedure, your surgeon may clear you sooner.
-
Arrive in time to be examined
Before surgery
UK guidance (BAAPS) suggests the in-person examination takes place at least 48 hours before surgery.
-
Home the same day
Surgery day
Have soft food and drinks ready at your accommodation.
-
Rest and rinse
The first days
ASPS advises against sunbathing, alcohol, swimming and long tours after surgery abroad.
-
A final check
Before you fly home
BAAPS recommends a check by your operating surgeon before you leave, and you should know whom to contact from home.
Recovery, day by day
Most people return to daily life within a week, while the cheeks take a few months to settle. These are typical ranges, not promises.
- Day 1
Sore and swollen
Stick to liquids, use the prescribed mouthwash and apply cold compresses if advised.
- Days 2–3
A stiff jaw
Move gradually to soft foods and keep your tongue off the stitches.
- Week 1
Back to routine
Swelling eases and most people return to work. Confirm your flight with your surgeon.
- Week 2
Still settling
The new shape is not visible yet. Keep your mouth clean.
- Weeks 3–4
Largely healed
Healing usually takes about three weeks, and a normal diet returns.
- Months 2–3
Contour emerging
The cheeks settle into their new shape as deeper swelling resolves.
- Month 6
A clearer result
The final result usually shows within a few months. Raise any asymmetry with your surgeon.
- Month 12
Further ahead
Long-term research is lacking; a stable weight helps protect the result.
Contact us straight away if you notice
- An unusual taste or cheek swelling, which can point to a salivary duct problem
- Severe facial pain and swelling in the hours after surgery, which can mean bleeding
- Weakness of the facial muscles, such as an uneven smile
- Shortness of breath, chest pain or an irregular heartbeat
In an emergency, call your local emergency number.
Aftercare at home
- Keep to liquids for the first 1–2 days, sometimes longer, then move to soft foods.
- Rinse with the prescribed mouthwash; salt-water rinses may also be advised.
- Keep your tongue away from the stitches; they dissolve on their own.
- Avoid hard or crunchy food for the first days.
- Use cold compresses if advised, especially in the first 3–4 days.
Risks and how they are reduced
It is a short operation, but still surgery. Reported complication rates range from about 8% to 25%, and most complications are temporary.
Careful selection is the main safeguard. Identifying the salivary duct, removing a measured amount of fat, a clean mouth and stopping nicotine reduce the risk further.
| Risk | How often |
|---|---|
Swelling and painSwelling was the most frequent problem in a 2025 review of 12 studies, and pain was also common; both usually settle. | Common |
Restricted mouth openingOpening the mouth can be difficult for a while (trismus). It is usually temporary. | Common |
AsymmetryThe cheeks can heal unevenly; this is assessed once the swelling has gone. | Common |
Facial nerve weaknessReported in under 1% of patients in the 2025 review; it may be temporary or lasting. | Rare |
Salivary duct injury, haematoma or infectionThe duct is identified before the incision. Haematoma (a collection of blood) and infection were each reported in about 0.5% of patients. | Rare |
Hollow cheeks with agePossible in slim faces. How often is unknown, as no study has followed patients for long enough. | Varies |
Results and how long they last
Healing takes about three weeks, and the final contour usually shows within a few months.
Removed fat does not grow back. Because the fat pad also shrinks naturally with age and long-term studies are lacking, careful selection and a stable weight matter.
How long it lasts: Removed fat does not return, but the face keeps ageing and long-term effects are not well studied.
With any surgical or interventional procedure, results vary from person to person. We recommend a detailed consultation with your doctor before any procedure.
Before and after
Before and after photos are shared only with patients’ written consent. You can ask to see examples during your consultation.
Before and afterQuestions to ask at your consultation
Take these to any surgeon you see — including us.
- Are you a specialist in plastic, reconstructive and aesthetic surgery, and where did you train?
- Is my fullness coming from the buccal fat pad, the chewing muscle or fat under the skin?
- Could removing this fat make my face look hollow later on?
- How much fat will you remove, and how do you keep the two sides even?
- Where will the operation take place, and who will give the anaesthetic?
- Whom do I contact if a problem appears after I fly home?
What shapes your plan and quote
After Op. Dr. Bilgehan İlker has examined you, you receive a personal written plan that states what is included. It depends on:
- Buccal fat removal alone, or combined with other procedures
- Local anaesthesia alone, or sedation or general anaesthesia
- Where the operation takes place
- Medicines, any tests beforehand and check-ups during your stay
We do not publish prices: every plan is personal and is written for you after your assessment.
Frequently asked questions
Is buccal fat removal permanent?
The fat that is removed does not grow back, so the change is long-lasting. Less clear is how your face then ages, as the buccal fat pad also shrinks naturally over the decades and long-term research is limited. A stable weight helps.
Does buccal fat removal make you look older?
It may, in the wrong face. ASPS warns that in thin or narrow faces, removing buccal fat may lead to a hollow look with age. This has not been measured over the long term, so careful candidate selection is the main protection.
How long is the recovery after buccal fat removal?
Healing usually takes about three weeks. Most people return to work and normal activities within a few days to a week, starting with liquids and then soft foods. Some swelling lasts longer, so the final contour shows only within a few months.
Is buccal fat removal painful?
The operation is done under local anaesthesia, so the area is numb while you are awake. Afterwards, pain and stiffness when opening the mouth are common, affecting about 19% and 30% of patients in a 2025 review, and are usually temporary.
What are the risks of buccal fat removal?
Most complications are temporary: swelling, restricted mouth opening, pain and asymmetry. Facial nerve weakness, infection and haematoma are rare, each reported in under 1% of 308 patients in a 2025 review. A hollow look with age is a recognised but unmeasured long-term concern.
Can buccal fat removal be reversed?
No. Once removed, the fat cannot be put back. If the cheeks later look hollow, a surgeon can try to restore some volume with facial fat transfer or fillers, but that is a correction, not a reversal, so take the decision slowly.
Will buccal fat removal leave a scar on my face?
Not on the skin. The incision, about 1.5 cm long, is made on the inside of the cheek and closed with dissolving stitches that do not need removing. Because the cut is inside the mouth, nothing shows on your face once healed.
Buccal fat removal or cheek liposuction: which do I need?
They target different fat. Buccal fat removal treats the deep fat pad in the cheek hollow; excess fat just under the skin may need another method, and width from the chewing muscle is different again. Which applies to you is decided at an examination.
Is there a non-surgical alternative to buccal fat removal?
The practice offers a non-surgical option: a device that applies heat from inside the mouth. No peer-reviewed studies of its effect or side effects were found, so it should not be seen as equivalent to surgery. Ask Op. Dr. Bilgehan İlker to compare both for your face.
How long should I stay in Istanbul for buccal fat removal?
Plan on around 7 days. For a short procedure under local anaesthesia, UK guidance (BAAPS) does not call for an extra stay, so your surgeon may clear you to fly after the first check-up. ASPS generally advises 7–10 days after facial surgery.
Medical informationThe information on this page is general information only. It is not medical advice and does not replace a diagnosis or treatment. Every surgical and interventional procedure carries risks, which will be explained to you in detail during your consultation. Whether this procedure suits you can only be decided after an in-person examination and assessment. We encourage you to also seek independent advice from your own doctor before deciding.
Sources
- ASPS: Buccal fat removal
- Cleveland Clinic: Buccal fat removal
- StatPearls: Buccal fat pad reduction
- Albuquerque et al. Complications of buccal fat removal: meta-analysis (2025)
- Moura et al. Buccal fat pad removal: an established technique? (2018)
- ASPS: Cosmetic surgery tourism
- BAAPS: Cosmetic tourism guidelines (2023)
A conversation, at your pace.
Wondering whether buccal fat removal would suit your face?
Send your questions, and photos if you wish. Op. Dr. Bilgehan İlker can tell you whether an examination makes sense.
- Nef 22 Ataköy, D Blok, Kat 1, Daire 36, Çobançeşme E-5 Yanyol Cad. No:22, Bakırköy / İstanbul
- Monday to Saturday, 10:00–18:00
- +90 542 280 27 51
- Dr. İlker speaks English and Turkish.
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