Some people naturally have fuller, rounder cheeks even at a healthy and stable weight. In selected patients, this fullness is partly related to the buccal fat pads—deep pockets of fat within the cheeks that contribute to facial contour.
Bichectomy, or buccal fat removal, reduces a carefully selected portion of this fat through small incisions inside the mouth, leaving no external skin scar. The goal is not to create a hollow or dramatically sculpted face, but to achieve subtle definition and better facial proportion.
At Cabo Plastic Surgery, Dr. Roberto López Konschot takes a particularly conservative approach to buccal fat removal. Because facial volume and proportions change with age, not everyone with full cheeks benefits from this procedure—and sometimes the best recommendation is not to remove buccal fat at all.
The goal is a result that looks balanced and natural today while respecting how your face may change over time.
Successful bichectomy depends less on how much fat can be removed and more on whether removing it will improve facial proportions without sacrificing natural fullness.
Understanding the procedure begins with knowing what bichectomy can—and cannot—change.
| Procedure | Bichectomy (buccal fat removal) |
|---|---|
| Purpose | Reduce fullness in the lower cheeks and refine the transition between the cheekbones and jawline. |
| Technique | Removal of a carefully selected portion of the buccal fat pad through small incisions inside the mouth. |
| Anesthesia | Local anesthesia for most standalone procedures, performed in the office. |
| Procedure Time | Approximately 30–45 minutes. |
| Scarring | No external skin scars; incisions are entirely inside the mouth. |
| Return to Activities | Most patients return to normal daily activities within 2–3 days. |
| Final Result | Contour continues to refine for approximately 2–3 months. |
| Starting Price | From $1,500 USD for a standalone bichectomy. |
| Evaluation | $130 USD for the in-office evaluation; final pricing is confirmed at that visit. |
Whether the procedure is appropriate at all is a question of judgement as much as technique.
Bichectomy should refine facial contours without creating excessive hollowing. The decision to remove buccal fat—and how much to remove—should consider facial structure, existing volume, and how the face may change with age.
Dr. Roberto López Konschot takes a conservative, anatomy-based approach, preserving natural facial balance rather than creating exaggerated angles. For patients with naturally thin faces or limited cheek fullness, the best recommendation may be not to perform the procedure at all.
The goal is subtle definition that looks natural today and remains balanced over time.
Understanding what bichectomy can achieve begins with the anatomy of the buccal fat pad.
Bichectomy, also known as buccal fat removal, is a surgical procedure that reduces fullness in the lower cheeks by removing a carefully selected portion of the buccal fat pad.
The procedure is performed through small incisions inside the mouth, so there are no external skin scars. By reducing excess cheek fullness, bichectomy can create a slimmer, more defined facial contour and improve the transition between the cheekbones and jawline.
Importantly, bichectomy addresses buccal fat specifically. Facial fullness caused by other factors—such as enlarged masseter muscles, subcutaneous fat, or overall facial anatomy—may require a different approach.
The buccal fat pad is a naturally occurring pocket of fat located deep within the cheek. Its size varies from person to person and can contribute to a rounder or fuller lower face, even in patients who are otherwise lean.
Why it matters Because the buccal fat pad is only one component of facial shape, the entire face must be evaluated before deciding whether reducing it will improve overall proportions.
The next step is determining whether your facial anatomy makes bichectomy an appropriate choice.
Bichectomy may be appropriate for patients with persistent lower-cheek fullness who want greater facial definition.
Bichectomy may not be appropriate for patients with an already thin or hollow face, limited facial volume, or fullness caused by something other than the buccal fat pad.
Careful selection is especially important in younger patients because facial proportions and volume distribution continue to evolve with age. When fullness is primarily caused by enlarged masseter muscles, another treatment may be more appropriate.
If bichectomy is appropriate for your anatomy, careful planning helps determine the degree of reduction needed for a balanced result.
Your consultation focuses on your facial anatomy, cheek fullness, existing facial volume, and goals. Dr. Roberto López Konschot evaluates whether the buccal fat pad is actually contributing to the fullness you want to improve and whether conservative reduction will complement your facial structure.
If bichectomy is appropriate, you will receive specific instructions regarding medications, oral hygiene, eating before the procedure, and other preparation. International patients may begin with a virtual consultation, with the final assessment performed in person.
Once the treatment plan is established, bichectomy is typically a short, in-office procedure performed through incisions entirely inside the mouth.
Bichectomy is typically performed in the office under local anesthesia and takes approximately 30–45 minutes.
Dr. Roberto López Konschot makes a small incision inside each cheek and carefully identifies the buccal fat pad.
No external scar Because the incisions are entirely inside the mouth, no scar is created on the skin.
A controlled amount of fat is removed from each side, based on the patient’s anatomy and desired degree of contouring.
Conservative by design How much is removed is decided by facial proportion, not by how much fat can be reached.
The incisions are then closed with absorbable sutures.
Combined procedures When bichectomy is combined with another facial surgery, it can be performed during the same surgical session.
Although recovery is generally brief, swelling takes longer to resolve and the final contour develops gradually.
Recovery after bichectomy is generally brief, although swelling may take several weeks to fully resolve.
During the first few days, mild swelling, tenderness, and tightness inside the cheeks are common. Patients typically:
Most swelling improves over the first few weeks, while the facial contour continues to refine for approximately 2–3 months.
Postoperative consultations are included as part of your care.
As swelling subsides, the change becomes increasingly visible—but the quality of the result depends on achieving definition without excessive volume loss.
As swelling resolves, bichectomy can create a slimmer lower cheek and greater definition between the cheekbones and jawline. The goal is a refined change that remains proportional to the rest of the face.
Results develop gradually, with the final contour typically becoming apparent around 2–3 months.
The fat removed during bichectomy does not typically return, but the face continues to change with aging and weight fluctuations. Because facial volume naturally changes over time, conservative removal and appropriate patient selection are essential to reduce the risk of excessive hollowing later in life.
For some patients, buccal fat reduction is only one part of achieving better overall facial balance.
Bichectomy addresses buccal fat specifically. When other areas also contribute to facial fullness or imbalance, additional procedures may provide a more harmonious result.
Improves fullness beneath the chin and helps define the jawline and neck.
Can improve overall facial balance when both nasal proportions and cheek contour are concerns.
Bichectomy may be incorporated into a broader facial surgical plan when appropriate.
Selected patients may benefit from treatments such as masseter Botox or strategically placed fillers rather than—or in addition to—buccal fat reduction.
The appropriate combination depends on which anatomical structures are actually contributing to the patient’s facial shape.
As with any surgical procedure, understanding the potential risks and long-term considerations is an important part of deciding whether bichectomy is appropriate.
Bichectomy is generally well tolerated in appropriately selected patients, but all surgical procedures involve potential risks.
These may include:
An important long-term consideration is overcorrection. Removing too much buccal fat can produce a hollow appearance that may become more noticeable as facial volume changes with age.
Individual risks and alternatives are discussed during your consultation based on your anatomy and treatment plan.
Bichectomy requires more than simply removing cheek fat. Patient selection, facial anatomy, and conservative volume reduction are essential to achieving a balanced result.
At Cabo Plastic Surgery, your care includes:
The following questions address some of the most common concerns about candidacy, recovery, results, and how bichectomy may affect the face over time.
It can if too much fat is removed or if the procedure is performed in someone without sufficient facial fullness. Careful patient selection and conservative reduction help preserve natural facial volume.
Age alone does not determine candidacy. Facial structure, existing volume, and anticipated changes with aging are more important. In some younger patients, waiting may be the better recommendation.
Not necessarily, but this is an important consideration. Facial volume changes naturally with age, and excessive buccal fat removal can make future hollowing more noticeable. For this reason, Dr. López Konschot evaluates the procedure from a long-term perspective, not simply the immediate result.
Usually not when performed alone. Most standalone bichectomies can be performed under local anesthesia in the office.
No external skin scars are created. The incisions are made inside the mouth.
Most patients return to routine daily activities within approximately 2–3 days, although swelling continues to improve for several weeks.
Early improvement becomes visible as swelling decreases, but the final facial contour is generally assessed around 2–3 months.
The buccal fat that is surgically removed does not typically return. However, your facial appearance will continue to change naturally with aging and weight fluctuations.
It can make the cheekbone-to-jaw transition appear more defined in appropriately selected patients, but the degree of improvement depends on your underlying bone structure, facial volume, and anatomy.
Yes. When appropriate, it may be combined with submental liposuction, rhinoplasty, facelift surgery, or other facial procedures.
Bichectomy may not be the right treatment. Fullness related to enlarged masseter muscles, submental fat, or other anatomical factors may respond better to a different treatment.
Once you understand whether bichectomy is appropriate for your anatomy and goals, the next consideration is the cost of treatment.
A standalone bichectomy at Cabo Plastic Surgery is typically performed in the office under local anesthesia, without separate hospital or operating-room fees.
| Treatment | Cabo Plastic Surgery — Starting Price |
|---|---|
| Evaluation (Consultation) | $130 USD |
| Bichectomy (Standalone) | $1,500 USD |
When bichectomy is combined with another facial surgery, the additional fee depends on the overall surgical plan. Your exact cost is confirmed after evaluation, and postoperative consultations are included as part of your care.
Because standalone bichectomy is typically performed under local anesthesia and does not require a hospital stay, recovery can usually be incorporated into a relatively short visit to Los Cabos.
A stay of approximately 3–5 days may be appropriate for selected standalone cases, allowing time for early recovery and postoperative evaluation before traveling home.
If bichectomy is combined with another procedure, the recommended stay will be based on the primary surgery and your individual recovery plan.
If you are considering bichectomy, schedule a consultation with Dr. Roberto López Konschot. Your facial anatomy, existing volume, and goals will be evaluated to determine whether buccal fat removal is appropriate and what degree of improvement you can realistically expect.
You will receive an honest recommendation and a personalized treatment plan, including alternatives when another approach may better suit your facial anatomy.
Schedule a Bichectomy ConsultationThis information is intended for educational purposes only and does not replace an individualized medical evaluation.
Bichectomy is not appropriate for every patient with facial fullness. Recommendations depend on facial anatomy, existing facial volume, age, skin quality, overall health, and aesthetic goals. Long-term changes in facial volume and aging should also be considered when determining whether buccal fat reduction is appropriate.
All surgical procedures involve potential risks. Individual risks, expected results, alternatives, and recovery will be discussed during your consultation with Dr. Roberto López Konschot.
Last Updated: September 2026
Medically Reviewed by: Dr. Roberto López Konschot, Board-Certified Plastic Surgeon