Yes, when performed by a qualified surgeon — particularly an Oral & Maxillofacial Surgeon familiar with the anatomy. Major complications (nerve injury, parotid duct injury) are very rare. Most risks (swelling, bruising) are mild and self-resolving. **Surgeon credentials matter:** ensure the operator has formal facial anatomy training.

How long do I need to stay in Istanbul?

**A 2-3 day visit is sufficient.** Day 1: arrival + consultation + surgery. Day 2-3: post-op check, then fly home. Some patients prefer a 4-5 day stay to combine the procedure with light Istanbul tourism (low-activity sightseeing only — no strenuous walking the first 48 hours).

When can I fly home after surgery?

**Day 2-3** is the earliest safe flight window after a post-op check. Long-haul flights (>5 hours) are best deferred to **Day 4-5** to avoid pressure changes during peak swelling. Compression from face masks and dry cabin air can be uncomfortable; antihistamine + hydration help.

Will there be a visible scar?

**No.** The incision is inside the cheek, in the buccal mucosa. Mucosa heals quickly without external scar. There is no facial cut. After 2–3 weeks the internal incision is barely visible.

How much weight do I lose with bichectomy?

**None.** Bichectomy removes 1.5–3 cc of fat per cheek (3–6 cc total) — this is not weight loss. The effect is purely facial contour refinement.

Will my face look hollow / gaunt as I age?

Conservative removal (1.5–3 cc per side, leaving most of the pad in place) avoids this. **Total fat pad removal is never recommended** — it leads to "skeletal" gaunt face appearance in later years (50+). At our clinic we always preserve the upper portion of the pad.

Can bichectomy be reversed?

**No.** The removed fat does not regrow. If excessive hollowing occurs, fat grafting or filler injection can partially restore volume — but this adds cost and may not match natural appearance. **This is why a conservative, surgeon-led approach is critical** at the initial procedure.

Does private health insurance cover bichectomy?

Bichectomy is classified as a **cosmetic procedure** — most private insurance plans do not reimburse it. Some policies cover it if combined with medically necessary surgery (e.g., correction of pathological cheek hypertrophy). We provide an English-language invoice for insurance submission.

What anaesthesia is used?

**Local anaesthesia** (articaine + epinephrine) is sufficient for most patients. The procedure is painless during surgery and well-tolerated. **General anaesthesia** is rarely required and only used in specific cases (complex revision, patient anxiety).

Can I eat normally after bichectomy?

- **First 24 hours:** Soft / liquid diet (smoothies, soups, yoghurt) - **Days 2–3:** Soft solids (pasta, scrambled eggs, fish) - **Week 1:** Avoid spicy, very hot, or hard foods - **Week 2+:** Normal diet resumes

Is there a risk of facial paralysis?

The **buccal branch of the facial nerve** runs near the buccal fat pad. With proper anatomical knowledge and careful dissection, transient paralysis risk is **<1%**, and persistent injury is very rare. This is the main reason for choosing a surgeon trained in facial anatomy.

Can I combine bichectomy with other procedures?

Yes. Common combinations: - **+ Masseter Botox:** Slim cheek + reduce jawline muscle bulk - **+ Lip filler:** Balance facial proportions - **+ Rhinoplasty:** Comprehensive facial harmony (separate visit recommended for safety) - **+ Dental aesthetic** ([Hollywood Smile](/en/blog/hollywood-smile-istanbul) / [veneers](/en/blog/laminate-veneers-istanbul))

How do I know if bichectomy is right for me?

The **cheek suck-in test** is the simplest screening: stand in front of a mirror, suck cheeks inward; if you see a clear "fullness" at the lower cheek that disappears, you likely have a prominent buccal fat pad. Send a frontal + side photo via WhatsApp for our pre-travel assessment — we'll tell you honestly if you're a candidate.

How do I get a written estimate?

Send a **frontal photo + side profile + smiling photo** to our WhatsApp or email — within 24–48 hours we provide a written estimate in EUR or GBP, valid for 60 days. Include any medical history (diabetes, smoking, medications). No commitment to book.

What if I'm not happy with the result?

**Realistic expectations are critical.** During consultation we discuss what bichectomy can and cannot achieve. If asymmetry or under-correction is noted at 3 months, **minor revision** is possible (touch-up). Over-correction (gaunt face) cannot be reversed except with fat grafting — this is why we are conservative. ---

Bichectomy Istanbul 2026 | Derya Dental Clinic

Bichectomy in Istanbul — 60-Second Answer

🌍 For international patients: This page covers cost (TRY/€/£), eligibility, the procedure step-by-step, recovery timeline, the 2-3 day visit logistics, and how to send your photos for a written estimate. See also our Dental Tourism Istanbul guide for travel and accommodation logistics.

What Is Bichectomy? (Anatomy)

Bichectomy is the partial surgical removal of the buccal fat pad of Bichat — a capsulated fat tissue inside each cheek, located between the chewing muscles. First described by French anatomist Marie François Xavier Bichat in 1801. In an adult, each cheek's buccal fat pad has approximately 8–10 cc volume.

Function:

Supports sucking reflex in infancy
Cushions chewing muscles from mechanical stress
Provides natural cheek fullness

Aesthetic effect:

Round face contour → "baby face" appearance
Excessive cheek fullness → wider face
Asymmetry can occur unilaterally

In bichectomy, only the lower portion (1.5–3 cc per side) is removed — never the entire pad. Total removal can lead to gaunt face in later years; conservative removal is the surgical standard.

Why Choose Istanbul for Bichectomy?

Three reasons international patients select Istanbul over the UK or Germany:

Cost saving 70–80%: UK private bichectomy is £3,500–6,000; in Istanbul £700–1,510 — without compromising surgeon qualification or sterile standards.
Surgeon-led care: Our clinic is led by an Oral & Maxillofacial Surgeon — not a cosmetic-only operator. Bichectomy involves anatomy near the facial artery branches, parotid duct (Stensen's), and buccal branch of the facial nerve; surgeon training matters for safety.
Single 2-3 day visit: Unlike full-mouth dental work, bichectomy needs only one short trip. Consultation + surgery on Day 1, post-op check on Day 2-3, fly home.

Cost Comparison — Turkey vs UK / Germany / Switzerland

Approximate prices for bilateral bichectomy (both cheeks), May 2026:

Country	Standard Bichectomy	Premium / Complex Case
🇹🇷 Turkey (Istanbul)	£700–1,125 / €820–1,310	£1,125–1,510 / €1,310–1,755
🇬🇧 United Kingdom (private)	£3,500–4,500	£4,500–6,000
🇩🇪 Germany	€3,000–4,500	€4,500–6,500
🇨🇭 Switzerland	CHF 5,000–7,000	CHF 7,000–9,500
🇳🇱 Netherlands	€2,500–4,000	€4,000–5,500

🌍 EUR / GBP equivalents are based on the May 2026 exchange rate. We provide a written estimate in your preferred currency, fixed for 60 days.

Who Is a Suitable Candidate?

Bichectomy is most effective for patients with anatomical cheek fullness (not weight-related fat).

Ideal candidate profile:

Age 25–40
Healthy, non-smoker
Body Mass Index (BMI) 20–27 kg/m²
Not slimmed down through weight loss; cheek volume is anatomical
Round or square face shape
Palpable Bichat fat pad on clinical examination
Realistic expectations

Not suitable for:

Under 25: Face still maturing, high risk of sunken cheek later
Over 45: Natural cheek volume already reduced; procedure may worsen appearance
BMI <20 (underweight): Insufficient fat pad; over-hollowing risk
Smokers: Healing impaired, infection risk 3x higher
Uncontrolled diabetes (HbA1c >8%): Slow wound healing
Bleeding disorders: Haemophilia, anticoagulant use
Body dysmorphic disorder (BDD): Psychological contraindication
Pregnancy / breastfeeding: Procedure deferred
Active gum infection: Periodontal treatment first

💡 Surgeon's note: During consultation we perform a "cheek suck-in test" — if the buccal fat pad is palpable when the patient draws cheeks inward, the procedure is meaningful. If the pad already feels minimal, surgery may worsen appearance. Alternative options: masseter botox (for muscle-driven jawline) or cheek liposuction (for true subcutaneous fat).

How Bichectomy Is Performed — Step by Step

Bichectomy is an outpatient procedure under local anaesthesia. No overnight hospital stay required.

1. Consultation and Planning (45–60 minutes)

Facial analysis (front, side, smiling photos)
"Cheek suck-in test" for fat pad palpation
BMI and systemic health review
Realistic expectation discussion
Optional 2D simulation

2. Surgical Preparation (15 minutes)

Antiseptic mouth rinse (chlorhexidine)
Marking 2 mm above the upper molar region
Local anaesthesia (articaine + epinephrine) inside the cheek

3. Incision (5 minutes)

A 1–1.5 cm incision in the buccal mucosa at the level of the upper molars. No external skin incision — no facial scar.

4. Buccal Fat Pad Identification (5–10 minutes)

Capsule below mucosa is dissected; the Bichat fat pad appears yellowish, lobular.

5. Conservative Removal (10–15 minutes)

1.5–3 cc per side is excised
Careful vessel coagulation (bleeding control)
Never the entire pad (gaunt face prevention)
Symmetrical amount on both sides

6. Suturing and Closure (5–10 minutes)

Resorbable or non-resorbable sutures
Typically 2–3 stitches per side
Resorbable sutures eliminate stitch-removal visit

7. Post-op Briefing (10 minutes)

Cold compress instructions
Prescription: pain relief, antibiotic, chlorhexidine rinse
Soft food guidelines
Follow-up appointment in 1 week (or remote check for international patients)

Total duration: 30–60 minutes

💬 Dr. Aykut Gürel: "Bichectomy looks deceptively simple, but the buccal fat pad sits adjacent to facial artery branches, the parotid (Stensen's) duct, and the buccal branch of the facial nerve. Anatomical knowledge and meticulous dissection are essential — which is why I strongly recommend an oral & maxillofacial surgeon for this procedure."

Recovery Timeline

Period	What to Expect
0–24 hours	Mild swelling, cold compress, soft/liquid diet, anaesthesia wears off
2–3 days	Peak swelling, tenderness, pain manageable with prescription, chlorhexidine rinse
4–7 days	Swelling reduced ~50%, normal activity possible, return to office
7–14 days	Swelling reduced ~80%, sutures dissolve or are removed, full social activity
2–4 weeks	Visible result emerging, jawline contour clarifying
2–3 months	Final result — facial contour stable, tissue fully settled
6+ months	Permanent — fat pad does not regenerate

💡 Recovery tip: For the first 48 hours, sleep with head elevated (2 pillows) to reduce swelling. Avoid hot showers, sauna, and intense exercise for 2 weeks.

International Patient Visit — 2-3 Day Plan

Day	Activity
Day 1	Airport arrival → hotel check-in (rest)
Day 1–2	Consultation + facial analysis + photo + simulation
Day 2	Surgery (30–60 min) → 4-6 h rest at hotel → soft diet
Day 3	Post-op check (15 min) + suture verification + final instructions → fly home
Days 4–14 (at home)	Recovery, swelling resolution; remote WhatsApp follow-up with surgeon
Month 2–3	Optional video consult to review final result

Many international patients combine the visit with a short Istanbul holiday — the city's historical sights and Bosphorus tour are accessible from the Maltepe district.

What's Included for International Patients

✅ Pre-travel WhatsApp consultation + written estimate (EUR/GBP)
✅ Facial analysis + 2D simulation
✅ Surgery (bilateral bichectomy)
✅ Local anaesthesia + medications
✅ Post-operative prescription (pain relief, antibiotic, mouthwash)
✅ Follow-up check on Day 2-3
✅ English-Turkish translation throughout the visit
✅ Airport pickup and clinic transfers (on request)
✅ Hotel booking assistance (partner hotels at preferred rates)
✅ Written invoice in English compatible with private health insurance reimbursement
✅ 6-month remote follow-up via WhatsApp

Not included: flights, hotel costs, optional cheek liposuction (priced separately if combined).

Realistic Expectations — Before vs After

What to expect:

5–15% slimmer face contour — particularly at the lower face
More defined jawline (V-shape) — the main effect, not "thinner cheeks"
Subtle, natural look — not dramatic
Permanent result — fat pad does not regenerate

What NOT to expect:

Dramatic face change — bichectomy refines, doesn't reshape
Quick result — first week swelling can give the opposite impression; true result at 2-3 months
Replacement for facelift — different procedures, different goals
Bone shape change — only soft tissue is affected; for bone restructuring see orthognathic / jaw surgery

Before/After Photos

Per Turkish privacy law (KVKK) and clinical ethics, individual patient before/after photos are not published online. During in-clinic consultation we share photos with prior patient consent.

Risks and Complications

Like any surgery, bichectomy has rare but real risks. Transparency:

Risk	Frequency	Notes
Mild swelling (1–2 weeks)	>95%	Expected, manageable
Bruising	30–40%	Resolves in 7–14 days
Asymmetry (mild, transient)	10–15%	Resolves with full healing
Infection	1–3%	Antibiotic prophylaxis reduces risk
Persistent asymmetry	<2%	May require minor revision
Facial nerve buccal branch injury (transient)	<1%	Usually self-resolving
Parotid (Stensen's) duct injury	Very rare	Surgeon-skill dependent
Excessive removal (gaunt face)	Very rare	Conservative approach prevents
Haematoma	<1%	Drainage required if significant

⚠️ Surgical disclaimer: All surgery carries risk. No guarantees can be provided. Only undertake bichectomy after qualified medical assessment with realistic expectations.

Bichectomy vs Other Facial Slimming Options

Procedure	Mechanism	Result	Permanence	Cost (Istanbul)
Bichectomy	Surgical fat pad removal	Subtle V-shape, slimmer lower face	Permanent	£700–1,510
Masseter Botox	Chemical muscle relaxation	Square jaw → softer	3–6 months (reversible)	£180–340
Cheek liposuction	Subcutaneous fat removal	Slimmer mid-face	Permanent (if no weight gain)	£900–1,800
Facelift	Skin tightening	Younger, lifted	5–10 years	£4,000–8,000
Filler dissolving	Hyaluronidase enzyme	Removes prior filler	Days–weeks	£180–410

💡 Combination: Some patients benefit from bichectomy + masseter botox at the same visit — fat removal slims the cheek, botox reduces jawline muscle bulk. Multidisciplinary approach.

Academic References

The clinical information in this guide is based on the following independent academic sources:

Yousuf S, Tubbs RS, Wartmann CT, et al. A review of the gross anatomy, functions, pathology, and clinical uses of the buccal fat pad. Surgical and Radiologic Anatomy, 2010. https://pubmed.ncbi.nlm.nih.gov/20309517/
Stuzin JM, Wagstrom L, Kawamoto HK, et al. The anatomy and clinical applications of the buccal fat pad. Plastic and Reconstructive Surgery, 1990. https://pubmed.ncbi.nlm.nih.gov/2293737/
Sezgin B, Tatar S, Boge M, et al. The excision of the buccal fat pad for cheek refinement: volumetric considerations. Aesthetic Plastic Surgery, 2019. https://pubmed.ncbi.nlm.nih.gov/31144024/
Hwang K, Cho HJ, Battuvshin D, et al. Interrelated buccal fat pad with facial buccal branches and parotid duct. Journal of Craniofacial Surgery, 2005. https://pubmed.ncbi.nlm.nih.gov/16148653/

Book a consultation by sending photos via WhatsApp or email. We provide a written estimate within 24–48 hours. International patients welcome.