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Removal of Bisha lumps

Lumps of Bisha are small encapsulated fat formations that are located between the buccal muscle and the superficial muscles of the face, placed directly under the cheekbone. They have functional significance only in infancy, as they are responsible for the process of sucking milk by forming negative pressure. Throughout life, they are subject to significant reverse development. Bisha lumps provide gliding muscles during chewing, facilitating it and protecting the delicate muscles of the face from injury. In conscious age, the significance of this function is lost, leaving behind only the swelling of the cheeks. Their peculiarity lies in the fact that neither losing weight nor playing sports, face lifting and injections can reduce them.

A neatly oval face, sharp cheekbones, sunken cheeks have always been an ideal of beauty. And with age, Bisha’s lumps begin to sag, forming the so-called “bulldog cheeks”.

Removal of Bisha lumps (bichectomy) is a minimally invasive plastic surgery to reduce the volume of the cheeks (Bisha fat accumulations) and to model the relief of the cheekbones. The technique of execution allows you to avoid scars on the skin and re-conducting the operation since even with weight gain, Bisha’s lumps do not reappear.

Indications for bichectomy:

– excess body fat on the cheeks, including after losing weight;

– congenital excess fat on the cheeks;

– age-related drooping of the cheeks, the formation of nasolabial folds and wrinkles;

– as an additional correction technique in plastic surgery;

– to move adipose tissue into the cheekbones to create volume.

What is the expected result?

– Reduced cheek volume

– Cheekbone formation

– Cheek lift

– The angle of the lower jaw becomes more defined

Contraindications to bichectomy:

– Oncology;

– Diabetes;

– Infectious diseases;

– Pregnancy or lactation;

– Autoimmune disease in the acute phase;

– Some dermatological diseases;

– Chronic diseases inactive form;

– Blood coagulation disorders;

– Significant fluctuations in body weight;

– Plans to increase or decrease weight in the future.

To begin with, you need to consult with your doctor to detect possible contraindications. During the consultation, it is necessary to warn the doctor about taking any medications, even if it is just vitamins, the presence of allergies and other diseases. Before the operation, the surgeon evaluates the degree of excess adipose tissue in the cheek area and the rationality of this operation, discusses the wishes of the patient, the doctor explains the extent to which they can be realised during the operation.

A prerequisite is passing of instrumental and laboratory examinations, which include:

– Complete blood count and urinalysis

– Blood glucose

– Blood type and Rh factor.

– Coagulation tests, coagulability, INR, PTI, APTTV

– Biochemical blood test (bilirubin, ALT, AST, total protein, urea, creatinine, C-reactive protein, liver tests, electrolytes (potassium, sodium, calcium))

– Blood test for HbsAg (viral hepatitis B)

– Total HCV antibodies (viral hepatitis C)

– Blood test for HIV and RW

– Electrocardiogram

– Consultation of GP

– Fluorography or chest X-ray results

How is the operation performed?

It is possible to get rid of Bisha lumps only with the help of surgical intervention. The operation can be performed both under local anesthesia and under general anesthesia. A small incision is made on the inner surface of the cheeks along the mucous membrane, 1-2 cm long. The tissues are moved apart with the help of thin instruments, fatty formations are removed, blood vessels are coagulated and an internal cosmetic suture is applied. After the operation of Bisha lumps removal, there are no signs of surgery on the face. How much tissue needs to be removed is determined by the individual characteristics of the face. If the face itself is thin, then the adipose tissue simply spreads over the surface. It is worthwhile to warn patients with severe thinness of the fact that, in some time, it can skeletonise – that is, it does not look very good after several years after the operation. In some cases, adipose tissue is not completely removed, but, for example, is moved to a higher position. Such an operation is often combined with an endoscopic lift of the midface. This surgical tactic allows, on one hand, to fill the lack of volume in the cheekbones, on the other hand, to preserve the fat cells necessary to maintain skin tonus.

The duration of the operation of Bisha lumps removal is 40 minutes.

What is rehabilitation after surgery like?

During the first 5 days, a slight swelling in the cheek area may be observed.

Pain sensations practically do not bother patients, with except for rare cases in which they are stopped by painkillers

During the first 10 days, one should avoid active conversations and facial expressions.

First time after surgery, it is recommended to eat liquid food and use an antibacterial dental gel.

Sutures are removed after 7-10 days, depending on the individual characteristics of the body.