Complications associated with bichectomy surgery: a literature review

The buccal fat pad also known as Bichat's fat pad has the same histological characteristics as fats located in other regions of the body, however, its particularity is the wrapping of a fibrous capsule that prevents it from being metabolized. Bichectomy is the surgical procedure that partially removes oral fat, consequently it is possible to observe the volumetric reduction of the lower third of the face and the definition of contours and angulations, making the face esthetically pleasing. However, this procedure is related to several potentially serious complications in the postoperative period due to the surgical technique.

A bibliographic search was carried out based on scientific articles, published in English and Portuguese, between 2015 and 2019. The search was carried through the electronic databases PubMed, SciELO, Medline, Bireme and Lilacs with the keywords "bichectomy," "buccal fat pad," "buccal adipose tissue" and "bichectomy and complications." Were included articles that reported the postoperative period and complications.

The anatomical knowledge of this region is essential to avoid iatrogenesis in surgical procedures, which can result in temporary or permanent sequelae. Among the complications of greater complexity in bichectomy there are: trismus, hemorrhages, facial infections, lesion of the duct of the parotid gland and facial paralysis, however common complications that are related to any surgical procedure can occur, such as edema and hematoma, despite being considered a technically simple procedure.

Bichectomy is a quick and technically simple esthetic-functional procedure, but it presents unpredictable risks of potentially serious complications.