Buccal fat removal in Lima, Peru: a more defined facial contour, with medical judgment

Buccal fat removal, known in Spanish as bichectomía, is a minor surgery that partially removes the buccal fat pads (in Spanish, bolsas de Bichat). These are deep pockets of fat that fill the cheek area, sitting between the chewing muscles. By reducing that volume in a measured way, the mid-face is slimmed and the appearance of the cheekbones and jawline is enhanced — what many call the "contour effect".

It is not a surgery to "make the whole face thinner" in a broad sense, nor a substitute for weight loss. Its goal is very specific: to sculpt the contour in people who have a genuine excess of cheek volume and want a slightly more defined face. In the right hands, the change is subtle and harmonious; your face still looks like you, just with a sharper transition between the cheek and the cheekbone.

At Elyzea, buccal fat removal is performed by Dr. Geldres, plastic surgeon, in our own certified operating suite in Miraflores. It is important to understand from the start that this is an irreversible procedure: the fat that is removed does not come back. That is why our philosophy is conservative, and the decision to operate — or not to — is made with medical judgment, never because of a trend.

When the indication is correct and the removal is measured, buccal fat removal offers concrete advantages:

• No external scar. The intraoral incision leaves no visible marks on the skin of the face.
• Contour definition. It slims the mid-face and enhances the appearance of the cheekbones and jawline.
• Short, outpatient procedure. It is performed under local anesthesia in about 30 to 45 minutes, with no hospital stay.
• Generally manageable recovery. Most people return to their activities within a few days, with simple care.
• Permanent result. Because the fat is removed for good, the contour change is lasting.
• Option for combined planning. When it makes sense, the contour can be complemented with aesthetic-medicine treatments within the same clinic.

The last point deserves a caveat that is also its main demand: because the effect is permanent, every benefit depends on the removed amount being right for your face. A result that looks beautiful at 30 should still look good at 45, when the face naturally loses volume. For that reason, at Elyzea we prefer to remove too little rather than too much.

This is the most important part of all this information, and the one we must explain most honestly: buccal fat removal is not for everyone. In many cases, the most professional recommendation is not to operate. Dr. Geldres advises against buccal fat removal in situations such as:

• Already slim or narrow faces. If the face is thin or long, removing fat adds no contour and can create a hollow, unhealthy look. In these cases the usual advice is not to do it.
• Concern about aging. Over the years, the face naturally loses fat and volume. A cheek that looks "full" today may be the reserve that keeps a youthful appearance tomorrow. Removing too much can bring forward and accentuate the gaunt look of aging.
• Expectations of major facial slimming. Anyone seeking a dramatic change, or who believes this surgery "slims the whole face", usually ends up disappointed. The effect is localized and moderate.
• Requests for aggressive removal. Asking to remove "all" of the buccal fat pad is a common mistake. Excessive removal cannot be undone and is a frequent cause of regret.
• Uncontrolled medical or oral conditions, relevant systemic diseases, or significant smoking without willingness to stop.

We stress the irreversible nature of the procedure: removed fat cannot easily be replaced. Restoring volume later requires other treatments, with results that do not always match the natural look. For that reason, if your case is not clearly favorable, at Elyzea we prefer to tell you frankly rather than operate. Saying "no" when appropriate is also part of good medical care.

Buccal fat removal is usually performed under local anesthesia. The inside of the cheek is fully numbed, so you stay awake, comfortable and pain-free during the procedure. Because it is local and outpatient, it avoids the risks associated with general anesthesia and lets you go home the same day.

One thing that sets us apart: your surgery is performed in Elyzea's own certified operating suite, inside the same Miraflores building that houses our aesthetic-medicine unit. We do not refer you elsewhere. This means sterile instruments, safety protocols and monitoring under our direct control, and a continuity of care from the consultation through to post-operative follow-up.

Safety also lies in judgment. The proximity of the buccal fat pad to delicate facial structures means the technique must be precise and the removal conservative. Dr. Geldres, plastic surgeon, operates respecting those margins. Please do not confuse the professionals: the surgery is performed by Dr. Geldres, while the clinic's aesthetic medicine is led by Dra. Geldres.

The result of buccal fat removal is gradual. It is not seen immediately, because the swelling of the first days masks the change. As the swelling subsides over the following weeks, the contour reveals itself, and the final appearance is usually appreciated once the swelling has fully resolved, over the course of several weeks to a few months depending on each person.

It is important to calibrate what you can expect:

• The change is subtle and harmonious, not a transformation. It slims the mid-face and favors definition while keeping your features.
• Results vary from one person to another depending on bone structure, the amount of fat removed and how the tissues respond. We do not promise a specific result.
• Because it is permanent, it is best to think of the result over the long term, bearing in mind that the face will keep maturing with age.
• The conservative approach aims for a contour that ages well, rather than a marked slimming that may look excessive over time.

If you want to better understand who gets the best results and why, we recommend reading our blog guide on buccal fat removal candidates and results. And if your goal is to define the contour without surgery, it is worth exploring the facial contouring options we offer.