Removal lumps of Bisha

Bisha lumps are a fatty body that is located below the cheekbone, between the skin of the face and the mucous cheek. These lumps, located between chewing and buccal muscles, form an additional volume of the lower part of the face.

This surgery is often necessary for patients, who did not manage to lose weight naturally. Usually, stored fat from the face disappear very slowly and even having achieved a slim figure you still can have excessively plump cheeks. No less important is the removal of fatty lumps for people whose skin tone and facial muscles got weakened with aging. This leads to sagging and the formation of "flews" – non-aesthetic folds falling on both sides of the lower jaw.

What Are Lumps of Bisha?

Fatty tissue in the cheeks is called lumps of Bisha, named after the French anatomist, who first described their characteristics and attributes. They perform two main functions in the body:

  • facilitate the process of suckling for infants (therefore practically all children have such plump cheeks);
  • ensure a smooth glide of the chewing and buccinator muscles during eating, and also protect them from possible external injuries.

With age, there is no longer need in lumps; they gradually decrease in size. If being more precise - they do not grow comparing with the development of other tissues. Baby fat disappears from the face, dimples appear, the cheekbones are getting more distinct.

Indications for surgery to remove Bish's lumps

Fat deposits under the cheeks can cause patients only an aesthetic discomfort. From a medical point of view they are not a pathology, regardless of size and shape. As a rule, they are removed, reduced or moved in such cases:

  1. there is obvious fat excess on the cheeks;
  2. a patient initially has got a round-shaped face enhanced by fat deposits;
  3. with age, cheeks have dropped, "flews" have formed and nasolabial folds have deepened;
  4. other aesthetically justified prerequisites to reduce the volume of cheekbones and cheeks.

It is important to realize that when excising lumps it is impossible to form an absolutely new face oval - however, it is possible to significantly correct its lower part, visually rejuvenate and smooth.

How is Removal Of Lumps of Bisha Conducted?

The procedure can be performed under both general and local anesthesia.  The choice of the method of anesthesia remains at the discretion of the doctor. The surgeon performs a small (1-2 cm) incision on the inner surface of the cheeks, through which he accesses fat excess. The amount of remove is determined depending on the patient’s wishes and the features of the face shape.

In some cases, fat is not extracted, but moves to the area of ​​the cheekbones to create their extra volume. After completing all the planned activities, the incision on the inside of the cheek is sutured with a cosmetic suture.

The rehabilitation period is rather short.

The patient has the surgery and can go home, all on the same day, just after recovering from anesthesia. The tissue swell on the face remains for 2-3 days, and thus, visually, the cheeks look even wider than they were before. Sutures (if not using bioresorbable material) are removed after 5-8 days.

As well as after any kind of surgery, patients will need to avoid physical loading for 2-3 weeks, also avoiding sauna and staying in baths for a long. Additionally, at this time it is not recommended to give an unnecessary burden directly on the face muscles (curve, laugh, cry, etc.). The patient will have to sleep on a high pillow to avoid edema, and mainly in back position not accidentally injuring the corrected areas.

Specific requirements after removal of the lumps of Bisha are applied to the patient's diet: the first 3 days the liquid diet is prescribed; for the next 2-3 weeks it is necessary to avoid solid foods that need to be chewed with a lot of effort. All food should be moderate temperature - nothing hot or cold. After each meal, the oral cavity should be thoroughly rinsed and, if possible, the teeth must be brushed. Additionally, the doctor will prescribe a course of antibiotics or alternatives to them to avoid inflammation on the internal tissues of the face.

Results evaluation of the surgery will be possible in a couple of weeks, when the swelling comes down, and the final form of the face will be acquired within 2-3 months, after complete healing and setting down of tissues.

Contraindications and possible complications

Fat removal from cheeks is not recommended for patients whose body weight deviates significantly from the norm to a greater or lesser extent; also, if it is planned to significantly reduce or remove it. Like any other kind of plastic surgery, removal of the lumps of Bisha must be done after weight stabilizing. In addition, there are other general surgical contraindications: clotting problem, infectious diseases, exacerbations of chronic diseases, etc.

Also, it is not recommended to perform plastic surgery under the age of 25, because until this age the natural decrease in fat layer thickness continues, and the previously operated face may appear to be thin or haggard - and it will be very difficult to restore the lost fat volume.

The probability of complications is minimal. In rare cases, the development of the inflammatory process on the internal tissues of the cheeks is possible. This may occur if the patient initially had hot spots of inflammation or soft tissues of the mucosa were injured (for example, involuntarily during sleep, playing sports or chewing solid food).