Comparative between Buccal and Vestibular Approaches for Bichectomies

Abstract

Introduction: Bichectomy is the name given to the surgical procedure that has the objective of removes the adipose body fat of the cheek, eliminating the portion corresponding to the “Bichat” fat pad, which includes around 30 to 40% of this structure. This procedure delivers as a result the reduction of the volume in the middle third of the face. And we use this technique as a good option to analyze and compare. Objectives: To analyze and compare which is the best and easiest approach for buccal fat removal between Buccal and Vestibular. Material and methods: A prospective study was carried out in the Service of Plastic Surgery of the General Hospital of Mexico, during a period of 1 year of evaluation. In an universe of 57 patients, comparing the easiest surgical approach during the plastic surgery formation, all the surgeons where residents between second to fourth year, the evaluation time, oedema, bleeding, post-surgical pain, and the comparison among buccal an vestibular approach. Results: 57 patients were analyzed, independent variables where buccal and vestibular approaches. The most common complication was oedema in 56%, bleeding in 3.5%, with Vestibular approach in 64.9%, and buccal 35.98%, the minor time were 10 minutes, and the mayor time were 35 minutes, so the best approach was vestibular by less soreness, pain, and bleeding, during the plastic surgery residency. Discussion: The bichectomy has an important historical antecedent since in the beginning it was a surgery even without importance in the medical field. The removal of Bichat fat currently has more aesthetic than reconstructive purposes. Conclusions: The best approach to have less complications during the plastic surgery formation is the vestibular, even it was a second or a fourth year plastic surgery resident, and one of the concepts if when you use the same approach your skill fullness improve.