In the list of services offered by plastic surgery clinics, or in real reviews of plastic surgery, one can now increasingly find mention of such an intervention as the removal of Bisha's lumps. The increasingly popular operation is one of the most controversial procedures in plastic surgery and causes a lot of controversy among both patients and surgeons. In this article we will try to explain what Bisha's lumps are, what are the advantages and disadvantages of surgery to remove them, and when you should seek the help of plastic surgeons.
What are Bisha's lumps?
Even the slenderest and fittest people have encapsulated fat cells near the duct of the parotid salivary gland and between the superficial (external) and masticatory muscles of the face. These are the so-called “Bisha lumps”. They are formed at the initial stage of a baby’s life. The main purpose of the lumps is to make it easier for the baby to suck milk from the mother's breast or bottle, and also to protect the facial muscles from injury.
As a person ages and grows, Bish's lumps lose their original purpose and become just an aesthetic detail that gives the face a certain roundness. However, not everyone likes such roundness. The size of Bisha's lumps varies from person to person, so for some, due to the presence of lumps, the face may have excess volume in the lower part of the face and emphasize folds and wrinkles in the nasolabial part.
What tests need to be done?
- Analysis for blood group, Rh factor.
- Clinical blood test and blood platelet test
- Coagulogram.
- Analysis for total protein, bilirubin, urea, blood sugar.
- ALT, AST, hematocrit.
- Clinical urine analysis.
- Fluorography.
- ECG with conclusion.
- RW, HIV.
- Hepatitis B and C.
You also need to get a therapist’s opinion to make sure there are no individual contraindications.
What does removal surgery do?
With surgical removal of Bisha's lumps, the lower third of the face becomes less massive, and the oval of the face becomes more aristocratic. Most often, after removal of lumps, the zygomatic part of the face is emphasized, and a slight characteristic depression of the cheeks appears, but not in all patients.
The most noticeable result of the operation will be in the following cases:
- absence of obvious signs of age,
- round face shape,
- a thin layer of fatty tissue in the facial area.
Many people unreasonably believe that bischectomy leads to unsatisfactory changes in appearance. Among the counterarguments to the operation are such consequences as sunken cheeks, asymmetry, deterioration in the aesthetics of facial features with age, etc. But it is worth noting that such results are only possible in the case of an unsuccessfully chosen clinic and insufficient qualifications of the surgeon. Otherwise, despite the debate about the advisability of such an operation, in general we can safely say that the removal of Bish’s lumps changes the proportions of the face for the better, making the face visually thinner, with clearly defined features. Many Hollywood and domestic celebrities have resorted and continue to resort to bischectomy. A well-performed operation can only improve aesthetics, but not spoil the appearance.
Removal of Bisha's lumps - indications and contraindications
Changing the shape of the face is a purely individual intention. Despite the visual roundness of the cheeks, this is not a pathology. Therefore, the decision to undergo surgery to remove excess fat deposits is only the result of an individual desire for aesthetic correction. Indications for its implementation may include:
- increased swelling of the cheeks;
- age-related transformations, expressed in their sagging;
- manipulations included in the range of plastic surgery services.
In some cases, such a correction is strictly contraindicated and impossible. The category of persons forced to refuse this medical service includes those who:
- susceptible to acute respiratory infections and weakened immunity;
- suffers from hemophilia and diabetes;
- has chronic liver disease;
- has a flexible body weight (periodically gains weight sharply or, conversely, loses weight) or plans to correct it in the very near future;
- have not reached 25 years (before reaching this age level, adipose tissue has the ability to decrease on its own).
- Specifics of cosmetic correction
Removal of Bisha's lumps can occur in two ways - internal access with a cheek incision of up to 2 centimeters, tightening and extraction of excess fatty tissue, and external access, which is characterized by manipulation using endoscopic equipment. In the first case, upon completion of facial correction, which takes place under local anesthesia for about half an hour, absorbable sutures are applied. In rare cases, at the request of the client, general intravenous anesthesia is additionally performed.
How is the operation performed?
Removal of Bisha's lumps is carried out under local anesthesia, through a microscopic incision of 0.7 cm in the mucous membrane of the inner side of the cheek. After removing the lumps, the surgeon applies absorbable sutures that do not require subsequent removal.
The postoperative rehabilitation period is quite short. According to the surgeon’s instructions, the patient follows a “liquid” diet with a certain temperature regime for some time until complete healing. A slight swelling goes away within 5-7 days. For the first month or month and a half, it is not recommended to eat spicy or rough foods, which can irritate the injured area. The first results of a bichectomy become noticeable a week after the operation, when the swelling disappears from the face. But the final result of the operation is summed up 4-5 months after the procedure, since by this time the restructuring of the facial muscular system and the change in skin tone are completed.
Rehabilitation after surgery
Our mucous membrane is very well supplied with blood, so wound healing occurs within 2-3 days. However, for several days after the operation, swelling and soreness may occur, which is why the cheeks and face as a whole may appear even larger than before the operation, these phenomena disappear on their own within 5-7 days, in some cases the swelling can last up to 10 days. 14 days.
To ensure the postoperative period goes smoothly, follow these simple rules for 3 weeks:
- sleep on your back with the head of the bed elevated, this will help relieve swelling
- do not eat solid food, so as not to engage the chewing muscles of the face; food should not be hot or cold;
- rinse your mouth with an antiseptic during the day (5-8 times a day) and especially after meals;
- eat liquid or semi-liquid food;
- give up salty foods, alcohol, smoking and visiting the sauna;
Are there any contraindications?
Restrictions on performing a bichectomy correspond to standard restrictions on any other surgical procedure. The operation is not performed if the patient:
- has diabetes
- has an inflammatory process in the tissues of the operated area,
- suffers from an infectious disease,
- is in the acute stage of a chronic disease,
- has problems with the functioning of the blood coagulation system,
- suffers from mental disorders or epileptic seizures.
It is also considered not very advisable to have surgery before the age of 25, since during this period facial features are still changing, in particular, volume is lost from the lower facial area. Therefore, surgery may not be necessary. The intervention is not recommended for very fat or very thin people, as well as for patients who have or are planning serious fluctuations in body weight.
Contraindications for removal.
Like other plastic surgeries, resection of Bisha's lumps is not performed in the following cases:
- Chronic cardiovascular diseases.
- Diabetes mellitus.
- Oncological diseases.
- Disorders of blood clotting processes.
- Excess weight.
- Significant (about 25%) underweight.
- Systemic diseases.
- Epilepsy.
- Mental illnesses.
- Colds.
- If you plan to dramatically reduce or increase weight.
- Diseases of the immune system.
- Any inflammation in the face, neck and mouth.
How to choose a clinic for removing Bisha's lumps?
An operation of this kind should be performed exclusively by a highly qualified surgeon with extensive experience in maxillofacial plastic surgery. The procedure itself is quite simple, but the incompetence of the doctor can jeopardize the patient's condition. Due to errors coupled with insufficient experience, complications can arise even after such a basic procedure - damage to the nervous structure, infection, unsatisfactory aesthetic results, and the like.
Therefore, preference should be given exclusively to experienced professionals and proven clinics with good modern equipment. At the Osnova plastic surgery clinic, surgery to remove Bisha's lumps is performed by highly qualified maxillofacial surgeons with extensive practical experience. Our specialists have the medical education necessary to perform such operations and supporting documents. Modern equipment of operating rooms allows us to guarantee patient safety and excellent aesthetic results of the operation. In the “before/after” photo gallery you can clearly evaluate the results of our surgeons’ work and decide on the advisability of the operation.
Why shouldn't you remove Bish's lumps? Advice from an experienced doctor
There are different opinions, including among doctors, about whether it is worth removing Bisha's lumps - the procedure has become quite popular recently. Plastic surgeon Alexander Vdovin discusses possible contraindications.
Let's go in order. If a patient aged 35-45 comes to me for a consultation and I see that she has slightly chubby cheeks, I directly tell her that this makes her look younger. Yes, everyone loves the faces of female models with perfectly defined cheekbones, because they are beautiful. However, one should not confuse natural characteristics with a person who has undergone surgery. Very often, sunken cheeks made artificially make you look older.
This operation is also not supported by the fact that the girls who had it done about 10 years ago today look painful and tired. It's all about hormonal changes that are inevitable with age. The associated deformation of Bisha's lumps is considered a normal process, but if they are removed, then visually this becomes even more noticeable. Therefore, the lower part of the face looks larger, which in no way makes its owner more graceful and beautiful.
Almost any operation to remove Bisha's lumps has irreversible consequences, and no plastic surgery techniques will help here. So, if the doctor operating on you wants to inject a certain drug into the area of the masticatory muscles, he will be faced with the fact that the latter will resolve. With implants it is even more difficult, since there will be nothing to secure them to.
Very often I hear that the popularity of this procedure is caused by the desire to follow fashion. Many years ago, fans of the film “Ghost” wanted to look like the main character and went in orderly rows to remove Bish’s lumps. Over time, new heroes and role models appeared, looking at whom modern girls want to be like them. And it’s not a fact that after some time the interest in the idol will fade away, but the results of the operation will remain. It's good if it doesn't cause emotional distress.
In fact, a good surgeon can always offer other methods for changing the shape of the face. Why are fillers bad? With their help, the volume of the cheekbones can be increased. But when the patient’s lump has become deformed, it would be more correct not to remove it completely, but to slightly change its shape and lift it. Not only will this give a good lifting effect, but the face will also have a natural volume.
Speaking about contraindications, one cannot fail to mention the rehabilitation period, which can last more than one day. And all this time you must wear a bandage. In this regard, fillers have another advantage, since immediately after their installation, the patient can go home. But it's not just about the bandage. After Bisha, a scar forms on the mucous membrane of the cheek, which causes discomfort, which resolves completely within 5-6 months. The removal of lumps itself is done under general anesthesia, the consequences of which may not be the most positive. Yes, to avoid them, before the operation the patient undergoes all the necessary tests, but the human body is a complex system, sometimes unpredictable. We cannot exclude the exacerbation of chronic diseases, the appearance of weather dependence, not to mention the heavy load on the heart muscle.
