What are Bisha's lumps: Pros and cons of removing them. Photos before and after surgery

Chubby cheeks are not included in modern fashion canons and do not evoke the cute image of baby dolls. Many women set a goal - to remove “hateful lumps” by any means.

The operation to remove Bisha's pouches - those same fatty bags left over from birth and supposedly forming excessive roundness of the cheeks and lower third of the face - has gained widespread popularity.

In the article we will discuss what rehabilitation rules should not be neglected after removing Bisha's lumps, as well as what complications you may encounter.

The procedure for removing Bisha's fat bags is very short in duration and is therefore considered simple by many. Also, some plastic surgeons are somewhat disingenuous when they call rehabilitation simple, but generally keep silent about complications.

After surgery - removal of Bisha's lumps:

Discharge from the clinic takes place on the day of the operation, a couple of hours later - under local anesthesia. General anesthesia most often involves discharge the next day after surgery.
It is better to take a week's vacation for the initial rehabilitation period.
Do not try to check or feel the postoperative sutures with your fingers.- you may get an infection or accidentally damage the stitches.
It is necessary to take the prescribed antibiotic and other medications, even if you don’t feel like it, as there is a risk of infection after surgery.
Wear a compression mask as prescribed by your doctor.
Food for 5-7 days should be liquid, pureed or grated, without dense ingredients. Large, hard pieces of food can cause the seams to come apart. The temperature of the food should be warm so as not to cause additional trauma to the oral cavity.
After each meal - rinse your mouth (for a week). It is important to rinse your mouth gently - rolling the water, without straining your muscles. As a rule, the doctor prescribes an additional rinse as a final mouth rinse.
Brushing your teeth - movements are smooth, no rapid friction, so as not to damage the seams and not cause additional discomfort. In the recommendations of some surgeons, you can find a ban on brushing your teeth (for a short period); removing plaque and food particles is done only by rinsing your mouth.
After removing Bisha's lumps, you need to sleep on your back; you can slightly raise the pillow (with an inclination angle of 30 degrees) to minimize postoperative swelling there is. Also, when sleeping on your back, there is no pressure on the muscles and nerves, which are no longer “hidden” by the fat pack.
For several days after removing Bisha's lumps, you should minimize active facial expressions - laughter, hyperactive facial expressions, screaming and singing, attempts to retract swollen cheeks and other activities on the face.
Alcoholic drinks of any strength and smoking are prohibited for at least two weeks, as they suppress regeneration processes during recovery. Also, alcoholic drinks can cause severe swelling and hyperemia.
Sports training, visiting the gym, Pilates and yoga are banned for two to four weeks. Classes are resumed only after consultation with the attending physician; some types of yoga may be approved after a shorter period of time.
Cryosauna, hammam, bathhouse, sauna and other warm rooms of bath complexes are banned for 2-3 weeks. Visits to the solarium, exposure to the sun in the city or on the beach in hot weather are canceled for the same period.
Recovery after removal of Bisha's lumps also implies a ban on long-term water procedures, so as not to overcool and overload the facial muscles. At the same time, water should not get into your mouth - if you cannot guarantee that no liquid will get into your mouth during swimming, you should avoid swimming until the sutures are removed/absorbed.

The full result of the operation should be expected after 4-6 months. During this period, residual slight asymmetry may be observed.

Pain in the sutures and cheeks- a normal phenomenon after surgery. The pain after removal of Bisha's pouches will go away in an average of 3-7 days. In this case, there is no need to endure pain - treat it with an analgesic recommended by the surgeon.
Swelling after removal of Bisha's lumps- the patients are very surprised, because in their opinion the intervention was insignificant. However, removing fat bags is an operation and swelling is inevitable; it subsides gradually over two weeks. Swelling can be quite severe and exceed the volume of the face before surgery, and swelling can also be more pronounced on one side. During this period, a compression mask is worn.
Numbness of the cheek - may appear due to touching the nerves that lie next to the lumps of Bisha. Muscle tissue may also be affected. Nerve conduction is gradually restored, which may take a month or more, depending on the damage.
Bruises - sometimes appear during the operation, resolve on their own; in consultation with the surgeon, a resorbable agent may be prescribed to quickly eliminate the hematoma and swelling.
Inflammation - appears when hygiene and asepsis instructions are violated, antibiotics are refused, if there is an infection in the body.
Facial asymmetry- occurs due to the following reason: fat bags of different sizes, due to their removal, reveal an asymmetrical structure. The situation may be the opposite, when lumps of fat hid the difference in structure.
After removing Bisha's lumps, cheeks sagged— this complication is not uncommon and accompanies patients of different ages and facial structures. Tissue gravity is an inevitable and sometimes very fast process. Without support (Bisha's lumps), the cheeks and skin creep down.

Blockages in the cheek area and early aging- often occurs after this operation, especially on thin faces - the complication does not develop immediately, but gradually as the woman ages. This unpleasant complication can be well studied on celebrities who have undergone surgery (Mary Kate Olsen, Angelina Jolie and others). Removal of Bisha's lumps occurs once and for all; in the future, the face may get better, but the fat sacs themselves are formed before birth (later they only decrease).
In the area of removal, over time (after 5-7 years), peculiar mesh wrinkles form, and their appearance does not parallel the general aging of the skin. This complication is caused by skin ptosis and lack of fat pad support.

Removing Bisha's lumps helps remove excessive roundness or swelling of the cheeks, uneven facial contours, correct the shape of the face and emphasize the cheekbones.

Fat bodies (lumps) of Bisha, in fact- This is a dense accumulation of fatty tissue in the cheek area under the skin. Bish's body is located on both sides between the facial and cheek muscles. Fat deposits can vary in size and can reach the size of a tennis ball. These formations are named after the name of the outstanding French anatomist.

All babies have Bisha bodies, but over time, most formations are reduced, but there are exceptions. They usually do not grow along with other tissues and should become invisible by age 25.

Anatomically, these fatty lumps are divided into 3 clusters:

Rear end fatty formations are located from the temporal muscle to the upper part of the lower jaw.
Anterior lobe The fatty lump is surrounded by an excretory stream through which saliva enters the oral cavity.
Secondary education located between the front and back. It should, as you grow older, decrease or gradually disappear. Most often, a small fat body remains.

There is still debate about the functionality of these fat deposits.

Functionality of Bisha's fat bodies:

Majority argue in favor of the fact that these lumps are most needed and used in infancy. They should help the baby suck and chew food. Subsequently, these formations do not develop, and sometimes even subside. In addition, adipose tissue will facilitate chewing by providing gliding to the facial muscles involved in this process.
Fatty tissue on the face, as throughout the body, has a shock-absorbing effect in case of injury, performing a protective function. The facial muscles are very sensitive and therefore require the protection that these formations provide.

There are cases when these lumps remain proportional in size and as a person develops, which not all owners of this phenomenon like, most want to get rid of them.

Indications and contraindications

Doctors approve such an operation in the following cases:

Round and convex cheeks.
Age-related changes.
Excess fat tissue on the face.

To finally decide whether you need this operation or not, you need to perform computer modeling of your face. Models of the current form and a new one will be created after removing Bisha's lumps. This way you can actually compare an approximate face before and after surgery, and finally decide the need for surgical intervention.

Contraindications for surgery:

Infectious diseases.
Decreased clotting blood.
Age (from 25 years).
Inflammatory processes in the area of the operation.
Progressive chronic diseases.
Diabetes.
Some cardiovascular diseases.
Unstable weight or low weight.

It is clear that before the age of 25, these formations can resolve or shrink. In case of serious chronic diseases and diabetes mellitus, such operations are prohibited.

In the presence of inflammatory processes and problems with blood clotting, surgical intervention will only worsen the patient’s condition. In case of cardiovascular diseases, problems arise with anesthesia and its tolerance. If the weight is unstable or small, practically no operations are performed.

Execution technique

When performing operations on the face, most will find it difficult to overcome this procedure psychologically, so this manipulation takes place under general anesthesia. But if desired, it can also be performed under local anesthesia. This procedure does not last long - approximately 45 minutes.

There are several options for performing the operation:

Removal of Bish's lumps through the oral cavity. Fat lumps are located close to the buccal mucosa, so this access will be sufficient. There are quite a few nerve receptors in this place, and if the surgeon is qualified, he will not touch them, and the patient, after the operation, will feel practically nothing. Healing occurs faster in the oral cavity, so in most cases, fatty lumps are removed this way. Procedure steps:
- Introduction of anesthesia.
- Open the mouth wide.
- In a place approximately opposite the upper row of distant teeth, a small incision, about 20 mm, is made with a scalpel. This is enough to pull out a lump of fat.
- The incision is carefully opened with forceps, and the fatty formation is pulled out in one piece; it is not cut.
- A cosmetic suture is applied.
- To protect against microbes, which are full in the oral cavity, a tampon with an antiseptic is placed on the seam.

Removal of Bisha's body through an incision on the face, occurs only if another operation is performed in the same area. It is not advisable to make incisions on the face just for this operation. In addition, facial incisions will take longer to heal, scarring may occur, and it will be very difficult not to hit nerves or impair facial motor skills.
Relocation of the fat body from cheeks to cheekbones, to give the oval of the face additional volume and aesthetic beauty.

Rehabilitation period

Result after 1 month

After surgery on the buccal mucosa, the patient can go home immediately. Only slight swelling on the cheeks will be visible, and in some cases it will not even be noticeable. It all depends on the person’s body and tolerance to anesthesia. The swelling subsides on the 3rd day.

Sutures can be applied either with ordinary threads or with self-absorbable medical material. In the first case, you need to see a doctor in a week to have the stitches removed.

In the second case, the stitches will dissolve on their own, and there will be no need to go to the hospital, so it is better that the stitches are applied with such threads.

You should refrain for 2 weeks from:

Saunas/baths and a long swim.
Physical activity.
React emotionally(e.g. cry/laugh).
Avoid long conversations.
Grimace.
Strain facial muscles.
Chew a lot or for a long time.
There's a cold one or hotter.
Sleeping on your face or on the cheek.

Pay special attention to oral hygiene. You should not put stress on your face; it is better to eat warm food that does not require any effort to chew. At first, eat only liquid food, and food particles should not be left in the mouth; after each meal, rinse your mouth.

Sleep only on your back to avoid swelling. It is imperative to take medications that will prevent inflammatory processes and, if necessary, painkillers.

Possible complications and side effects

Side effects can only occur if medications are not prescribed by a doctor. Removing fatty tissue is a completely safe procedure if done by an experienced surgeon. Also, pain after surgery may not occur if the face is inactive - this is a sign of good work by the surgeon.

The possibility of complications is minimal, but still possible:

They hid inflammatory processes from the doctor, and he did not diagnose them.
Damaged cheek after surgery, because they neglected the advice that should have been followed during the post-rehabilitation period.

In this case, the operated area will become inflamed. You should immediately consult a doctor to prescribe treatment.

Efficiency and results

Before and after removal

The effect of this surgical intervention will be observed, this is simply guaranteed, but whether the patient will like it is a question.

When the rehabilitation period passes, the volume of the cheeks decreases, this becomes very noticeable if the volume of the fatty lump was large:

Naturally, after this procedure the contour of the face will be changed, the lines should become smooth, the cheekbones should stand out.
The cheekbones will be especially emphasized when transferring Bisha's lumps.
Also, the oval will tighten, there will be a clear chin.
Generally, the appearance is rejuvenated, the visibility of wrinkles in this area is reduced. For example, nasolabial wrinkles will be less sunken.

The result is clearly different from what it was before the operation.

The result is fixed forever, the previous one will not return. If you gain weight, you will simply have subcutaneous fat, which will go away when you lose weight.

Price

The pricing policy for this operation varies from 25 to 50 thousand rubles, but it can also be more expensive.

There are many nuances on which the operation will depend.

It all depends on:

Method of carrying out operations.
The selected anesthesia.
Quantities removed adipose tissue.
Clinic status and specialist qualifications.
Availability of additional services(for example, computer simulation).

There are many popular procedures in aesthetic surgery, one of which is the removal of Bisha’s lumps. According to experts, Bisha's lumps are encapsulated fatty deposits consisting of 3 lobes. They are located near the auricular salivary glands, between the masticatory and superficial facial muscles, and stretch from the mandibular to the infraorbital region.

These lumps give the lower half of the face a natural roundness. The intervention helps patients achieve more subtle and graceful facial features.

Purpose

The main function of Bisha's lumps is to reduce muscle friction during human consumption of food in childhood. They also provide cheek tone to simplify the baby’s sucking movements during breastfeeding and prevent cheek biting from the inside. Lumps of fat protect facial muscles and nerves from damage.

Over time, the use of lumps becomes less necessary. Also, Bisha's lumps can sag with age, strengthening nasolabial and skin (in the mandibular region) folds.

Removing Bish's lumps allows you to make facial features more expressive. Many women are willing to undergo procedures of varying complexity in order to achieve the desired refined facial features and thin cheekbones. You can evaluate the results using reviews with photos before and after using various techniques.

Bisha's lumps are deposits of fat reserves in the form of lumps inside the cheeks, consisting of 3 lobes: anterior, posterior, middle.

The formations are localized between the parotid salivary gland, the infraorbital groove and the upper edge of the lower jaw.

These fat accumulations visually enlarge the lower part of the face, which is especially noticeable in young children. It is thanks to such swellings that babies have such plump cheeks. Scientist Marie Bisha discovered and substantiated her theory about the fatty tissues of the cheeks, their characteristics and functional significance; in honor of his name, the name Bisha's lumps appeared.

Reasons for appearance

The appearance of fatty bodies in the lower part of the face is due to the following reasons:
Lumps of fatty tissue perform important shock-absorbing functions for the child's developing jaw muscles.
Helps develop sucking and chewing skills in infancy.

Perform a protective function against possible external damage.

Over time, the need for fat reserves in this area decreases, and the lumps decrease in size.

Reasons for removal , removal occurs solely for aesthetic reasons. The specificity of the lumps lies in the special density of adipose tissue; even after general weight loss, the lumps do not decrease in size.

Common indications for surgery:

Bisha's lumps (photos before and after removal):

Contraindications

Possible danger of removing Bisha's lumps

The most dangerous outcome of removing Bisha's lumps is associated with the possible consequences of general anesthesia. Among them are additional stress on the heart, the emergence of susceptibility to weather changes, and exacerbation of chronic diseases. The risk of postoperative complications is not always justified, since there is a possibility of a complete lack of correction effect.

With age, changes in the structure of the skin occur; the lack of fat reserves can make the face look tired and unhealthy.

Surgery to remove Bisha's lumps

Preparing for surgery

At the stage when a clinic and a doctor have already been selected, it is necessary to undergo preparatory preoperative measures:

Stages of surgery on the inside of the cheeks

One of the methods of performing the operation is removal from the inner surface of the cheeks, which is considered the safest due to the close proximity of the lumps to the inside of the cheek wall.

Correction stages:

The total procedure time is no more than 30 minutes. Approximate cost: 25,000-50,000 rubles . Such a wide range of prices is due to the popularity of the clinic and the reputation of the doctor.

Bisha's lumps (photos before and after surgery, what lumps look like):

Operation through incisions on the face

This technique is used in addition to any other surgical correction that involves cutting the skin on the face. A more complex and traumatic method requires special surgical skill, since nerve endings and salivary glands are concentrated at the site of the incisions.

Sequence of actions during the operation:

Choice of anesthesia.
The surgical site is delimited by surgical material.
Treating the operating area with antiseptic agents.
An incision is made in the cheek through which fatty lumps are removed and cut off.
In case of damage, small vessels are cauterized.
The incisions are sewn together with a special cosmetic suture.
At first, the mark from the suture will be noticeable, but upon completion of rehabilitation it will become invisible.

Approximate price: 30000-60000 rub.

Rehabilitation and recovery

After completion of the operation and complete recovery from anesthesia, the patient can leave the clinic. The duration of rehabilitation is approximately 2-3 weeks.

Basic principles of the rehabilitation period:

Consequences and possible complications after surgery

Negative consequences are rare.

Sometimes a surgeon’s mistake or failure to follow the rules for preparing for surgery can lead to the following consequences:

Allergic manifestations in the form of a rash, breathing problems or heart function. Also common signs include pressure changes and bouts of vomiting.
Due to the carelessness of the surgeon, the integrity of the tissues located next to the operated area (muscles, glands, nerves) may be compromised.
Severe pain syndrome. On average, the pain subsides completely within one week.

Possible complications:

The development of inflammation on the inside of the cheek as a result of injury to soft tissues by hard food or accidentally during sleep, can also be caused by the presence of foci of replenishment in the body before surgery.
Facial asymmetry.
Infection of incisions.

You should not save on your own health by choosing a dubious clinic or agreeing to the experiments of an inexperienced surgeon.

It is important to monitor weight gain, the return of extra pounds is fraught with the resumption of fatty deposits in the cheeks .

Using a laser

Removal of fatty tissue from the cheeks with a laser beam is called bishectomy. The main feature is minimal trauma, significantly reducing the risk of complications. Laser exposure promotes rapid tissue regeneration, shortening the recovery period. The coagulative properties of the rays ensure instant sealing of blood vessels.

Main stages:

Once the local anesthetic begins to take effect, a laser incision is made on the inside of the buccal mucosa.
The fat body is separated and removed.
Self-absorbing sutures are applied.
You need to wear an elastic bandage on your face for some time.

Average price of the procedure: 45,000 rubles.

Bisha's lumps (photos before and after removal using a laser beam):

Methods for removing fatty lumps at home

Exercises

Various techniques are known to remove fatty lumps without surgery.

For home use, you can use a set of exercises:

After training, you should perform stretching and muscle relaxation exercises. Gently tilt your head from side to side to stretch the muscles of your neck and face to the maximum possible amplitude.

The first noticeable results of using facial fitness will be noticeable after a month of regular exercise.

But don't expect big changes. Without an integrated approach combined with nutrition, massages and hardware techniques, it is difficult to achieve clear success.

Oil and masks

A good effect can be achieved by performing a facial massage using various oils. Oils have a wide list of beneficial properties, thanks to which the skin becomes elastic, toned and fresh. Massage improves blood circulation in problem areas, fills cells with oxygen and triggers accelerated metabolism.

Using available products at home is an economical and affordable way of care.

Sunflower or olive oil are better suited for normal skin, St. John's wort and jojoba oil are better for oily skin, almond oil has a pronounced tightening effect.

Examples of recipes for preparing oils:

Add a little honey to the almond oil and massage your face in a circular motion for about 5 minutes. This composition ensures smoothing of unevenness and fine wrinkles.
Add lemon, bergamot and cypress oil to sunflower oil.
Rose, jasmine and cedar oils are mixed with a base of almond oil.

Prepared mixtures should be stored in the refrigerator, but before use it is better to take it out and leave it to stand for a while to reach room temperature. It is recommended to massage with oil in courses, if necessary, repeat 1-2 times a week to maintain skin tone. In addition to oils, the use of masks in various variations is common.

Several recipes for masks used in combination with other techniques to reduce the volume of curvy faces:

1 tbsp. yeast dissolves in a small amount of milk. The resulting solution must be evenly distributed over the surface of the face in several layers. You need to wait until one layer dries, then start applying the next one. The mask is suitable for daily use.
Mix a couple of spoons of oatmeal with natural yogurt and leave for 20 minutes until the flakes become voluminous enough. Apply the resulting mixture in a thick layer over the entire face, rinse thoroughly after 30 minutes. You can repeat the procedure every other day.
Stir blue clay with water until you obtain a consistency similar to sour cream. Apply to face and let dry, which will take about 15 minutes. It is recommended to use twice a week.
Using suppositories to treat hemorrhoids as an emergency way to combat swelling on the face. This drug is known for its quick-acting calming properties. To prepare the mask, you need to melt a candle and apply it to the skin of your cheeks at night. This method is not intended for regular use. Only one-time application is allowed for special occasions.

Treatment without surgery

Lymphatic drainage massage

The essence of the procedure is to stimulate lymph outflow(excess fluid containing breakdown products and other substances from the intercellular space). Carrying out a massage once a week will help you gain a pronounced oval face, get clearer cheekbones and smooth out wrinkles in the lip area.

There are many techniques for lymphatic drainage massage; it is possible to perform it yourself or in a salon.

Description of the basics of the technique:

You need to cleanse the skin; fruit peeling or a honey mask are good for this purpose.
Preparing the skin with a warming massage.
Strengthening the forehead - the palms located at the temples should be brought to the middle of the forehead and moved back, repeat three times. An important point is that you should massage the muscles, not the skin.
Puffiness of the eyes is relieved by moving your finger from the inner corner of the eyes to the outer. It is necessary to perform 5 repetitions and change the direction of the massage.
Smooth out wrinkles near the lips - find the middle of the chin and press on this point with your fingers. With this pressure, move your fingers to the middle of the nasolabial fold, the number of repetitions is 5 times.
To lift your cheeks, open your mouth and relax your muscles. Using both hands, lift the lower jaw towards the upper jaw about 3 times. Next, from the point in the corners of the lips, draw a line to the outer corner of the eye with moderate pressure, then to the earlobe and back to the lips. As you reach each point, you need to stop for a couple of seconds. and keep moving. The number of repetitions is approximately 5 times on each side.
The cheeks are taken with your fingers and using force, but at the same time gently, the skin is pulled in different directions. Perform several repetitions.
Folded hands, palm to palm, are placed towards the nose. Then the face is smoothed out under pressure.
With three fingers, grab your cheeks and stretch the skin; at the end point you need to twist the skin and release. Repeat three times.

In a salon setting, lymphatic drainage equipment is supplemented with special equipment (lpg), cupping massage or the use of cosmetic electrodes is used.

In the presence of inflammation, after plastic reconstructions, with nearby vessels, this technique is not recommended.

Bisha's lumps (photos before and after a course of lymphatic drainage massage):

RF lifting

RF lifting (the second name for the thermolifting procedure) is an electromagnetic effect on the skin and subcutaneous fat. Provides fat burning and skin tightening.

Description of the stages of the radio frequency method:

The first results of lifting are noticeable immediately, the tightening effect gradually increases over about 2 months after the procedure.

Mesotherapy

It is one of the methods of injection correction. Special solutions are injected under the skin into problem areas. The basis of meso cocktails is always hyaluronic acid - the main source of elastin and collagen production, stimulates metabolic processes, and has a beneficial effect on fat burning. Other components include amino acids, vitamins, enzymes.

Step-by-step description of the technique:

Preliminary consultation with a doctor and collection of information about the patient, possible contraindications, and the presence of allergic manifestations.
Cleansing procedures for facial skin.
The drug is administered either manually or by machine.
A soothing mask is applied.
You should follow your doctor’s recommendations for about a week, do not touch your face with your hands, and treat your skin with antiseptic agents.
The redness disappears after a few days.

The effectiveness of mesotherapy depends on the patient’s initial data (age, tissue condition, individual characteristics), the level of professionalism of the cosmetologist and the correctly selected composition of the substances administered. Noticeable changes appear after the second procedure.

The average course number is 7 procedures with an interval of one week. It is recommended to repeat the course every six months.

Bisha's lumps with an example of the result after a course of mesotherapy (photos before and after):

Surgeons' opinions on the effectiveness of the operation

Many surgeons agree that changing the shape of the face using surgical methods is advisable. The main reason for this opinion is that removing Bish's lumps helps to achieve the correct proportions of the face.

The fact remains undeniable that surgery is the most effective method of getting rid of excess fat in the cheeks. Other techniques can only partially reduce tissue. This adjustment in combination with a facelift gives the maximum effect in the fight against age-related changes.

Unlike other correction methods, the results after surgery last a lifetime.

At the same time, it must be taken into account that surgery is not the only option, or rather, a last resort. After all, there is a large selection of less radical manipulations to visually reduce chubby cheeks (injections, cosmetic threads, fillers). A competent surgeon will always offer an alternative to surgery, if possible.

Modern cosmetology provides a wide range of techniques for combating Bish’s lumps. It’s not difficult to get acquainted and decide on an acceptable option. All the necessary information is available with photographs before and after using any of the techniques.

Article format: Svetlana Ovsyanikova

Video on the topic: Bisha's lumps

What are Bisha's lumps? Photos before and after removal:

Bisha's lumps: removal surgery, before and after photos:

plastic surgeon, specialist in minimally invasive rejuvenation surgery, dermatocosmetologist

“If you don’t know the history of medicine, then the interest in removing Bisha’s lumps could be amazing. But there was bloodletting, treatment with mercury, lobotomy in the treatment of depression... Vitality was restored by rectal smoking!!!

In the 21st century, trends spread virally through Instagram: they cut a cheek, and here we have a socialite with chiseled cheekbones and the sexy face of a lady vamp.

In fact, after removing Bisha's lumps, the face changes in a maximum of 20 girls out of 100, in those who have a truly hypertrophied volume of fatty tissue. For the remaining 80, the placebo works: “I did it” is enough to be satisfied.

Popular

From an aesthetic point of view, there are no and cannot be indications for removing Bish’s lumps. This is a pointless intervention, the same as removing the 8th and 7th teeth to highlight the cheekbones.

In general, this operation is not in the arsenal of a plastic surgeon; it remained in the textbooks of the 20th century. We are busy with more meaningful issues, for example, how to maintain youth and do it as efficiently as possible with minimal stress on the body. But cutting and removing lumps of fat from the cheeks is definitely easier than performing modern minimally invasive and effective surgery. Therefore, it is beneficial for someone to call nonsense a “star procedure.” You don’t need to specialize for years or master modern techniques - just learn how to cut out Bisha’s lumps, call yourself a plastic surgeon and start receiving treatment.

A professional plastic surgeon will never suggest that you simply get rid of fatty tissue. He will find a way to effectively use it for volumetric plastic surgery of the same cheekbones, or chest, or hips, or with age-related drooping of the oval of the face. He also knows that 5-7 years after removing Bish’s lumps, unnatural expression wrinkles will form in the center of the cheek. The lump of adipose tissue provided by nature is no longer there, and the skin begins to “draw in” as if into a funnel in place of the former Bish’s lump. We call this “granny dip” because similar changes occur in older people whose cheeks fall under the cheekbone due to the absence of their own teeth.

Bisha's lump is formed in infancy. Do you know the desire to tug a baby doll’s cheek? But the baby doll grows up, and it seems to him that his face is round, ugly and unfashionable. I would like to replace the expression of childish naivety with fashionable sunken cheeks. But if the baby doll is patient for a couple of years, the cheeks will harmonize naturally. And the remaining fat will come in handy.

For example, after 40 years, when the middle zone of the face loses volume, causing the clarity of the facial contour to disappear. It is more rational to replenish it with the patient’s own fat tissue than with artificially created fillers or implants. There is no risk of rejection, allergic reactions or unpleasant side effects. The methods of fat grafting and liposculpture are based on this.

What do stars do who have perfect cheekbones, no gaps, and at the same time achieve the effect of a “slightly retracted” cheek? Definitely not removing Bisha's lumps.

Without an incision, through a skin puncture, the thinnest silicone threads are inserted under the skin and “anchored” in it. By pulling them out, the corners of the lips are captured, so you get perky raised corners of the lips, a slightly sunken cheek (due to the tension of the threads) and an emphasized high cheekbone, as the thread lifts the tissue upward. The effect is achieved without removing anything, and the natural state of the tissues also does not change; there are no scars or any traces of correction left. The operation does not affect facial expressions - the face retains a living human appearance. The effect lasts from 3 to 5 years, but it can be removed by removing the threads, and strengthened by tightening it again after this period. Of course, the manipulation is complex and requires additional specialization of the doctor.”