Modern canons of beauty do not always correspond to objective reality. However, a huge number of people follow them no matter what. Today, pronounced cheekbones and an underlined jaw line are in fashion. However, not everyone is given the opportunity to be the owner of the chiseled line of Oji, and Bish's lumps are to blame for this. Specially for estet-portal.com, Candidate of Medical Sciences, otolaryngologist of the highest category, plastic surgeon Viktor Yushchenko spoke about how to achieve a refined facial contour with the help of their partial resection.
What are Bish's fat lumps
Bish's Lumps – These are fat cells that every person has from birth. They are necessary for an effective sucking reflex during breastfeeding. These fat pads atrophy with age, but in some people they can remain large enough to give the face a rounded appearance. It happens that Bish's lumps are clearly hypertrophied, and then the face looks puffy.
It is very important to differentiate enlarged lumps of Bish and diseases that can cause such a facial appearance.
Enlargement of the cheeks can be observed with endocrine disorders, hereditary diseases, etc. Therefore, we perform the operation for partial resection of Bish's lumps in the Nove Tilo clinic only after we are absolutely sure that everything is fine with the patient's health, and the cheeks – it's just his personality. In this case, we can help to correct them a little.
To whom partial resection of Bish's lumps is indicated
We do not perform this operation for everyone. Indications are determined both by the desire of the patient and the opinion of the doctor regarding the appropriateness of this procedure. The main task of partial resection of Bish's lumps – this is obtaining the most aesthetic result, by improving the so-called Oji line (S-shaped curve of the cheek, which is expressed in the zygomatic area), which by modern standards is the standard of beauty. Only through a careful study of the patient's facial features, a careful approach to his somatic condition, can any intervention be undertaken.
The operation for partial resection of Bish's lumps is performed only for young patients
There is a misconception that such operations can only be performed on young patients. In reality, this is not so. As we age, the fat pad of the cheeks sags, as does the skin of the face. Ptosis of Bish's lumps provokes the appearance of jowls, which are one of the most noticeable signs of aging.
For older patients, we recommend resection of Bish's lumps as an adjunct to a lower third of the face or neck lift.
For young patients, on average they are people 20-30 years old, we perform a resection through a small incision (about 1 cm) in the oral cavity at the level of the 7th upper tooth. Then we go into the space where Bish's lumps are located and perform their partial resection. Under no circumstances should they be completely deleted.
This is due to the fact that fat lumps in their structure represent a whole system and have several spurs, for example, temporal and maxillary. Therefore, with their total resection, there is a risk of getting excessively sunken cheeks. During the procedure, 2-3 ml of fat is removed, while using a syringe, we always control the amount removed.
It is important to keep symmetry in mind during resection of Bish's lumps, as the patient may initially have asymmetric facial features, which will become even more noticeable after the operation.
In this case, after discussing everything with the patient, we can remove a different amount of fat.
After the operation, the incision is closed with a self-absorbable suture. Unfortunately, there is no immediate effect due to the presence of edema. It takes at least a month to see the final result.
How is the resection of Bish's lumps performed in combination with a facelift
The second option for removing Bish's lumps is performed for age patients in combination with a lift of the lower two-thirds of the face or neck. From one access (in front of the ear or behind the tragus), both lifting and resection of Bish's lumps can be performed. This procedure is more difficult because during work we pass in close proximity to the parotid salivary gland and branches of the facial nerve.
Our task is to delicately isolate these structures, determine the location of the lumps, and then resect them, controlling the volume to be removed. At the Nove Tilo Clinic, we use this combined approach because it allows you to enhance the lifting effect, emphasize the line of the lower jaw, and also provides a longer-term result.
For partial resection of Bish's lumps, as well as for any other plastic surgery, there are clear indications. Today, the task of the surgeon is not only to perform the operation, but also to dissuade the patient from unnecessary intervention.
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