L'ablation de la graisse buccale

 

Qu'est-ce que l'ablation de la graisse buccale ?

L'ablation de la graisse buccale, également appelée bichectomie ou Hollywood Cheek, est une chirurgie esthétique du visage qui vise à rendre les pommettes plus saillantes et les lignes du visage plus nettes en retirant le tissu adipeux buccal dans la région des joues. L'élimination de la graisse buccale transforme les lignes du visage en forme de U en une forme de V plus nette. L'ablation de la graisse buccale ne laisse aucune marque de piqûre visible et est permanente tant qu'il n'y a pas de prise de poids excessive.

 

Pourquoi l'élimination de la graisse buccale est-elle pratiquée ?

 

L'ablation de la graisse buccale est pratiquée sur les patients qui présentent un excès de graisse sur les joues en rapport avec la structure de leur visage. Le tissu adipeux masque les traits du visage et donne un aspect plus gonflé aux joues du patient, ce qui peut donner à tort l'image d'un surpoids.

 

Après l'opération d'élimination de la graisse buccale, des lignes nettes apparaissent sur le visage du patient sous la forme d'un triangle inversé esthétique.

 

Quelles sont les conditions de l'élimination de la graisse buccale ?

 

La bichectomie, qui peut également être définie comme une chirurgie d'amincissement des joues, peut s'appliquer aux hommes comme aux femmes. L'ablation de la graisse buccale n'est pas recommandée aux patients suivants :

 

  • Les patients qui ont moins de 25 ans, car les traits du visage des jeunes patients peuvent continuer à changer jusqu'à 25 ans.
  • Les patients dont l'indice de masse corporelle, IMC, est supérieur à 25, car les patients en surpoids ou obèses sont souvent insatisfaits de leur apparence après une perte de poids.
  • Les fumeurs et les personnes âgées de plus de 45 ans.
  • Les patients qui ont des joues fines. Le prélèvement de graisse buccale convient mieux aux patients qui ont des joues pleines, ce qui permet d'éviter les effets indésirables qui pourraient apparaître avec l'âge avancé.
  • Les patients qui ne sont pas aptes à subir une anesthésie générale. Les antécédents médicaux du patient sont examinés et les tests diagnostiques préopératoires appropriés sont effectués pour évaluer l'éligibilité.

Quels sont les éléments à prendre en compte avant l'ablation de la graisse buccale ?

 

Avant l'intervention chirurgicale, il est recommandé aux patients de suivre les recommandations suivantes :

 

  • Le patient doit se rendre à l'hôpital un jour avant son opération pour que les tests préopératoires soient effectués.
  • Le patient doit arrêter de fumer, de boire de l'alcool et de consommer des drogues récréatives un mois avant l'opération.
  • Le patient doit éviter les médicaments contenant de l'aspirine ou de l'ibuprofène (Advil, Motrin IB, autres) pendant les deux semaines précédant et suivant l'opération. Ces médicaments peuvent augmenter le risque d'hémorragie interne. Les patients doivent confirmer chaque médicament et supplément qu'ils souhaitent prendre avec leur coordinateur de patients.
  •  

Comment l'élimination de la graisse buccale est-elle effectuée ?

 

L'élimination de la graisse buccale peut être réalisée sous anesthésie générale ou locale. Une incision est pratiquée à l'arrière de la cavité buccale, près de la deuxième molaire supérieure, dans la bouche. Le muscle buccinateur devient alors visible, ses fibres sont séparées, sans incision, jusqu'à ce que la graisse buccale soit accessible. Une fine enveloppe recouvrant la graisse est alors ouverte et la graisse est délicatement extraite par une pression douce appliquée de l'extérieur. La graisse est ensuite cautérisée à la base et retirée. Le reste du coussinet adipeux buccal est ensuite replacé à son emplacement anatomique et la muqueuse buccale, ainsi que les incisions, sont suturées. L'intervention dure en moyenne 30 minutes.

 

Quels sont les éléments à prendre en compte après l'ablation de la graisse buccale ?

 

Il est recommandé aux patients de suivre les recommandations suivantes :

 

  • Ne rien manger ni boire jusqu'à trois heures après l'opération.
  • Prévenir le gonflement de la bouche en appliquant des pressions froides pendant 15 minutes à intervalles réguliers au cours des 3 premiers jours suivant l'ablation de la graisse buccale.
  • Se gargariser avec de l'eau salée toutes les 12 heures pendant les 7 premiers jours suivant l'intervention chirurgicale puisque celle-ci est pratiquée à l'intérieur de la bouche.
  • Éviter les activités physiques intenses.
  • Utiliser les médicaments prescrits selon les instructions du chirurgien plasticien.
  • De mettre de la crème solaire lors des sorties à l'extérieur pendant les premières semaines suivant l'opération, surtout si celle-ci a été pratiquée en été.
  • De garder une bonne hygiène dentaire pour éviter une infection car les points de suture sont à l'intérieur de la bouche.
  • Attendre une semaine pour que le gonflement diminue, et 2 à 4 mois pour que les joues atteignent leur aspect définitif.
  •  

Quels sont les risques liés à l'élimination de la graisse buccale ?

 

Bien que l'élimination de la graisse buccale soit une chirurgie esthétique simple et de courte durée, comme toute chirurgie majeure, elle comporte certains risques. Les risques possibles de l'opération d'élimination de la graisse buccale sont notamment les suivants :

 

  • Saignements
  • Thrombose veineuse profonde, complications cardiaques et pulmonaires.
  • Sérome
  • Hématome
  • Infection
  • Lésion d'un canal salivaire
  • Lésion des branches du nerf facial, entraînant une faiblesse temporaire ou permanente du muscle facial.
  • Un engourdissement ou d'autres modifications des sensations.
  • Un gonflement prolongé
  • Résultat esthétique sous-optimal et/ou changements minimes.
  • Risques associés à l'anesthésie
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