Complicações da bichectomia – relato de caso

Abstract

INTRODUCTION: Bichectomy is a type of aesthetic and functional surgery that involves the partial or complete removal of a fatty structure located in the middle third of the cheek, known as the Bichat Ball or Bichat Fat (BGB). Although the procedure is relatively straightforward, fat removal, like any surgical procedure, carries risks and potential complications. Therefore, it is crucial for the procedure to be performed by experienced and skilled professionals. Additionally, there is a recovery period after surgery, during which the patient must take special precautions to avoid complications and ensure a successful recovery. CASE REPORT: The authors' objective in this study is to document a clinical case of a surgical complication (hematoma formation)following the removal of the Bichat Ball. As part of the surgical protocol, an anesthesiawith 4% Articaine (Articaine Hydrochloride with Epinephrine 1:100,000 – DFL) was administered to a patient without comorbidities at the base of the vestibule, anesthetizing the buccal and posterior superior alveolar nerve. Subsequently, an incision of approximately 1.5 cm was made, and the planes were dissected with Metzenbaum scissors until reaching the Bichat Ball, which was clamped with Kelly forceps and removed. The patient developed a hematoma approximately five days later and was treated with amoxicillin, nimesulide, and tramadol until the signs and symptoms subsided. FINAL CONSIDERATIONS: The Bichat ball removal procedure, while relatively simple, can lead to various consequences, including bruising, difficulties with eating, aesthetic complications, infections, and, in extreme cases, the patient's death.