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VOLUME 25 , ISSUE 3 ( March, 2024 ) > List of Articles


Bichectomy Surgery and EMG Masticatory Muscles Function in Adult Women: A Longitudinal Study

Alice Helena de L Santos Cardoso, Marcelo Palinkas, Nicole B Bettiol, Patrícia S de Lima, Paulo B de Vasconcelos, Samuel P Xavier, Gabriella SG Silva, Thamyres Branco, Isabela H Regalo, Selma Siessere, Simone CH Regalo

Keywords : Bichectomy surgery, Buccal fat removal, Electromyography, Masticatory muscles, Stomatognathic system

Citation Information : Cardoso AH, Palinkas M, Bettiol NB, de Lima PS, de Vasconcelos PB, Xavier SP, Silva GS, Branco T, Regalo IH, Siessere S, Regalo SC. Bichectomy Surgery and EMG Masticatory Muscles Function in Adult Women: A Longitudinal Study. J Contemp Dent Pract 2024; 25 (3):207-212.

DOI: 10.5005/jp-journals-10024-3656

License: CC BY-NC 4.0

Published Online: 19-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Aim: This longitudinal study aimed to evaluate the electromyographic activity of the masseter and temporal muscles in adult women who underwent buccal fat removal. Materials and methods: The sample consisted of 20 healthy adult women with no temporomandibular dysfunction and normal occlusion, who were assessed before, 30, and 60 days after the surgery. The electromyographic signal of the masseter and temporal muscles was captured through mandibular tasks including rest, protrusion, right and left laterality, and maximum voluntary contraction with and without parafilm. The results obtained were tabulated and the Shapiro-Wilk normality test was performed, which indicated a normal distribution. Statistical analysis was performed using the repeated measures test (p < 0.05). Results: Significant differences were observed between time periods in maximum voluntary contraction for the left masseter muscle (p = 0.006) and in maximum voluntary contraction with parafilm for the right temporal (p = 0.03) and left temporal (p = 0.03) muscles. Conclusion: Bichectomy surgery did not modify the electromyographic activity of the masseter and temporal muscles during the rest task but may have influenced variations in the electromyographic signal during different mandibular tasks after 60 days of surgery, suggesting compensatory adaptations and functional recovery. Clinical significance: Understanding the impact of buccal fat removal surgery on the stomatognathic system function provides insights into postoperative functional recovery and potential compensatory adaptations, guiding clinical management and rehabilitation strategies for patients undergoing such procedures.

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  1. de Sena YRB, Rabêlo Júnior PMS, Gonçalves LM, et al. Comparison of bichectomy techniques through a clinical case and 6-month follow-up. J Lasers Med Sci 2022;13:e2. DOI: 10.34172/jlms.2022.02.
  2. Pokrowiecki R. Extended buccal lipectomy (bichectomy) for extreme cheek contouring. Int J Oral Maxillofac Surg 2022;51(7):929–932. DOI: 10.1016/j.ijom.2021.09.003.
  3. Pimentel KF, de Lima Sousa MG, Dos Santos Passos A, et al. The impact of partially removing the Bichat fat pad in the linear facial measurements, satisfaction with facial aesthetics and quality of life: A single-arm CONSORT-guided clinical trial. Clin Oral Investig 2023;27(1):249–262. DOI: 10.1007/s00784-022-04718-0.
  4. Velasquez F, Nuñez E, Gutiérrrez JD, et al. Chilean patients’ perception of their oral health-related quality of life after bichectomy. Patient Prefer Adherence 2022;16:2721–2726. DOI: 10.2147/PPA.S360471.
  5. ISAPS. The International Study on Aesthetic/Cosmetic Procedures Performed in 2018. 2018;01–49. Available from:
  6. ISAPS. The International Study on Aesthetic/Cosmetic Procedures Performed in 2021. 2021;01–57. Available from:
  7. Moura LB, Spin JR, Spin-Neto R, et al. Buccal fat pad removal to improve facial aesthetics: An established technique? Med Oral Patol Oral Cir Bucal 2018;23(4):e478–e484. DOI: 10.4317/medoral.22449.
  8. Chouikh F, Dierks EJ. The buccal fat pad flap. Oral Maxillofac Surg Clin North Am 2021;33(2):177–184. DOI: 10.1016/j.coms.2020.12.005.
  9. Matarasso A. Managing the buccal fat pad. Aesthet Surg J 2006; 26(3):330–336. DOI:
  10. Hermens HJ, Freriks B, Disselhorst-Klug C, et al. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol 2000;10(5):361–374. DOI: 10.1016/s1050-6411(00)00027-4.
  11. Di Palma E, Tepedino M, Chimenti C, et al. Effects of the functional orthopaedic therapy on masticatory muscles activity. J Clin Exp Dent 2017;9(7):e886–e891. DOI: 10.4317/jced.53986.
  12. Siéssere S, de Albuquerque Lima N, Semprini M, et al. Masticatory process in individuals with maxillary and mandibular osteoporosis: Electromyographic analysis. Osteoporos Int 2009;20(11):1847–1851. DOI: 10.1007/s00198-009-0885-2.
  13. Esposto DS, Palinkas M, Gonçalves LMN, et al. Effect of breast cancer treatment on the stomatognathic system. Braz Dent J 2018;29(4): 368–373. DOI: 10.1590/0103-6440201801791.
  14. Zurlo F, Larson K, Bogardus C, et al. Skeletal muscle metabolism is a major determinant of resting energy expenditure. J Clin Invest 1990;86(5):1423–1427. DOI: 10.1172/JCI114857.
  15. Soysal P, Ates Bulut E, Yavuz I, et al. Decreased basal metabolic rate can be an objective marker for sarcopenia and frailty in older males. J Am Med Dir Assoc 2019;20(1):58–63. DOI: 10.1016/j.jamda.2018.07.001.
  16. Lee KL, Cho HJ, Bae H, et al. Anatomical considerations when treating compensatory hypertrophy of the upper part of the masseter after long-term botulinum neurotoxin type a injections. Toxins (Basel) 2020;12(3):202. DOI: 10.3390/toxins12030202.
  17. Zhang HM, Yan YP, Qi KM, et al. Anatomical structure of the buccal fat pad and its clinical adaptations. Plast Reconstr Surg 2002;109(7):2509–2518. DOI: 10.1097/00006534-200206000-00052.
  18. Rugh JD, Hatch JP, Moore PJ, et al. The effects of psychological stress on electromyographic activity and negative affect in ambulatory tension-type headache patients. Headache 1990;30(4):216–219. DOI: 10.1111/j.1526-4610.1990.hed3004216.x.
  19. Roman-Liu D, Grabarek I, Bartuzi P, et al. The influence of mental load on muscle tension. Ergonomics 2013;56(7):1125–1133. DOI: 10.1080/00140139.2013.798429.
  20. Cecílio FA, Regalo SC, Palinkas M, et al. Ageing and surface EMG activity patterns of masticatory muscles. J Oral Rehabil 2010;37(4):248–255. DOI: 10.1111/j.1365-2842.2010.02051.x.
  21. Dong Y, Wang XM, Wang MQ, et al. Asymmetric muscle function in patients with developmental mandibular asymmetry. J Oral Rehabil 2008;35(1):27–36. DOI: 10.1111/j.1365-2842.2007.01787.x.
  22. Pond LH, Barghi N, Barnwell GM. Occlusion and chewing side preference. J Prosthet Dent 1986;55(4):498–500. DOI: 10.1016/0022-3913(86)90186-1.
  23. Al-Dboush RE, Al-Zawawi E, El-Bialy T. Do orthodontic treatments using fixed appliances and clear aligner achieve comparable quality of occlusal contacts? Evid Based Dent 2022;23(4):160–161. DOI: 10.1038/s41432-022-0844-8.
  24. Mezey SE, Müller-Gerbl M, Toranelli M, et al. The human masseter muscle revisited: First description of its coronoid part. Ann Anat 2022;240:151879. DOI: 10.1016/j.aanat.2021.151879.
  25. Yu SK, Kim TH, Yang KY, et al. Morphology of the temporalis muscle focusing on the tendinous attachment onto the coronoid process. Anat Cell Biol 2021;54(3):308–314. DOI: 10.5115/acb.21.074.
  26. Alcântara MT, Ribeiro NR, Abreu DF. Complications associated with bichectomy surgery: A literature review. Minerva Dent Oral Sci 2021;70(4):155–160. DOI: 10.23736/S2724-6329.20.04415-5.
  27. Kohl BA, Deutschman CS. The inflammatory response to surgery and trauma. Curr Opin Crit Care 2006;12(4):325–332. DOI: 10.1097/01.ccx.0000235210.85073.fc.
  28. Tilley SL, Coffman TM, Koller BH. Mixed messages: Modulation of inflammation and immune responses by prostaglandins and thromboxanes. J Clin Invest 2001;108(1):15–23. DOI: 10.1172/JCI1 3416.
  29. Sherwood ER, Toliver-Kinsky T. Mechanisms of the inflammatory response. Best Pract Res Clin Anaesthesiol 2004;18(3):385–405. DOI: 10.1016/j.bpa.2003.12.002.
  30. Gutiérrez-Gutiérrez G, Barbosa López C, Navacerrada F, et al. Use of electromyography in the diagnosis of inflammatory myopathies. Reumatol Clin 2012;8(4):195–200. DOI: 10.1016/j.reuma.2011. 10.012.
  31. Becker K, Goethel M, Fonseca P, et al. The strategy of the brain to maintain the force production in painful contractions – A motor units pool reorganization. Cells 2022;11(20):3299. DOI: 10.3390/cells11203299.
  32. Yasuda R, Hayashi Y, Hell JW. CaMKII: A central molecular organizer of synaptic plasticity, learning and memory. Nat Rev Neurosci 2022;23(11):666–682. DOI: 10.1038/s41583-022-00624-2.
  33. Khasanov R, Svoboda D, Tapia-Laliena MÁ, et al. Muscle hypertrophy and neuroplasticity in the small bowel in short bowel syndrome. Histochem Cell Biol 2023;160(5):391–340. DOI: 10.1007/s00418-023-02214-4.
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