Facial liposuction is the most common facial plastic surgery. Bichectomy is the surgical excision of the buccal (Bichat) fat pad to reduce the size of the lower lateral face for aesthetic and reconstructive purposes. Although such a simple procedure has been gaining popularity worldwide, the impact of bichectomy on ear size and ear creases has not been investigated. Of note, there are 2 types of ear creases termed diagonal earlobe creases and preauricular vertical creases. Furthermore, several studies have demonstrated that ear size increases as we age. Moreover, with aging facial fat undergoes redistribution to the lower lateral face. The purpose of this letter is to bring attention to such a gap in the literature that carries a potential aesthetic indication for bichectomy in preventing the occurrence or improving the aesthetic appearance of ear creases and age-related ear elongation. Further research involving the ever-increasing sample of post-bichectomy patients is much needed.