The Viral Buccal Fat Removal Procedure Has Some Experts Concerned

If you spend any amount of time on the internet, you have probably seen some chatter about buccal fat removal, and probably against your will. 

The conversation was catalyzed after former "Glee" actress Lea Michele, who has had quite a transformation, sent the internet into a frenzy with her new look after she posted a selfie on Instagram in which her jawline seemed noticeably more pronounced than in selfies prior. A rage of rumors stirred online. "Miss your cute cheeks. Why did you do that to your face?" one Instagram user commented. "Why does everyone overdo the plastic surgery? Why!?!?!?" another Instagram user lamented. The impact of the photo has loomed large across social media, sparking debates about whether or not it is wise to undergo the procedure. 

But, let us rewind. What is buccal fat anyway? And why is it being removed? Per the Cleveland Clinic, buccal fat is the soft, squishy fat pad found in the hollows of your cheeks that, depending on how much you have, can make your cheeks look more or less round. Patients tend to seek buccal fat removal to achieve the appearance of an enhanced jawline and sharper cheekbones. And let us be clear: addressing your insecurities is valid, so long as you are well-informed and seeking medically safe options. There is some discordance, however, both online and amongst plastic surgeons, over whether or not buccal fat removal is a reasonable procedure to have done, and how far it should be taken if so. 

One source of contention is over whether or not the buccal fat pad increases, or diminishes, as we age, a crucial determination when considering buccal fat removal. There are two schools of thought: that gravity contributes to the appearance of aging skin, and that volume loss contributes to the appearance of aging skin. While popular belief maintains that the buccal fat pad diminishes as we age — at least one study has shown that aging is associated with superficial fat volume loss and transfer from mid face to lower face — others argue that buccal fat not only retains its volume but increases as we age. 

According to plastic surgery office Many Faces of Chicago, buccal fat is unlike other superficial fat found in the face and retains its volume over time. Plastic surgeon Dr. Benjamin Talei, speaking with BuzzFeed, also noted that the buccal fat pad is indeed different; it is full of stem cells, unlike anywhere else in the body except the eyes. 

According to PlasticSurgery.org, however, buccal fat does shrink over time. "Based on what we know about facial fat compartments and how facial fat atrophies as we age, the concern is that removing the buccal fat pad may look good now but over time could become overly hollow," Dr. Ira Savetsky told the organization. And speaking to Byrdie, Dr. Samuel J. Lin echoed the same sentiment: "The natural aging process causes fat loss in the face, which increases with every decade."

As research continues to develop, plastic surgeons urge restraint when seeking buccal fat removal. Though it takes at most an hour under the knife to complete — a plastic surgeon cuts open the inside of your cheeks to remove the fat, per Byrdie — the surgery is irreversible; fat cannot be added back into the cheeks in the same way it is removed. This is why some plastic surgeons recommend the procedure in tandem with other skin-tightening or volume-enhancing procedures. 

And complications are not out of the question, both medical and cosmetic. As such, plastic surgeons are particular about who qualifies for the surgery. Speaking with BuzzFeed, Dr. Youn said, "You've got to be really careful on who you do this surgery on." The procedure is often completed on older patients in conjunction with a facelift, while younger patients with narrow faces should steer clear of buccal fat removal, as the sculpting effect of the surgery could become more severe over time. 

On TikTok, users express a wide range of thoughts about their buccal fat, from body positive affirmations, to before and after photos of their procedures. Some caution against modifying their bodies for a temporary trend, while others have no regrets, like Chrissy Teigen once shared in an Instagram story. As with any other cosmetic procedure, if you're interested in buccal fat removal, you should consult a medical professional to see if the surgery is safe for you.