‘You can make a 25-year-old look 45 with a 15-minute procedure’ — the pros, cons and risks of the latest celebrity cosmetic surgery craze

A few years ago, the phrase “hip dip,” referring to the indent present in many people’s upper leg, started gaining popularity. Searches for the term skyrocketed online. Suddenly, this “body part” most people had never even heard of became the subject of a collective obsession.

No sooner did one learn of the existence of “hip dips” did one also learn that they were undesirable. No good, not cute. Instead, what was desirable was a smooth, swaying curve seamlessly connecting the waist to the knee — in other words, the Kardashian hourglass.

Cosmetic surgeons began posting patient photos on social media, extolling the virtues of fillers and fat transfers to “correct” this apparent anatomical shortcoming. Fitness influencers promoted workout plans targeting the region, something many experts deemed a waste of time as “violin hips,” as they’re sometimes nicknamed, are mainly caused by the shape of one’s pelvis, something no amount of exercise can modify.

Well, we’re calling it: Buccal fat is the new hip dip. A region of the human physique few of us ever gave much thought to until, somehow, it permeated the zeitgeist and became yet another thing to feel self-conscious about.

“It seems to be one of the hot trends on social media now,” says Dr. Sherrell J. Aston, a world-renowned Manhattan plastic surgeon. Indeed it does. On TikTok, videos pertaining to buccal fat have amassed over 255 million views.

If you’re unfamiliar with the term, “buccal,” pronounced “buckle,” comes from the Latin word bucca, meaning cheek. So “buccal fat” refers to the fat pad — our face comprises several, which help give it its shape — wedged between the cheekbone and jawbone.

“There are some people in whom it’s large from birth,” says Dr. Steven A. Hanna, a Canadian plastic surgeon who works with Aston and is currently completing a fellowship in New York City. “They have very round faces and look like cherubs.” Those are the people he and Aston consider prime candidates for buccal fat excision, a procedure during which excess fat is removed to narrow the face.

As far as cosmetic surgeries go, this is one that’s considered relatively minor. It takes less than half an hour to perform and the sutures are hidden inside the mouth so there aren’t any bandages or external scars, only a bit of swelling for a few days.

“Recovery was super easy,” says Patricia Gloria, a dog groomer out of Upland, California, who got the procedure done in December. “Maybe a little pain the day after, but I took some Tylenol and was completely fine. I felt back to normal after a week.”

The 33-year-old had always had “chubby cheeks,” she says, but in recent years, she’d noticed they’d begun drooping, which made her insecure about her appearance, especially in photos. She saw a buccal fat removal before-and-after on Instagram and was stunned by the results. “I had no idea this surgery existed,” she says. She went in for a consultation and was scheduled to go under the knife a month later. “I couldn’t wait. I wanted to feel confident again and be able to take pictures with family and friends.”

As soon as she looked in the mirror after the surgery, she was elated. “I could immediately see a difference,” she says. “It’s only been two months, but I’m really pleased with the results so far.”

She’s in good company. In Hollywood, pretty much anyone who’s anyone these days is rumoured to have gotten buccal fat removal. It’s as though it’s become part of the “welcome to fame” package, as commonplace as nose jobs and veneers. Bella Hadid is said to have had it, as is Zoë Kravitz and Lea Michele and Anya Taylor-Joy and Eiza Gonzalez. Two years ago, Chrissy Teigen posted a video to her Instagram Stories in which she pointed to her newly chiseled cheeks and shared she’d done “that buccal fat removal thing.” (Other celebs haven’t been so forthcoming.)

The result is a parade of perfectly sculpted faces splashed over social media and red carpets. No wonder more and more people are walking into cosmetic surgeons’ offices asking to have it done.

Aston says he’s definitely noticed increased interest around the procedure, though that doesn’t mean he’s been performing it any more than usual. “I’ve sent many young people away saying, ‘You’ll like it now, but you won’t like it as you get older.’”

Because here’s what you need to know: As we age, the fat in our face naturally shrinks, causing us to look more gaunt. “Think about it: How do people in nursing homes look?” asks Aston. “They’re hollower in their cheeks.” So while some people, like Gloria, might benefit from the procedure, those who don’t resemble baby angels in a Renaissance painting run the risk of looking older as a result, especially in the long run. “There is evidence that the buccal fat pad is structural,” says Hanna, meaning it plays a role in holding up the face. Taking it out could thus lead to more sagging over time.

And there’s a kicker: You can’t undo it. “If someone takes that fat out when they’re 25 — particularly some of the models who are having it done; they’re pretty thin to begin with — they may feel like they’ve got great cheek contour now, but the problem is, unlike some of the things we do, it’s not a procedure you can reverse,” says Aston. “You can’t fill that buccal space out with fillers very well. You can’t fill it out with fat graphs.”

Even Sarah Balladares, a physician assistant and esthetic injector in Louisiana who got buccal fat removal two years ago, admits “there’s a strong possibility that some people [who get it done] will look older long term.” That said, she doesn’t regret the procedure in the slightest and recommends it to patients when appropriate. “I get to look in the mirror every day and feel confident in my decision to have had the surgery,” she says. For her, it all comes down to finding a good doctor and making sure the procedure is truly right for you.

Seeking out an experienced surgeon is essential for another reason: “If you don’t do it correctly, you can have significant issues,” says Aston. There’s a facial nerve branch that runs through the area and if that nerve is damaged during the procedure, there’s a risk of hindering motor function in the face. A 2018 study found there was a “26.3 per chance of injury to the buccal branch of the facial nerve during total removal of the buccal fat pad simply based on anatomical variation.”

All to say, while it may be a quick surgery with minimal downtime, buccal fat removal isn’t as straightforward as it can seem on the outside. “It’s a trendy procedure and there are some people who will just do it,” says Aston. “A 20-year-old lady shows up in somebody’s office and says, ‘I want to take these out,’ and there are some people who say, ‘Yeah, sure.’ But I think it’s a good procedure for a limited number of people. Otherwise, you can make a 25-year-old look 45 with a 15-minute procedure.”

Katherine Lalancette is the beauty and lifestyle director of The Kit, based in Toronto. She writes about beauty and trends. Reach her on email at [email protected] or follow her on Twitter: @kik_tweets

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