"Buccal-ing Me Fat": Buccal Fat Removal And the Eternal Pursuit of Beauty

        In eighth grade, the girls in my class discovered two gathering places: the locker room and the bathroom. The locker room had its obvious perks; it was ideal for gossip, unlike the bathroom with stalls in which the objects of our whisperings could be lurking. We would stand behind an open locker door to share stories of someone tripping in assembly or going to the movies with a boy or being caught leaving the dean’s office. Unless we were the ones being talked about, the locker room was our safe space – the literal shelter of our sheltered lives. 

The bathroom, though, was uniquely sacred, for only in the bathroom could we perform the holiest ritual of pre-teenage girlhood. We stood under fluorescent lights, staring into the distorting mirror – that most critical feature of the bathrooms – and primped and preened and adjusted the collars of our mandated button-down shirts. Most importantly, though, we wished. We wished for better hair and better skin and better bodies, whatever “better” looked like that year. It felt like we would do anything to look like anyone else. 

Though belonging to this cult of insecurity was satisfying in and of itself, I remember having a few distinct problem areas – “problem areas” being the parts of my appearance that I felt desperately begged for change. There was the frizziness of my hair, which I would fix a few years later with a good curl cream, and the texture of the skin on my shoulders. What had bothered me for the longest, though, was the soft shape of my face. 

In elementary school, I imagined a magic toolbox that would allow me to remold my face exactly the way I wanted. I remember my best friend at the time dreamed of scissors that could cut off whichever parts of her body she deemed least desirable. I’ve since learned that these scissors are a near universal symbol of female coming-of-age. My friends all dreamed of our own potential after-photos, with pieces of ourselves dissected and removed. If this amputation of the self had been possible, I wonder, what would we have left?

Buccal fat removal is already the trending cosmetic procedure of the year, fighting to replace the Brazilian butt lifts that were so popular in 2022. According to Dr. Andrew Jacono, as reported by Madison Malone Kircher for The New York Times, “There are facial compartments that define the shape of the face, and there are superficial ones and deep ones…Buccal fat is one of the deep facial fat compartments that kind of give structure to the cheek area…we’re born with how much we have.” In this irreversible procedure, the fat pad is removed, either totally or those parts deemed excess, in order to create a chiseled, defined face. 

This operation is controversial among cosmetic surgeons. In fact, some such as Dr. Tunc Tiryaki refuse to perform it at all. As he explains to Maya Allen for The Cut, “Buccal fat removal doesn’t create definition, it just creates emptiness between the cheek and the jawline…In the long run, when we get older, we lose volume in our cheeks, so patients start looking really gaunt, almost like ghosts.” This empty, haunted look eventually exacerbates the aging that cosmetic surgery desperately tries to eradicate. This procedure instigates a cycle that necessitates further procedures; the empty space left by the removal must be “fixed” with filler. The metaphor writes itself – when we cut off pieces of ourselves, we create a void which demands to be filled. 

This trending procedure is simply one task on the trend cycle’s infinite to-do list. The beauty standard is always changing, as is evidenced by the chaos of runways, fashion magazines, and the ever-evolving bodies of celebrities and Instagram models. As Laura Pitcher wrote for Nylon, “In November, the New York Post released a controversial and now-viral story, waving goodbye to ‘booty’ and officially declaring heroin chic ‘back’…From there, nostalgic Y2K-inspired fashion trends, dramatic and intentional celebrity weight loss, and the constant reinforcement of the skinny ideal from the fashion industry have created a perfect storm for what’s being called the ‘thin is in’ culture shift.” Women have risked and lost their lives undergoing Brazilian butt lifts, and already, that body type is officially shifting from the object of culture’s affection toward undesirability. What was, until a few months ago, considered the peak of beauty, is now embarrassingly dated – God forbid, even cheugy!

I say the trend cycle is “officially” shifting because the cycle, like any power which dictates how we must function and present, has clear leaders. The Nylon article cites Kim Kardashian as one of these leaders, her infamous curves said to have sparked the “Era of the Big Booty” (2014-2022), but as she trades her fillers for that controversial pre-Met Gala weight loss and BBL reduction, heroin chic creeps back into the mainstream. “A term popularized in early-1990s, ‘heroin chic’ was the glamorization of the look of an extremely thin physique, dark under eye circles, and often disheveled hair and clothing, as embodied by models of the era. Rumblings of the aesthetic’s return have been repeated on social media for the past year.” Exclusivity lives at the heart of heroin chic; only those with the time and money to so vigorously  prioritize and pursue aesthetics can achieve the deceivingly effortless look. Heroin chic’s ultra-thinness is often the expensive product of weight loss pills, personal trainers, and cosmetic surgeries such as buccal fat removal. This procedure exemplifies our paradoxical dreams of luxury and scarcity. It’s clear, therefore, that the opulence our culture so dearly adores has evolved to embrace, or rather, worship, restriction. 

I can admit that I’m not immune to the social obsession with restriction; there is a palpable appeal to achieving the beauty standard, a simple desire to be desired. I can imagine a world in which buccal fat removal was trending some five to ten years earlier, and in that world, I would’ve wanted it desperately. I like to think that I’m past all of that now – past all the dreaming, the denying, the wishing for change – but sometimes the voice of insecurity is unrelenting. 

One evening last summer, I returned from a birthday party with my girlfriend. Her bathroom has a mirror that covers most of the wall behind the sinks, similar to that in my middle school. We were tired and sweaty and we’d just had one of our first-ever arguments, and she looked in my eyes through the mirror and said something along the lines of “I love your soft face. It’s given me a whole new type of face to appreciate.” I remember feeling that specific hot red rage, then embarrassed as my middle school matured mind returned. Then, I felt alone. Didn’t she know me at all? Didn’t she know that my soft face was one of the worst things about me – the failure that I had spent so many years trying to apologize for?

The funny thing about my loneliness at that moment is that she did see me; she likely knows my face better than I do. She doesn’t need, nor want, nor know, to forgive me, because she sees nothing reprehensible, nothing that necessitates apology, in the simplicity of my face. A face is just a face, and in loving one, there is just love. Therefore, if our softness is in fact loveable, why don’t we allow our bodies to take up the space they need? Why do we reject the clearest realities of ourselves – that we look the way that we look? 

My answer to these questions begins with a small truth: It is hard to have a body. We suffer inevitable aches and pains. Even more painful are the changes – the changes that our culture tells us are not only unattractive, but wrong. It is wrong to have smile lines and wrinkles, cellulite, stretch marks, proof of the passing of time, proof of gravity. We are disgusted by our bodies when they show evidence of our existence. Our bodies remember all of our worst moments, our failures, our eventual transition from life’s tender beginning to its sober conclusion. The ways we sag and soften and age foretell the end that is to come, but, more importantly, that we can’t control it. If we can afford to trick ourselves into believing that our bodies – our one uncontrollable asset – can, in fact, be submissive to us, can change at our will, why would we not change it?

Wealth is desirable because it allows us to hold reality like clay – to shape it, or press thumbprints into it, or to rip pieces off and throw them away. Who could be blamed for participating in the realities of their world? Rather than condemnation, I want to entertain the possibility that our current desires, dictated by cultural obsessions with wealth and the fickle beauty standard, are not in our best interests. I want to say that we have other options.

We might choose simple acceptance – I can look at myself and be okay. I have not achieved perfect self-acceptance, but I know that the all-consuming trend cycle will change and change and never be a true metric for my beauty or my goodness, and neither will my buccal fat. I can reject affection for my softness, and that I am exactly who I am. Maybe, though, I can choose something different. Love allows us to see reality for what it is, and survive despite it.