TikTok is divided on buccal fat removal

The idea of altering appearances in the name of beauty has been around since, well, humanity could look itself in the mirror. Nowadays, it seems like a trendy new cosmetic procedure is popping up every other day – and lately, TikTok For You Pages have been buzzing with hot-blooded takes on buccal fat removal, sparked by recent photos of Lea Michele and Amelia Gray Hamlin with seemingly dramatic facial changes.

Also known as a “buccal lipectomy” or “cheek reduction surgery,” buccal fat removal refers to a plastic surgery procedure that eliminates “a naturally-occurring pad of fat in the cheek hollow area,” according to the American Society of Plastic Surgeons (ASPS). Those who undergo the procedure often aim to achieve a “slimming” effect in their midfaces, and to make their cheekbones and jawlines appear more prominent.

From a historical standpoint, full, cherub-like cheeks have often been considered as a sign of youth and beauty — just look at this spread of French Regency paintings. But as stars like Bella Hadid and Lea Michele (neither of whom has said they’ve ever had the procedure, per Harper’s Bazaar) sweep the red carpets and dominate Instagram feeds with chiseled cheekbones, it seems increasingly more people are looking to cosmetic procedures to replicate the look. The #BuccalFatRemoval hashtag on TikTok currently has more than 140 million views; the videos include people analyzing celebrity before-and-after photos, sharing their own buccal fat removal journeys, and pushing back on the trend.

While buccal fat removal is a newly trending topic, the procedure has actually long been one of Hollywood’s worst-kept “secrets,” New York-based plastic surgeon Lara Devgan, MD, told The New York Times. Some celebrities, including Chrissy Teigen, have admitted to undergoing the procedure. “I did that Dr. Diamond buccal fat removal thing here,” Teigen said in an Instagram video last year, referring to the surgeon that performed her procedure. “Since I quit drinking, I’m really seeing the results, and I like it. No shame in my Dr. Diamond game.”

Teigen isn’t alone. With a 92% rating on RealSelf, a healthcare marketplace where patients can research procedures and connect with plastic surgeons, buccal fat removal seems to have a pretty high satisfaction rate among patients who have undergone the procedure.

But not everyone is thrilled about the trend. TikTok is also filling up with videos of people proudly asserting their happiness with their fuller cheeks. “Heard y’all are obsessed with buccal face fat removal so here’s 15 seconds of me in love with my chubby cheeks,” wrote TikToker @chilislut, alongside a reel showing off her cherub-like cheeks in several photos.

And then there are the medical professionals cautioning people who think they’re ready to jump on board. “Unfortunately, I think many surgeons will take out the wrong [facial] fat in addition to the buccal fat,” said board-certified Beverly Hills plastic surgeon Jourbin Gabbay, MD, in a Dec. 19 TikTok video. “This is a delicate procedure that needs a lot of experience on how to do it, and sometimes, [surgeons] will go for the fat that’s a little more superficial … and create this hollowed out look.”

Indeed, buccal fat removal isn’t as simple as getting fillers or Botox. Not only is it much more expensive — estimates range from $3,000 to $40,000, depending on factors like the doctor and where it’s performed — but the procedure also involves anesthesia (local or general), incisions, and stitches. According to Healthline, recovery takes about three weeks, with swelling and potential bruising that diminishes over time; in the beginning, you’ll need to stick to a liquid diet. And, as with any procedure, there are risks. “The buccal fat pat is intricately intertwined with certain important [facial] structures,” said NYC-based plastic surgeon Gary Linkov, MD, in an October 2021 YouTube video. These important facial structures include nerves, blood vessels, and muscles that could sustain permanent damage in the hands of an inexperienced surgeon.

According to the ASPS, the best candidates for buccal fat removal are those who have “realistic expectations,” and are “bothered by the appearance of [their] chubby cheeks.” But the procedure isn’t typically recommended to people who already have slim, narrow faces, as “removal of the fat may cause the face to look more gaunt with age.” In other words, buccal fat removal could result in premature aging and lead patients to seek additional cosmetic procedures, like fillers and fat transfers, to restore lost facial volume as they grow older.

While today’s beauty standards may change as quickly as fleeting fashion trends, it’s important to consider all the risks involved for any cosmetic procedure and consult with a board-certified plastic surgeon before you make any decisions. Undergoing plastic surgery to alter your physical appearance isn’t as risk-free as changing your outfit: It’s easy to undergo a procedure, but it’s often much more difficult to reverse its effects. Unfavorable results can stick around for a lot longer than you’d like them to, so doing your research before going under the knife is critical.