Yes, the fact buccal fat removal is already 2023's buzziest aesthetic trend *is* problematic—here's why

If you've been on any form of social media in the past few weeks, there's high chance you've stumbled across the term 'buccal fat removal'. Names such as Chrissy Teigen, Bella Hadid, Miley Cyrus and Lea Michele have all been mentioned in the increasing number of stories and posts surfacing on the internet around buccal fat removal—mostly through sheer speculation.

On TikTok the #buccalfatremoval trend currently has 6.3million views with related terms only adding to this number, making it destined to be one of the most popular beauty trends of 2023. However, while some posts are naming buccal fat removal one of the most popular aesthetics trends of the year, others are keen to highlight the trend's issues. The rest of us, who are simply being subjected to the conversation whether we like it or not, are left with a whole bunch of questions. Namely, what the hell is buccal fat removal and why on earth is there so much noise around it?

If you're currently wondering what I'm talking about, let me explain. Buccal (pronounced buckle, like the belt fastening) fat is something that, as a beauty editor, I know about, but I'm very aware that it's not a term anyone outside of the world of cosmetics and aesthetics would likely have on their radar. Essentially, buccal fat is the name given to the fat pads that exist at the sides of our cheeks (between the cheekbone and jaw bone). Everyone has buccal fat pads—they're a key part of our facial anatomy that give our faces shape. Remember, those with more pronounced cheek bones still have buccal fat pads.

Buccal fat removal is a cosmetics procedure that involves having those fat pads removed to create a more 'defined' facial anatomy (and razor-sharp cheekbones). The reason it's become such a hot topic? A combination of celebrity hooks, a highly engaged social media space and a growing want for more defined facial features have created a perfect storm.

Back in 2021, Chrissy Teigen took to her Instagram stories to show the results of her buccal fat removal. Since then, there has been ongoing debate online about which other celebrities might have also had the procedure. However, when actress Lea Michele posted a selfie to Instagram a few weeks ago, the conversation around the procedure really took off. People turned to Twitter to discuss whether or not they thought Michele had undergone buccal fat removal. Tweets were posted with pictures of other celebrities that also may or may not have undergone the procedure, with nothing more than selfies and pap shots as evidence.

As a beauty journalist of over eight years, this sat uneasy with me—for a whole bunch of reasons. My brain has been swimming with opinions on the buccal fat removal trend for weeks now, but they just weren't making sense. I've felt angry then nonplussed, understanding then conflicted, and none of these emotions make for a good piece of journalism. To create some order to the chaos inside my head, I have spent the last two weeks speaking with some of my most trusted aesthetics experts, from surgeons and doctors to fellow journalists in a bid to help properly articulate why the buccal fat removal trend is so problematic. So here goes...

Tweakment vs. surgery

My first port of call for insight was my own aesthetician, Dr Ahmed El Muntasar, who is a GP as well as being an award-winning aesthetician. Every six months I see Dr El Muntasar for Botox, a fact that leads me onto a very important point that I would like to put out there—I am not against cosmetic procedures and tweakments. If somebody wants to have a procedure to make them feel better about themselves, I'm all for it. Providing they know the risks, have a trusted doctor to visit and are fully educated on the matter, I don't believe that anybody should be shamed for their cosmetic choices. My issues with buccal fat removal exist entirely with the narrative of the trend rather than the people who opt for it.

"Buccal fat removal has become a very popular online trend with so many people getting it done," says El Muntasar. "Although, I'm not a fan of buccal fat removal because there are so many risks." You see, although all cosmetics procedures have risks (bleeding, infection, swelling etc.), social media posts would have you believe buccal fat removal is less of a full procedure and more of a tweakment—but this isn't the case.

"It really alarms me to see this [buccal fat removal] blowing up as a trend on social media,’ says Alice Hart-Davis, founder of The Tweakments Guide. "Yes, extracting buccal fat will accentuate your bone structure and works a treat for people with heavy, well-padded lower cheeks. BUT it's not a tweakment, it's surgery and it's not reversible."

Unlike other popular aesthetics procedures such as filler and Botox, buccal fat removal is a permanent change to your face that can't be reversed. The fat pads are removed "through tiny 5mm incisions which are made on the inside of the mouth", says Mr Tunc Tiryaki, Consultant Plastic Surgeon at the Cadogan Clinic.  And this isn't something many social media posts will tell you, which leads me onto my next point.

Miseducation on social media

Earlier in this story, I mentioned the rise of trending hashtags on TikTok. The fact that #buccalfatremoval currently has 6.3million views and counting cements it as a very popular trend. What's more shocking, however, are some of the other trending terms around the procedure. The #buckelfatremoval hashtag has 1.1million views on the platform—that's over 1million people receiving information on a serious cosmetics trend from creators who are spelling the term incorrectly. 

Of course, I'm the first to admit that a skill for spelling doesn't automatically make you an expert in the area, but in this case it raises questions about how many of these creators have ever bothered to Google the procedure at all. 

The good news? Clicking through to the #buckelfatremoval hashtag presents almost no return—indicating that perhaps there is some form of misinformation management around the area on the app.

The ageing debate

Something social media doesn't tell you? Buccal fat removal is deemed a short-term gain by a huge amount of experts. "[Buccal fat removal] is not a procedure I would ever perform as I have seen the results of accelerated ageing as little as three years post-procedure," says Mr Tiryaki. "As a specialist facial plastic surgeon, I have seen countless examples of buccal fat removal accelerating ageing. Whilst patients may be really happy with the initial result of chiselled cheeks and jawline, after a few years the results tell a different story, making the patient look older than their years with a hollowed appearance and more visible lines and wrinkles alongside sagging skin."

And Dr El Muntasar agrees. While buccal fat removal will likely result in a more defined look in your younger years, as we age those all-important fat pads prove more important. "I have seen a lot of patients that had buccal removal 15 years ago and regret it because they now look older than they should," he says.

"It’s important to remember that fat is an integral part of our facial structure, giving shape and making fine lines and wrinkles less visible. The psychological impact of accelerated facial ageing caused by buccal removal can be monumental, affecting self-confidence and self-esteem," adds Mr Tiryaki.

The success stories

It is, of course, important to note that lots of people turn to buccal fat removal for their own self-confidence and see great results from the procedure. In fact, just last week US magazine The Cut published a story written by its grooming editor, Garrett Munce, where he documents the resounding success from his buccal fat removal a few years ago. His account highlights the rise in self-confidence he has felt since undergoing the procedure, even saying he's never looked back.

Munce's most important message, however, is that he undertook a lot of research. He spoke with a number of surgeons (being in this business does mean we editors have some of the world's best cosmetics surgeons on speed dial—and that's something we know not everyone else has), he weighed up the pros and cons carefully and he ultimately decided to go ahead. 

And this is a point I really want to get out there—my thoughts on buccal fat removal as a procedure itself are really no different to my thoughts on any other cosmetic surgery. If you want it, do it, but my God make sure you've done your research and are fully clued up outside of social media posts. Buccal fat removal is a procedure that should be taken seriously, just as Munce relays.

Thin is in

My final thought around buccal fat removal is probably the one that I find most problematic—and that is around the rise of fatphobic beauty trends. Factually, fat is integral to our anatomy and any attempt to remove it in a bid to appear slimmer and more defined is something that I believe to be worrying when it is a decision taken frivolously. 

Of course, taking mental health, self-esteem and health levels into account means I don't believe that all fat-removing procedures are wrong. I totally understand that such surgeries and procedures can sometimes help improve self-confidence and I could never say I stand against something that turns out for the better. However, I do believe there should be room for open conversation here.

In the case of buccal fat removal, the experts I spoke with were keen to address that the procedure is currently 'on trend'. "Unfortunately, thin is in again and this is the biggest driver for patients seeking the procedure as they wish to achieve a slimmer-looking face with defined cheekbones and jawline. Just like fashion, the face and body are subject to changing trends with fox eyes, excessive cheek and lip filler recent examples of short-lived facial fads," says Mr Tiryaki.

The better news? Dr El Muntasar has seen a slight change in desires in clinic. "Social media is all about telling women what they should look like, sound like, what they should eat, drink, and wear and it is so much pressure to sustain these unattainable standards of beauty and lifestyle. However, I think there has been a shift in people not following influencers and these trends as much as people are starting to find their own voice and personality—which I think is amazing."

And I have to agree. While buccal fat removal is the aesthetic trend du jour, the biggest beauty trend for 2023 is without doubt owning your face, doing with it what you please and, most importantly, treating  your body with the kindness it deserves.