On Tuesday, Glee and Funny Girl star Lea Michele posted some tousle-haired, smokey-eyed new selfies to her Instagram account. Her face, already slender, looks particularly chiseled, her cheekbones slicing diagonally downward to create an almost Bella Hadid-like hollow look.
The selfies sparked a wave of discourse on Twitter as many speculated that Michele had gotten buccal fat removal, a cosmetic surgical procedure that removes a naturally-occurring pad of fat from one’s lower cheek area in order to give the face a slimmed-down appearance.
“The surgery has been around for many years, but with the advent of social media, I think it’s really seen a resurgence and popularity,” plastic surgeon Dr. Ira Savetsky, author of the 2021 study The Role of the Buccal Fat Pad in Facial Aesthetic Surgery, told The Daily Beast. “The reason why buccal fat pad removal is so popular is because the jawline has become really popular. Everyone wants a snatched jawline, that’s what the kids are saying these days.”
“Patients who feel like they’re viewed as ‘too young’ or ‘unserious’ because of their childlike large cheeks enjoy the new contours of their face after their procedure,” Gotham Plastic Surgery’s website reads.
Men represent approximately a quarter of prospective patients interested in buccal fat removal, Dr. Richard Swift, an NYC-based plastic surgeon, told The Daily Beast. “I’ve had guys who want to have more defined faces, I’ve had models come and see me,” Dr. Swift said. “Someone said that they were not getting roles because they had facial fullness, and they wanted to be more competitive.”
“The American Society of Plastic Surgeons currently does not publish yearly statistics of buccal fat removal procedures; therefore, predicting future trends of this procedure is difficult,” plastic surgeon Dr. Samuel J. Lin told Byrdie in October. Nevertheless, anecdotal evidence suggests a huge boom.
Like Kylie Jenner-core lip injections before it, buccal fat removal has spawned a corner of the internet in which very young women track their healing process and given rise to a host of speculation regarding which other celebrities besides Michele may have had it done.
After reviewing images of the actresses, Dr. Swift told The Daily Beast he thinks Michele and Zoë Kravitz likely have gone through with buccal fat removal. “I think Lea and Zoë have much more definition than they had before,” Dr. Swift said. “Zoë Kravitz had more of a baby face, and if you look at the submalar area, that’s really well defined now.” The Daily Beast reached out to Michele and Kravitz for comment.
The procedure takes around 20 minutes to complete with local anesthetic, and generally costs patients around $5,000 in New York City, Dr. Savetsky said.
“The buccal fat pad is anterior, or towards the front of the lower face above the jaw,” Dr. Savetsky said. “Buccal fat pad removal gives people that shadow or that really thin lower face, and it’s a relatively easy procedure.”
“The drawback is that from an aesthetic standpoint, facial fat is very precious, and we learned from anatomy studies and studying how people age that as we get older we lose fat in the face,” Dr. Savetsky said. “If you’re someone who has chubby cheeks, that’s a good patient because you’re removing excess and leaving them with a relatively normal amount of buccal fat. But if you perform the procedure on someone who doesn’t have excess buccal fat or if you remove too much, while it may look good in your twenties and thirties, as you age and as you lose more fat in your face you’re going to look overly hollow as you get older.”
“Out of every five people that walk into my office that want it, probably only one is a good candidate for it,” Dr. Savetsky said.
Julianne, 25, got buccal fat removal surgery when she was 23.
“I had always had a round face, but when I got older I started carrying weight in my face even when I lost weight, so I just wanted a slimmer/contoured look,” she told The Daily Beast.
“I was actually originally just going for chin lipo and added the buccal fat removal minutes before,” Julianne said. “I had mine done in Mexico, Mexicali specifically, and for both surgeries it was $1735. It was $1400 for the neck/chin lipo and the buccal fat removal cost $300 to add on. $35 for a face garment.”
“I know there’s controversy because you’ll lose weight in your face as you get older and you’ll want rounder cheeks then, but I don’t think I’ll have any regrets then either,” Julianne said. “I’m very happy about the change it did for me.”
The increasing ubiquity of the procedure within the cultural lexicon has also sparked a wave of backlash amongst those frustrated with the normalization of accessible plastic surgery.
“I’ve honestly been surprised that the culture has taken to plastic surgery with such enthusiasm at the same time as we were starting to work through some of the problematic aspects of diet culture,” beauty writer Jessica DeFino told The Daily Beast. “For the past couple of years we have been championing this unattainable ideal of beauty in place of diet culture, which set the stage for diet culture to come back and be recast as active empowerment and body autonomy. Now we’re seeing these things collide in the buccal fat removal procedure, which is ultimately glorifying a fatphobic, capitalist ideal of unattainable beauty.”
Last September, perpetually-online celeb Chrissy Teigen divulged on Instagram that she’d had the procedure done by Beverly Hills plastic surgeon Dr. Jason Diamond. Teigen, recognizable for her round, full cheeks, looks distinctly more angular.
Dr. Diamond told The Daily Beast he’s been performing buccal fat reductions on good candidates for the surgery of all ages since 1997, but “around 2010 or 2012, people started marketing the shit out of it on Instagram and their social media when that stuff started to become popular.... All of a sudden, you’d see these younger doctors promoting the procedure.”
Just like you or I would bring a picture of a famous actress to a salon looking to emulate her haircut, famous people go to Dr. Diamond for buccal fat removals hoping to look like other famous people. “Zoë Kravitz, Megan Fox and Kim K are the people that even the celebrities want to look like,” Dr. Diamond said.
Tannia Hewlett, 39, is a registered nurse first assistant to plastic surgeons based in Dallas; Hewlett underwent buccal fat removal surgery last year.
“My lower face had jowls and I had chipmunk pockets on the side of my face,” Hewlett, who had chin liposuction done in addition to buccal fat removal, told The Daily Beast. “The healing was great. You can’t eat crazy amounts of food immediately afterwards, but the swelling goes away and I can’t even feel the incisions now. It took maybe 6 months, and now they’re completely gone.”
“I absolutely love it,” Hewlett said. “My face looks so much slimmer, and it took care of the chipmunk pouches I was very self-conscious about.”
“I did a lot of research beforehand and made myself aware of the risks, but I was very confident in saying that even if I took these fat pads out, it wouldn’t cause a huge difference in my face,” Hewlett said.
On TikTok, videos with hundreds of thousands of views document women in their early and mid-twenties making trips to Mexico for buccal fat removal and chin liposuction procedures, emerging with feline, angled features that evoke social media’s most famous beauty influencers.
“We put thinness on a pedestal, so it stands to reason that some people, and women in particular, would eventually gravitate toward procedures that mimic the gauntness of low body weight,” Tamika Turner, who runs the culture and beauty TikTok @prettycritical, told The Daily Beast.
“On the other hand, there’s something really insidious about the vocal pushback I’ve heard on celebrities’ recent procedures,” Turner said. “When it comes to body modifications, it’s important to remember that not everyone is chasing the same aesthetic. Pointing out that someone looks much older or saying that they won’t age as well reveals that you think they owe the world a plump, youthful face. What you may think is a critique of a society that pushes people towards plastic surgery is really a demand that women mold their aesthetics to your taste.”
“I feel hesitant about people who are super young doing that surgery, because it’s not like filler which you can technically get dissolved, or Botox, which your body metabolizes,” Ama Kwarteng, beauty director at Coveteur, told The Daily Beast. “I feel like people are grouping it in the same category as Botox or filler, but it’s just so much more permanent than that.”
Buccal fat removal “is very hard to reverse,” Dr. Savetsky said. “When I’m doing a facelift for an older woman I am putting fat back into her face, but adding fat back into that space is very, very difficult, because it’s a deeper area. It’s almost irreversible.”