Buccal facial fat removal: Lose now pay later

In 1999 I read a short story that forever changed how I interpret the world. It was a story called Lose Now Pay Later.


Set sometime in the not too distant future, two girls are walking through the mall and find a new dessert shop, called The Health Brigade, thats open. There are no people inside, just sleek and shiny machines dispensing these frozen yogurt like treats called Swoodies. The store is completely automated and all of the desserts inside are free. They try the Swoodies and find them to be the best, most tantalizing thing they have ever tasted. And addictive.

They go back the next day to find a line around the corner to get these desserts because word got out around town that they are so good. And free. More and more of these automated Health Brigade shops open up all around their town to keep up with demand. Yet still no people are seen who actually work there and the desserts are still free. No one seems to be bothered by this. 

After leaving the Health Brigade dessert store for their daily visit the girls both notice they're starting to get fat, and everyone in town is starting to balloon up too. One of the girls lamented that she wished there was an easy way to eat all of the Swoodies she wanted and not gain weight. 

Then as they're walking through the parking lot they see an tall freestanding booth, like an upright tanning bed, and a thin, short, odd looking woman standing next to it. When they asked what the device was, she aloofly stated in an unusual voice that it was a "slimmer", you step inside and lose unwanted fat. $1/lb. 

The one girl's skeptic side spoke to her and reasoned that there is no easy way to lose weight. Pills, wraps, fad diets etc. don't work. So neither could stepping into a machine. The attendant could not care less if she patronized her booth, apparently she didn't need their money and sometimes that says the product is that good. This was apparently the Hermes of parking lot kiosks.

But eventually the girl paid $5.00 and found that after stepping in the machine and then stepping out a minute later she was 5lbs lighter. Then her friend tried and they think they found a loophole: Eat all the free crap you want, go to this booth, lose the fat and pay the weight loss fee. 

When they go back to the booth the following day after their daily Swoodies binge the attendant pricks their wrist and makes a tiny, permanent blue dot. The attendant says for safety they need to make a mark on the wrist for every 10lbs lost from the machine. And after a short while the girls notice that most people around town are starting to get a "bracelet" of these tattooed dots around their wrist as more of these odd booths with even odder attendants start opening up.

Still no one questions why the desserts are free, why no one is running these health stores, or how these weight loss machines work. 

The story closes with the narrators brother's concern over what he is seeing happening in their town. He thinks what is going on is strange, and that maybe these Swoodies shops and Slimmer booths are connected. He said that they are run by aliens who are harvesting human fat from the Swoodies, collecting it in their Slimming machines, and then sending it to their home planet to use as fuel. And those little dots are markers to let the aliens know whose fat is becoming less viable, as the more fat taken the less efficient it is for fuel and eventually those people with prominent "bracelets" will be rounded up and discarded as waste. 

The sister dismissed her brothers concerns as stupid. Why wouldn't the Health Brigade tell them to stop eating Swoodies if they weren't good for them? And if there were aliens, surely they would know that a human being would never sacrifice their dignity and freedom just to be able to eat dessert and still be attractive. And she can stop eating Swoodies and going to that machine whenever she wanted. 

And then she admired the delicate little tattooed bracelet on her thin wrist and probably went back to get more dessert. 



The above story changed how I look at a lot of things but one thing that it changed for me was how I look at the cost of vanity. There is no such thing as a free lunch, as the adage goes, and here that means that cosmetic procedures cost more than their sticker price. They will cost you your youth.

The biggest up and coming cosmetic procedure is buccal fat removal, or cheek reduction surgery. If you ever wondered how celebrities suddenly got a sculpted look to their face, it is because of this procedure. The procedure simply takes out the fat pads in the lower parts of the cheeks, giving a hollowed look that is associated with top fashion models and heroin addicts. 

Hollowed cheeks and prominent cheekbones are the hallmark "Model Look"


Image of a patient before and after getting buccal fat removal surgery


Buccal fat removal targets those who are unhappy with the roundness of their face, those who have a "baby face" and would like to achieve a more mature look, or want a more sculpted appearance.


Buccal fat removal is therefore targeted primarily at younger people, usually teens to early 30s who want that model look, but their biology is getting in the way. 

The problem with the procedure is that it removes the very thing that keeps your youthful appearance: the fat in your cheeks.

Since most of the people who get this procedure are young, the results may look great now. But when you age, you naturally lose volume in your face. And the buccal fat pads keep that youthful look naturally into your mid to later years. Without those fat pads the face will get a gaunt, saggy and aged appearance. And then that causes people to get filler which distorts and ages the face even more. 

If you consider older people who look younger than their years, one thing they have in common is a naturally fuller face. Elderly people with a little (healthy) weight on them look much younger than those of the same age who are thin, and this is because fat in a matured face makes a younger appearance. 

Twin on the right weighs more than her twin on the left. The fullness in her face from added facial fat is among the factors that contribute to her younger appearance. 


Twin on the left weighs 38 pounds less than twin on the right and has more wrinkles and saggier skin. Twin on the right's extra weight provides some filling for her smile lines and provides a fuller more lifted appearance. The study who provided these photos determined that in twins over 40, more weight gives a younger appearance.


Buccal fat removal was relatively unheard of a few years ago, and it is now one of the most requested procedures in plastic surgeon offices. And that is because of Instagram. No one is happy with how they look anymore and that is because these "models" are bombarding highly impressionable teenagers and unconfident adults with their highly edited photos manipulated to unrealistic extreme proportions and lying to everyone by telling us that this is their natural look.

And no one seems to be bothered by this.

If all you saw was images of people with green skin and told this is natural, and beautiful you would probably start wondering why your skin wasn't green and looking for ways to change your color. No matter how dangerous.

And the problem is that when you see an image, you are not getting the full story. Before and after shots of buccal fat removal just make it appear like this is a quick and easy way to become "beautiful" and to finally be happy with yourself. Just lose the face fat now.

But you will have to pay later.

And what no one is saying is that young people are pretty good at being bad at considering the long term consequences of their actions, and since young people are the ones getting this procedure, they are setting themselves up for a lifetime of dissatisfaction.

We do not see the long term effects of buccal fat removal from Instagram photos, but if the above twin study photos are any indication, you will age your face and once those fat pads are removed, there is no getting them back. Once you are unhappy with your face again because now it looks too old, whereas before it looked too young, your only option is filler. And that will distort and age the face even more. 

Some believe that doctors would of course tell you if this procedure was unsafe, would not make you happier as a person, and will cause aging. But why would they? Surgeons are businesspeople and want to make money just like anyone else so why would they turn down a customer? Just like those people running the Health Brigade wouldn't tell the humans to stop eating their Swoodies, doctors are not going to turn away a cash source. And you're a great cash source because surgeons are well aware of how addictive cosmetic surgery is. And once you're in, you'll never be out. 

Instagram and these other apps are designed to make us feel bad about ourselves. And yet no one seems to be bothered by this. Somehow before I go on Instagram, I am fine with what I have, with where I live and how I look. And then after I go on the app suddenly my clothes are not good enough, my house isn't opulent enough and my face isn't hot enough. And I know I am not the only one. So what happens? The shopping for clothes or for a plastic surgeon. But the issue here is deeper, it signifies the dissatisfaction with ourselves, our expectation that clothes and handbags will solve our problems and a different face will make us finally be happy with our mirror image. The quick and easy fix.

But there are no quick and easy fixes to deep rooted problems just like there is no booth we can walk into and loose 10lbs in an instant. And of course people would sacrifice their dignity and freedom just to look like a model.

But at the end of the day this Sisyphean effort for solace makes us all worse for wear.

You don't need this procedure. 

Buccal fat removal: Lose the fat now, pay with your youth later.