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PaperclipPerfector  1d ago (text post)   1010 thread views

Friday Fun Thread for May 23, 2025

Be advised: this thread is not for serious in-depth discussion of weighty topics (we have a link for that), this thread is not for anything Culture War related. This thread is for Fun. You got jokes? Share 'em. You got silly questions? Ask 'em.

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I'm thinking of biting the bullet on plastic surgery. I've always had chubby cheeks, without that much definition even when I was 10 kilos lighter, and buccal fat removal was something I'd been eyeing for years. I just didn't really have the money or the impetus to go for it back then.

I had an appointment with a reputable plastic surgeon today, and started off with a debate on whether he could exclude body dysmorphia in my case lol. I explained that in a psychiatric context, didn't any degree of dissatisfaction with one's physical appearance that involved attempts to modify it count? Why doesn't going to the gym or dieting to lose weight count? Besides, you'd need to have significant impairment in psychosocial functioning to warrant it. The DSM-5 includes, under BDD:*

Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others

While the roundness of one's face is a subjective thing, it's certainly not non-observable.

At any rate, he pretty successfully upsold me, explaining that I had hypertrophic masseters, which would make mere buccal fat removal not have very significant effects on the overall contour of the face. He also explained that instead of discarding buccal fat, as is the norm, he finds benefit from it being re-injected below the eyes and on the chin. To help tone down the masseters further, he suggested botox. I'm not particularly keen on semi-annual injections into my face, but I think it's worth a shot.

Anyone undergo anything similar?

*If it's unclear, he was taking the piss. I don't have body dysmorphia, it's a high bar to cross.

I'm not particularly keen on semi-annual injections into my face, but I think it's worth a shot.

I'd consider getting a second opinion to make sure there isn't some 'one and done' permanent surgery available rather than this SaaS (Surgery as a Service) ongoing maintenance payment.

Botox just works that way. I'm not sure I'd consider it a surgery in the first place. The others should, at least in ideal circumstances, be one and done. While I'm far from a plastic surgeon, I think his points were reasonable.

I came out of it with a relatively positive impression of the surgeon, he seemed quite prudent and even suggested that I take time to think this through. Unfortunately, I'm flying back to the UK soon, and it's going to cost me an order of magnitude more. For what it's worth, his credentials are impeccable, so I'd struggle to find someone else in the time frame I'm working under.

All good points. Why not give it a go then? If its low risk (you've done a credential check) and affordable you can give it a trial and see if you like the results.

I probably will. It's certainly much cheaper in India versus what it would be in the UK. The buccal fat removal is permanent (without fillers or transplants to reverse it), but I can always forego the botox in the future.

Of course you might end up looking weird. I'm guessing these places have pics of their previous work? A former colleague had a vanity-driven surgery to suck fat out of his baggy (in his mind) eyelids. But because he has serious sleep issues and his genius response to this was just to begin taking Ambien, he looks now like a guy with two black eyes about a week into healing. This is post-surgery.

Don't mind me, though, I'm generally adamantly against cosmetic surgery to begin with.

He's just about as credentialed as one can desire for a plastic surgeon, I believe he trained at Harvard. He also showed me several cases with before and after photos, and I was impressed by the results. Of course, they don't show off the botch jobs..

Cosmetic procedures vary in their risk, buccal fat removal is safe as it goes, with a pooled risk of complications of around 1-3%. That covers both minor and major issues. I'm not as up to speed on the reimplantation of the fat or the botox, but from first principles, they're probably not any worse. All the incisions are inside the mouth, which means no visible scars. Not much bleeding, so the risk of haematomas or infection are rather minor. That's ignoring the risk of failure or non-ideal results. Buccal fat naturally goes away with age, so if overdone, can leave you with sagging cheeks or jowls. I can consider that a problem for another few decades down the line, it can be fixed.

At the end of the day, it's up to one's personal risk appetite and how content they are with their appearance.

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