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Notes -
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:*
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.
Last week I went to a followup on my stitches that the doctor who stitched me up had suggested I schedule with their plastic surgery practice. She didn't actually tell me I needed anything beyond using silicon scar tape at night, which I had already heard through the grapevine, and at any rate I'm pretty happy with how the scar is healing up, and anyway I'm married. But my wife has been highly amused, because she can now say that I went to a plastic surgeon before she did.
In general, my wife went off right now when I told her this Q, you want to be doing a lot of stuff before you start plastic surgery. Buccal fat removal in particular is really risky because you can't get it back, so if you take it out now, and your face continues to slim out as is typical with aging, you might be looking like skeletor in another ten years. ((Mrs. FiveHour: Buccal fat is the most evil procedure, alongside maybe lip filler.)) Then you get filler to fix that, filler has all kinds of problems with fading or migrating, so you have to fix that, and now you're on the plastic-surgery-overcorrection cycle. There are a lot of other options in the aesthetic treatment range to attempt first.
Have you ever heard of or tried microcurrent devices like the Ziip? It's a microcurrent device that basically electrocutes your facial muscles. The designers claim all kinds of benefits from facial contouring to clearing up skin. My wife has one, I've played around with it, but I've never been disciplined enough or cared enough to keep up with it for months. When I've used it on the "contouring" setting it does get some of that sharper look I think you're going for, and it's relatively cheap and very low risk compared to other choices you have. I know there are also salons or spas or whatever that offer a higher-end version of the home product in microcurrent facials, which you could try without committing to purchasing one and using it all the time. Rescue Spa is the top end, but I don't think they're overseas.
My wife recommends botox, it is cheap and low risk. Find a reputable provider and get very little. Start small, most women do way too much which leads to the paralyzed look. What's nice is it just goes away if you use the right amount. My wife gets them biannually, it's no big deal, small amounts in the forehead. It'll be ten years before it approaches the cost of a real surgical procedure. Let it fade off completely between shots.
Also possibly PRP injections below the eyes are something to look into, according to Mrs. FiveHour.
In general there's nothing wrong with trying to look better, and there are ways to do it, but especially as a man you absolutely must avoid the appearance of having had plastic surgery. For women there is at least a little leeway, in that obvious plastic surgery at least often has the effect of making her look slutty and sexually available, so it's not all bad. For men, visible plastic surgery is pretty much the worst thing possible, making a man look vain, effeminate, faggy, untrustworthy, and foolish. So start light and focus on the long game.
I'm aware of the risks, but they seem small and acceptable to me. My surgeon has recommended 2ml of fat removed per cheek, which is AFAIK, a very conservative value. I've probably got a decade or more before my cheeks shrink by themselves, and looking at older family members, it's not very noticeable. I think the risk of becoming gaunt is manageable.
I'll have to look into it, but my gut feeling is that it's not reliable. I can't see an obvious MOA from merely passing current through the face muscles!
Good advice, send her my thanks. I believe masseter botox doesn't have much impact on facial expressions or wrinkles, the biggest side effect is usually decreased chewing strength and fatigue, and that usually wears off quick.
Fillers are okay as a temporary solutions, but autologous fat grafts, especially from the buccal area, tend to be far more lasting. I'm a little skeptical of PRP as a therapy tbh. Is she recommending it for enhancing the upper cheek? I don't really have baggy eyes, or at least I don't care about them.
I see a dozen woman a day on the streets who I can tell have had work done. I struggle to name a single non-celebrity man. Most men opt for hair transplants as their foray into cosmetic surgery. The BFR and masseter botox don't leave any visible scars, and barring the risk of lopsidedness (unlikely with a skilled surgeon), I really doubt anyone could tell. They'd probably think I've lost weight and worked out, which to be fair, I'm doing alongside the procedure. I'm interested in a rhinoplasty, which would be harder to explain away, but I doubt anyone would particularly care.
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