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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:*
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.
What did the surgeon say the downsides would be? My understanding is that plastic surgeons had collectively cooled on it, due to problems like proximity to nerves and difficulty in achieving symmetry (especially if done under local anesthesia), in addition to possible long term appearance problems or unrealistic expectations about short term appearances.
He most warned about inadequate results requiring followup, and a (short) post-op recovery period. Also advised me not to rush into things, which is made moot by the fact that I won't be back home for another 6 months. He did check my expectations by explaining that just BFR wouldn't achieve the desires I was seeking.
My (basic) research into complication rates was heartening, with <1% neurological complication rates, particularly facial nerve injury. Even then, most of the time it's transient. There just isn't that much critical infrastructure in the typical site of insertion.
Asymmetry is always a concern, but be suggested 2ml of fat per cheek to start with, which is on the low end.
In the UK, I'd expect a great deal more boilerplate about potential risks, but that's not as common in India, and he might have felt that as a fellow medical professional, I would know of the side effects .
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