Coming

CHISELED FACES

Everyone is talking about buccal fat pad removal, a not-really-new plastic surgery procedure that is reportedly making the rounds in some celebrity circles.

Rumor has it that star of Broadway’s Funny Girl Lea Michele, supermodel Bella Hadid, and singer Miley Cyrus all had their cheek pads removed to reveal more chiseled and defined facial contours. Model Chrissy Teigen has said publicly that she underwent the trending procedure. From here, it took off on social media, causing a spike in Google searches, and the hashtag #buccalfatremoval blew up on TikTok.

In the right candidate, this low-risk procedure can provide impressive aesthetic results and enhance zygomatic prominence and overall contour of the face. There are some concerns, though. The results are permanent. Once your buccal fat is gone, it’s gone for good. Fillers may help restore volume, but that is only a temporary fix. As people age, they naturally lose fat in their faces, and when combined with prior buccal fat removal, this can result in a gaunt, unhealthy appearance.

Expect more patients to seek consultation about this procedure in the coming months and be prepared to go over the benefits, risks, and alternatives with each of them.

Going

ENDO’S QWO

Endo’s Qwo (collagenase clostridium histolyticum-aaes) scored FDA approval as the first injectable to reduce cellulite in July 2020. Qwo is a liquid enzyme that targets the buildup of collagen in septae bands. The idea of an injectable cellulite treatment resonated with many patients who were not satisfied with the results of available energy-based cellulite treatments.

But, in December 2022, just a few months after the company launched Butt First, a direct-to-consumer awareness campaign about Qwo, Endo ceased the production of Qwo owing to concerns about the extent and variability of bruising following initial treatment as well as the potential for prolonged skin discoloration. For more than a year, Endo worked to address those concerns, including by launching an open-label study, APHRODITE, in June 2022 to test different interventions and whether they might mitigate bruising.

Qwo is gone for now, but FDA approval remains. So, it is possible that Qwo or another version of this injectable may be available in the future.

Until then, there is lots of innovation taking place in cellulite treatment. BTL’s Emtone simultaneously delivers both thermal and mechanical energy to break up cellulite, and Sofwave just scored FDA approval for cellulite reduction. Allergan Aesthetics, an AbbVie company, completed its acquisition of Soliton, Inc, manufacturer of the Resonic device, which utilizes Rapid Acoustic Pulse technology to treat cellulite, and Avéli from Revelle Aesthetics, Inc, has FDA clearance for long-term reduction in the appearance of cellulite in the buttocks and thigh areas of adult women.

Qwo may be gone, but we have more options than ever before to address cellulite.

Dr. Graivier disclosed no relevant financial interest.