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The Sunday EssayOctober 15, 2023

The Sunday Essay: A hollow cheek 


Thin is in. It was never really out. 

The Sunday Essay is made possible thanks to the support of Creative New Zealand.

Images by Sara Moana.

I have found  myself so concerned with what other people think about my appearance that I almost recognise how fruitless it is to engage in the circus at all. Still, I continue conforming to rules I’ve made for myself: I don’t wear shoes like ballet flats because I have small feet and highlighting that would make my legs look bigger. I hate to wear jackets, hoodies or shirts that cut off at my hips because that’s my widest point. I rarely wear a cap sleeve because, obviously, that will make my upper arms look big. 

In the Trinny and Susannah era, that would simply be considered an awareness of how to dress your body. In the short-lived period of self-love and body positivity we enjoyed from around 2015-2020, it would be regarded as a problem to feel one “couldn’t wear” a particular item.  

That period is over now. We are coming full circle from body positivity to what I can only describe as thinography: being skinny to perform the social dance.

Thin is in. It was never really out out. 

This might have slipped by you if you weren’t a tween or teenage girl at the time, but in the mid 2000s, American writer Scott Westerfeld published a series of young-adult novels titled Uglies, Pretties, Specials and Extras. As with most dystopian YA novels, a freak occurrence in the near future decimates the population, leaving survivors asking: What regime can we enforce in our attempt to rebuild society? 

The central plot point surrounds the Surge, a rite of passage for all teens in which they receive a series of cosmetic surgery procedures that will make them, finally, Pretty. Once they have their surgery and achieve facial symmetry, they go and live in New Pretty Town. All those dwelling in New Pretty Town are so uniformly beautiful that no one has cause to be jealous, promoting equality and mitigating potential interpersonal issues. But eventually, war strikes: some people, the Specials, are receiving too much body modification, which throws everything into disarray. 

I see stark parallels to our aesthetically competitive life. Sometimes I feel like I’m pre-empting some kind of Pretty war. There are perfect soldiers, or there are Uglies. Seemingly, no in-between. 

My personal experience with thinness is only as complex as yours, probably. On skinniness, I was a relatively unaffected teen. Surprisingly so,  given the creative range of eating disorders I witnessed during my time at Epsom Girls Grammar School. It was common to “eat” only a cup of St. Pierre’s miso soup for lunch. I listened to friends dissect their developing bodies, complaining of gross inadequacy in the eye of whoever they were wanting to impress.

I took little issue with my weight until I lost a lot of it at age 19. It wasn’t intentional, it was by way of a parasite that lived inside me for far too long, resulting in a loss of 25 kilograms. At its peak, that took me to a precarious weight of 42 kgs. 

What was even more drastic than the weight loss itself was the reaction it garnered. Any naïvety or confidence I held regarding how I was perceived by others pre-weight loss was stamped out with little ceremony. My sunken and sickly face was admired for how much it jutted in and out at the right places. “I wish I had cheekbones like yours” was a stand-out quote. So was, “Your jawline is so defined.” I hadn’t kept a meal down for nearly a year. I had become accustomed to headaches and fatigue and near-constant irritability. 

What arose from all this newfound attention was an obsession with maintaining these features that people praised me for, even after I managed to kill the parasite. I internalised each of the comments and gripped the meaning I ascribed to them. Even when a sickness ends, I found, it often lingers in secret, mysterious ways. 

In the last quarter of 2022, I learnt about buccal fat removal,  when it seemed like everyone who lived in my phone was getting it. The cosmetic procedure takes a grape-size pad of buccal fat tissue from the interior of your cheek to reduce its roundness and potentially highlight the bone structure of your face in a more “flattering” way. 

Oh, you got your buccal fat removed? Should we throw a party? Should we invite Cillian Murphy? 

These fat pads won’t ever grow back, ensuring a lifetime of customer satisfaction. However, the procedure, like most cosmetic surgery, remains relatively gate-kept by its own cost. It’s difficult to pinpoint precisely, but depending on your surgeon stateside (where it is more widely offered than in New Zealand), removing your buccal could cost you anywhere between 5,000 to 20,000 USD. 

What do people love about a face that hollows? When I lost weight, I moved quite drastically from a child with puppy fat on my cheeks to an adult responsible for keeping up serious appearances. Buccal fat, in my opinion, shouldn’t be the enemy of a girl who graduated from childhood mere years earlier. An ample cheek should plainly remain a signifier of youth, joy, health, and prosperity. 

Perhaps they find, in cavernous cheeks, that there is something missing, something to be added back. There’s no longer any visual distraction from the basic features. Eyes, nose and a mouth. People love to look at uncomplicated things, and they crave an appealing composition, but internally this relationship to appearances is never uncomplicated. 

I diagnose the buccal trend as secondary to the reign of Ozempic, a diabetes drug touted by various major and minor celebrities as a weight loss aid. While Ozempic may make you drop 10 kilograms in a month by synthetically replicating the GLP-1 hormone that makes you feel so full you can’t eat, I wonder what happens when you stop taking it. Googling “Ozempic side effects” produces disturbing results, with more popping up daily, full of exciting and enchanting terms like jaundice, kidney failure, severe dehydration, and diarrhoea. 

Fun words like these remind me of when it was typical for me to wake up in the morning and race to the bathroom to throw up a sulfuric yellow stomach acid until my throat burnt and my brain felt like a rock inside my skull. 

This symptom, when described to medical professionals I sought out for intervention, was regularly weaponised against me. When the Omeprazole I was initially prescribed hardly made a dent in my inability to keep food in my stomach long enough to digest it, I was subjected to a litany of questions from doctors who queried my relationship to food, my body and whether I was sure I wasn’t making myself throw up for some other, concealed reason. 

You cannot, of course, expect a general practitioner to fix everything, but you can, at the very least, hope that the woman who has been your doctor since you were a toddler would not repeatedly suggest you are bulimic when it is wholly untrue.

What I didn’t possess, at the time, was the strength to truly fight anyone about these accusations. Any denial I expressed was disregarded as an obvious attempt at deflection; secrecy is paramount to bulimics. The irony is that puffy cheeks are one of the telltale signs of bulimia, not sunken ones. Self-induced vomiting causes enlargement of the salivary glands. 

When, after almost a year and three different doctors and something like 17 blood tests, the problem was revealed to be a parasite, I was left feeling little relief, and next to no vindication. 

Instead at age 20,  I stood outside my work, where I had been preparing and serving hot cross buns since 5am, and wept. I wore one of three pairs of pants I’d bought to fit my drastically different body, and sank against a  wall, swallowing my emotions as best I could while the doctor on the phone briefly apologised and explained the next steps. 

A friend told me about a place called Skinography in Three Lamps earlier this year. I was initially hooked by the incredible name, but also because their website boasted a “Buccal Facial”.

The buccal facial is a ballet of the fingers. They dance your skin about with their hands, so your face looks good. At one point, they place their hands inside your mouth (gloves on) and massage your cheeks. When you leave, they remind you how important it is to keep up the practice to maintain the effects of their labour. 

The demand for the treatment is high: when I initially tried to book in with the owner, there was a six-week waitlist. A page on their website invites you to join the waitlist for the “Sculptural Buccal Technique” training course. 

The day after my session, my skin looked amazing. Taught, plump, and fresh. My cheeks were so in I texted a picture to my mum, and she replied: “Amazing!” Honestly, I thought so, too. 

But these expressions of admiration about beauty, however well intentioned, can be fraught. Soon after doctors figured out what my mystery illness was, middle-aged women would say things to me like, “Wow, I wish I’d pick up a parasite like that! I could do with losing some weight.” I would just stare back at them silently, with a mixture of pity and rage. 

Over the years, my proximity with these beauty trends has varied. I deactivated Instagram for eight months, because my For You page was full of workout plans and diet food recipes. For a while, I became obsessed with pilates, working out six or seven days a week. The phone and the thin people around me became an inescapable reminder of what I was not able to achieve, physically, now that I was actually “healthy” again. 

One reason for my susceptibility to this messaging is my competitive nature in twisted tandem with people-pleasing tendencies. My body became my primary investment, but the returns were never that good, because when the addiction is to external validation, the market will almost always be volatile. The pendulum swing back to heroin chic reminds us all that the ideal body does not, and will never exist. Whatever striving, starving, slimming or sucking in one does, being at the apex of beauty can be swiped away as soon as what’s en vogue shifts.  

In the midst of oscillating beauty trends, both losing weight and gaining it invite a labyrinth of self reflection. For me, it was a demoralising experience, one in which I learned to understand that the bones underneath my skin were deemed higher in value than nearly anything else I possessed. 

Four years on from the eviction of my internal visitor, I have only recently begun to eat breakfast again. The habit of skipping breakfast originated, I think, from a place of discomfort in the mornings, and slowly developed into a way to eat less calories in a day. I still find myself reflexively feeling the underside of my chin after a big meal out of an irrational fear that I have gained back the weight I only lost from being so sick. I run my fingers over my cheeks and see if they dip the same way they did when I was getting endless compliments about my gaunt face. It’s the most praise I’ve ever received in my life.

Keep going!