The internet has managed to breed yet another insecurity in people: Their buccal fat. You’re probably wondering how people can be insecure about something that you’ve never even heard of — and you’re not alone. “How are they still inventing new flaws for us?” one Twitter user inquired. Buccal fat (pronounced buckle) is the fat pad located in the cheeks that can make some faces appear rounder. Some people have naturally defined cheekbones and more sculpted faces, “while some others have more cherubic faces” sometimes referred to as “chipmunk cheeks,” New York facial plastic surgeon Andrew Jacono explains, according to the New York Times. Buccal fat removal procedures involve removing part of patients’ buccal fat to give them the same appearance achieved by sucking through a straw — the same look people strive to create when contouring below the cheeks with makeup.

Why is buccal fat even a topic of conversation? It became a hot topic on the internet in recent weeks after social media users began speculating that certain celebrities may have removed some of their buccal fat for more defined cheekbones. This selfie actress Lea Michele posted on her Instagram, showcasing her exceptionally chiseled face, spurred a lot of speculation. Former supermodel Chrissy Teigen has been more vocal about the beauty trend, saying in a video posted to her Instagram page, “I did that buccal fat removal thing here,” and tagged her Beverly Hills plastic surgeon, Jason Diamond.

It’s not just celebrities that are getting in on this elective procedure: “I’m doing three times as many buccal fat reductions this year than I was five years ago,” said Jacono, who charges USD 40k for the procedure. The procedure usually costs somewhere in the USD7k-16k range, according to other plastic surgeons. For London plastic surgeon Yannis Alexandrides, buccal fat removal was the third most popular procedure in 2022, after rhinoplasty and liposuction, The Independent reports.

Other plastic surgeons have refused to perform the procedure because cheeks naturally hollow as we age. Those who have undergone the procedure risk looking extremely malnourished or sunken as they age and their cheeks lose fat and collagen. The procedure is also difficult to reverse and attempting to do so requires several additional procedures. Beauty standards seldom last long, and trends are fickle by definition: The bushy brow look that actress Cara Delevinge is widely credited with instigating has already been traded for a thinner brow look. And celebrities who once boasted their curvy figures have now lost dramatic amounts of weight as the trend swings towards being skinny. Those who undergo the relatively permanent buccal fat removal procedure risk being left behind when the trend shifts again.

It’s also not without its health risks: Bleeding is the main risk associated with the surgery, an official from the American Society of Plastic Surgeons told the New York Times. Nerve injury, incision infection, facial numbness, and ending up with an asymmetrical face are all also potential risks, according to the Cleveland Clinic.

So if it all seems so negative, where did this trend come from? Social media is often blamed for encouraging people to seek out plastic surgery but Tunc Tiryaki, a consultant plastic surgeon at London’s Cadogan Clinic, has identified one feature in specific: Filters. He believes Instagram and Snapchat filters — which are often designed to make faces look more chiseled and V-shaped — have contributed to the rise in buccal fat removals, the Independent reports. “When you come back to reality, of course, this doesn’t correspond with our real anatomy,” he explains. Celebrities who appear to have gotten the surgery are also blamed for giving rise to the trend.

Damned if they do and damned if they don’t: It’s easy to point the finger at celebrities for fueling cosmetic surgery trends, as they have a bad rep of promoting unattainable beauty standards. While the stigma around plastic surgery has, in many ways, decreased in recent years, many celebrities still shy away from admitting they’ve gotten work done. However, celebrities that have been open about the cosmetic procedures they’ve undergone are accused of promoting plastic surgery to some of their more impressionable fans, many of whom are young women and teenage girls. On the flipside those that refute claims of having procedures done or simply remain tight lipped about it are slammed for holding up unrealistic standards.

So who can we blame for coming up with these difficult to achieve, fleeting beauty standards? Beauty reporter Jessica Defino has identified four suspects: “Patriarchy, white supremacy, colonialism, and capitalism, Refinery29 reports. You can blame them for trends from the fox eye lift to brazilian butt lifts peaking and then going out of style. The trends dying out has triggered a conversation about what it means when body types and facial features associated with different ethnic groups are no longer trending? “As a Black woman, seeing these predominantly white creators discuss the body type that I grew up seeing on my family and idolized within Jamaican communities cited as a trend feels like a form of erasure,” a woman told Refinery29.