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Buccal fat removal is a surgical procedure designed to remove fat from the lower part of the cheeks, creating a more defined look. It's an increasingly popular option for those who want to slim down their cheeks or reduce fullness in their face.
But before you consider surgery, it's important to understand how the procedure works and the potential risks involved. You may also want to explore nonsurgical ways to reduce facial fat.
What is buccal fat?
Buccal fat is the layer of fat located between your cheekbones and jawline, giving your face its natural fullness. Everyone has buccal fat, but the amount can vary from person to person. Some people naturally have fuller cheeks, while others have more defined or slimmer faces. Factors like genetics, age, and body weight can all affect how much buccal fat you have.
While buccal fat can provide a youthful appearance, too much of it may give the face a rounder or puffier look. People who opt for buccal fat removal surgery often want a more defined look, particularly in the lower part of the face. It's especially popular among those who feel their face looks too round or chubby, even if they are at a healthy body weight.
Surgery to remove buccal fat
Buccal fat removal surgery is a cosmetic procedure during which a surgeon removes a portion of the fat pads in the lower cheeks. The surgery is typically done under local anesthesia, although intravenous or general anesthesia can also be used. The surgeon makes a small incision inside the mouth, so there are no visible scars. He or she removes just enough fat to slim the face without making it look too hollow or gaunt.
The surgery usually takes less than an hour, and most people can go home the same day. After buccal fat removal surgery, your doctor may recommend sticking to a liquid diet for several days or more. They might also give you instructions on using special mouth rinses to help lower the risk of infection.
Recovery from buccal fat removal is fairly quick, typically about two to three weeks. You may experience some swelling, bruising, or discomfort in the days following the procedure, but this usually goes away within a week or two. Full results are visible once the swelling has completely gone down, which may take several months.
Risks and complications of surgical buccal fat removal
As with any surgery, buccal fat removal comes with risks and potential complications. These can include:
Infection. Any time you have surgery, there's a risk of infection. Proper care, such as using a special medicated mouth rinse after surgery, can help lower this risk.
Bleeding. Though rare, some people may experience bleeding during or after the procedure.
Nerve damage. There is a small risk of damaging the facial nerves, which could lead to temporary or permanent numbness in the cheeks.
Overcorrection. Removing too much buccal fat can result in a hollow or sunken appearance, especially as you age and naturally lose fat in the face.
Facial asymmetry. Buccal fat pads on both sides of the face are not always the same size. Even with careful planning, a surgeon might remove too much fat from one side, leading to an uneven or distorted appearance.
Because of these risks, it's important to consult with an experienced surgeon who has performed many buccal fat removal surgeries. The doctor should evaluate your facial structure to determine if you're a good candidate for the procedure.
Nonsurgical ways to reduce face fat
If you're not ready to consider surgery, or want to explore nonsurgical ways to reduce facial fat, there are a few options you can try:
Source: Harvard Health Publishing
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If you're struggling with bloating or discomfort after consuming dairy, beans, or certain vegetables, digestive enzyme supplements might be what your body needs to process these tricky foods.
What are digestive enzyme supplements?
There's a lot that goes on behind the scenes during digestion. As food makes its way through your gastrointestinal (GI) tract, your digestive organs break it down into smaller parts, in part by using digestive juices. Digestive juices contain enzymes that break down food into smaller components of carbohydrates, fats, and proteins. There are different enzymes for different components; for example, the enzyme amylase breaks down carbohydrates, the enzyme protease breaks down proteins, and the enzyme lipase breaks down fats.
Your pancreas, stomach, and small intestine naturally produce these enzymes. However, sometimes the body doesn't produce enough enzymes. This can slow down digestion and lead to uncomfortable symptoms like bloating and gas.
Sometimes people can't make enough digestive enzymes because of a health condition like chronic pancreatitis or cystic fibrosis. In these cases, a doctor will prescribe enzyme pills to substitute for the lack of natural enzyme production.
However, in cases of lactose intolerance or difficulty digesting complex carbohydrates found in beans and certain gas-producing vegetables, over-the-counter (OTC) digestive enzyme supplements may be enough improve digestion and provide relief from discomfort.
How do supplements like Lactaid and Beano work?
Lactaid and Beano are two popular digestive enzyme supplements that can help people digest specific foods more easily. Both supplements target specific digestive issues by providing enzymes the body may not naturally produce in sufficient quantities. And both are available without a prescription.
Lactaid dietary supplements contain lactase, an enzyme that breaks down lactose, a sugar found in dairy products. People who are lactose intolerant lack sufficient lactase, leading to symptoms like gas, bloating, and diarrhea after consuming dairy. Lactaid dietary supplements can be used every time you eat foods that contain dairy. But many people find that they can digest certain forms of dairy (like hard cheeses) more easily than other forms (like milk or ice cream). A little experimentation can help you figure out when you need an assist from an enzyme supplement.
Beano contains alpha-galactosidase, an enzyme that helps break down a type of non-absorbable fiber found in beans, root vegetables, and some dairy products. These foods can be difficult for the body to digest, and may cause gas and bloating. Beano breaks down the non-absorbable fiber before it reaches the intestines, where it would otherwise ferment and produce gas. Taking Beano before meals can help prevent gas-related symptoms like flatulence, abdominal cramping, and bloating. Beano is taken in tablet form right before eating or with your first bite.
Who can benefit from digestive enzyme supplements?
Digestive enzyme supplements can benefit people who struggle to digest certain foods due to low levels of the enzymes that process those foods. For example, individuals with lactose intolerance (which affects up to 75% of the world's population) may benefit from lactase supplements like Lactaid.
Similarly, more than 20% of the population experiences abdominal pain caused by intestinal gas resulting from difficulty digesting complex carbohydrates in beans and certain vegetables. They may find relief from supplements like Beano.
While the evidence is still unsettled, some people with irritable bowel syndrome (IBS) may find digestive enzymes helpful for managing their symptoms.
Are digestive enzyme supplements safe?
Digestive enzyme supplements are generally safe for most people, but there are a few important considerations.
For example, Beano may cause allergic reactions in people with alpha-gal syndrome or mold allergies. Those with galactosemia, a metabolic disorder that causes an inability to metabolize the sugar galactose, should consult their doctor before using Beano.
Pregnant and breastfeeding women and young children should check with their doctor before using a lactase product like Lactaid.
Finally, as is the case with all OTC supplements, digestive enzyme supplements are not regulated by the FDA. As a result, the quality and content of these products can vary. This means you can't always be sure about the ingredients or enzyme concentration in these supplements. Prescription enzyme medications, on the other hand, are tightly regulated.
Source: Harvard Health Publishing
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If you have a serious medical condition that affects your gastrointestinal (GI) tract, you may need an ostomy. An ostomy can be life-changing, and in some cases, lifesaving. It's estimated that up to one million Americans currently live with one.
What is an ostomy?
Ostomy is a medical term for a surgery that changes the way urine or stool leaves the body. This article will focus on ostomy procedures related to stool.
Briefly, during an ostomy procedure, the surgeon connects the small or large intestine to a stoma, or opening, in the abdominal wall. This allows waste to exit the body while bypassing part of the digestive tract. Instead of leaving the body through the anus, stool collects in a special pouch placed inside or right outside the abdomen. An ostomy may be temporary or permanent.
Who might need an ostomy?
An ostomy may be needed if an injury or illness prevents waste from exiting the body. For example:
In some cases, ostomy may be reversed once treatment for the underlying condition is complete or an injury has healed.
Types of ostomies
There are two main types of ostomies: a colostomy and an ileostomy. Your surgeon will recommend one or the other depending on which part of your intestine is affected.
Colostomy
During this surgery, diseased or damaged portions of the colon, or large intestine, are removed, and the remaining portion is diverted through an opening in the abdominal wall.
Ileostomy
With this surgery, diseased or damaged portions of the ileum, or small intestine, are removed and the remaining part is redirected to an opening in the abdominal wall.
What to expect after surgery
A nurse will go over everything you need to know about post-surgical care — including how your ostomy bag works — before you leave the hospital. You will be in the hospital for anywhere from three to 10 days after the procedure. You'll usually be sent home once stool begins to exit your body through your stoma.
You'll experience many changes after surgery, including the following:
Changes in bowel movements. You may find that your bowel movements are looser and less formed. This should improve with time, as your digestive tract heals.
Excess gas. It's normal to be gassier after ostomy surgery. Avoiding the following can help:
You may also need to temporarily limit high-fiber foods like raw fruits and vegetables, nuts, and seeds. You'll be able to gradually reintroduce these foods after a few weeks.
Dehydration. Up to 30% of patients become dehydrated after ostomy surgery. It's the most common cause of hospital readmission. In general, it's recommended that adult men drink 13 cups of fluid a day, and adult women 9 cups. You'll need to increase that by about 2 to 3 cups per day after surgery. The best fluid choices are water, broth, and Pedialyte.
Managing your ostomy bag and caring for your skin
A common problem with ostomy bags is leakage of body waste. A study published in the journal Nursing Open found that about 14% of ostomy patients report leakage at least once a week. You can help reduce the chance of this happening by carefully following the care instructions provided by your nurse.
For example, you'll need to empty your ostomy bag when it's one-third full (usually five to eight times a day). In addition to reducing the risk of leakage, this will help to prevent unpleasant odors. You'll go to the bathroom and empty the pouch's contents into the toilet, then clean the bottom of the pouch with toilet paper. You will also need to change your pouch every three days or so. You can shower or bathe either with or without your ostomy bag.
The skin around your stoma can become irritated from the ostomy bag. To help prevent this, your ostomy pouch comes with a skin barrier. Also called a wafer, this barrier sticks to the skin and helps keep the ostomy bag in place. It's very important that the skin barrier is the right size. If it's too small, or too large, it can injure the stoma, cause skin irritation, or cause an unpleasant odor. Your nurse can help you determine if your skin barrier fits properly.
You should replace the skin barrier whenever you change your ostomy bag. Clean around your stoma with warm water and a washcloth, dry the skin, then apply the new skin barrier. Pastes and powders are also available over the counter to make the skin barrier easier to apply and to help prevent irritation.
Common challenges and solutions
Here are some common challenges you may encounter after your ostomy — along with solutions to make them more manageable.
Odor. Ostomy pouches are designed to contain odors. But odors are normal when the pouch is being emptied. Ostomy pouch deoderants and room sprays can help neutralize unpleasant odors during emptying.
Travel. You can still hit the road (or a train, or a plane) with an ostomy bag. Bring twice the number of supplies that you normally need. Pack some with you, and some in another place like your suitcase in case one gets lost. You can also download a TSA Travel Communication Card, and a Restroom Access Communication Card, to discreetly let airport and airplane staff know you have an ostomy.
Trouble absorbing medications. Because an ostomy shortens the duration of the digestive process, it may be harder to absorb medications after ostomy surgery, especially if you take enteric-coated pills or time-release capsules. Tell all your doctors and your pharmacist if you have had ostomy surgery. They can make sure you get medications in the form you need, whether they are prescription or over the counter. Let them know immediately if you see any full or partially digested pills in your ostomy bag.
Anemia. It may be harder to absorb nutrients such as vitamin B12 from food after ostomy surgery. As a result, you can develop anemia, a condition where your body can't produce enough red blood cells and that can make you feel very tired. Ask your doctor whether you should take a vitamin B12 supplement.
Sex. You may feel self-conscious about having sex after your ostomy. Open communication with your partner is key. You may want to simply start with kissing and cuddling. Intercourse won't injure your stoma, but a side lying position may be most comfortable. Sometimes, men experience temporary problems with erection. Women may notice vaginal dryness. There are medication options to help with both.
Exercise and other physical activies. People who have an ostomy can do all the activities they did before surgery, from biking and skiing to jogging or gardening. If you play contact sports, you may want to purchase a stoma guard. Also talk to your doctor about stomach strengthening exercises, to reduce the risk of developing a hernia.
If you are a swimmer, you may worry that your ostomy bag will leak in the water. Ostomy pouches are specially designed to prevent that from happening. If you are still worried, you can apply waterproof tape to the pouch for added security. You may also want to empty your pouch before you dive in.
Although the idea of having an ostomy pouch can take some getting used to, and despite the need to deal with certain challenges, research suggests that most people enjoy the same quality of life after the procedure that they had before their ostomy.
Support and resources for living with an ostomy
These resources can make it easier to live with an ostomy:
United Ostomy Associations of America. This nonprofit organization provides informational materials on life with an ostomy, as well as support groups.
Wound, Ostomy and Continence Nurses Society (WOCN). This website provides resources for patients and families. It can help you find an ostomy nurse to help with ostomy care, as well as adjusting to life with an ostomy.
Source: Harvard Health Publishing
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If you've ever fainted at the sight of blood or from standing up too fast, you've experienced what's known as vasovagal syncope, the most common cause of fainting. Up to a third of people have experienced an episode of vasovagal syncope at some point in their lives.
Occasional episodes of vasovagal syncope are rarely a cause for concern. But if they happen often, it's a good idea to see a doctor to rule out more serious underlying causes.
What is vasovagal syncope?
Vasovagal syncope occurs when the vagus nerve, which carries signals from the brain to the rest of the body and controls functions including heart rate and blood pressure, becomes overstimulated in response to triggers such as stress, dehydration, or donating blood. The heart rate slows and blood vessels widen, causing a drop in blood pressure and reduced blood flow to the brain. This can lead to a loss of consciousness.
Lying or sitting down (and even falling) quickly restores blood flow to the brain, allowing blood pressure to return to normal. Most people regain consciousness within a few seconds after passing out.
While vasovagal syncope is not life-threatening in itself, it can lead to serious injuries as a result of falling.
Common triggers of vasovagal syncope
Common triggers of vasovagal syncope include:
Less common triggers of vasovagal syncope include coughing, straining to have a bowel movement, or urinating while standing up (in men).
Symptoms of vasovagal syncope
Fainting due to vasovagal syncope is often preceded by feeling dizzy, lightheaded, or nauseous. Your skin may feel cold and clammy and you may black out or have blurry vision. If you're standing up, you will lose control of the muscles in your lower body and will slump or fall down.
How to manage syncope if you're prone to fainting
If you have fainted before and recognize the signs, here are some things you can do to restore blood flow to the brain before you actually pass out.
If you know your triggers, take preventive measures to avoid fainting or to avoid falling if you do faint. For example, if having your blood drawn is a trigger, ask to lie down during the procedure. If you've fainted before due to dehydration, make sure you drink enough water or other liquids throughout the day.
When to see a doctor
See your doctor if you have recurrent fainting episodes or if you experience confusion or heart palpitations during an episode. Your provider may want to rule out other causes of fainting. If you also experience chest pain or shortness of breath, call 911 right away.
Not all fainting is related to the vasovagal nerve. Other common causes include heart problems, low blood sugar, panic disorder, seizure disorders, neurological disorders, substance use disorders, and some prescription medications.
Treatment options for recurrent syncope
In general, the best way to avoid fainting due to vasovagal syncope is to avoid your triggers, recognize warning signs, and adopt prevention strategies if you do feel warning signs coming on.
If the underlying cause of your fainting episodes is not related to overstimulation of the vasovagal nerve, your doctor will likely recommend further testing. In that case, treatment will address the underlying cause.
Source: Harvard Health Publishing
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You can find rice in a rainbow of colors: purple, black, gold, red, brown, and, of course, white. But when you're faced with the decision of brown rice versus white rice, how do you know which to choose?
What is the difference between brown rice and white rice?
The difference between the two comes down to more than just color. It's also about how they are processed.
Brown rice is a whole grain, which means it contains all three components of the grain: the bran, endosperm, and germ.
When white rice is processed, it's stripped of the bran and the germ. The remaining endosperm is starchier and not as nutrient-dense as the whole grain.
White rice typically cooks faster than brown rice.
Nutritional comparison: Brown rice versus white rice
Brown rice and white rice can both be part of a healthy diet. But because brown rice retains the bran and germ, it's more nutrient-dense than white rice. For example, brown rice delivers more fiber, magnesium, potassium, iron, and certain B vitamins (B1, B3, B6, and B9) than white rice.
White rice is easier to digest, in part because it's lower in fiber. That may be beneficial for some people at certain times. For example, individuals with irritable bowel syndrome or inflammatory bowel disease may need to watch how much fiber they get during flare-ups of those conditions.
But if you're otherwise healthy, a diet rich in fiber-filled whole grains — including brown rice — is linked with a number of health perks, including reduced risk of heart disease and type 2 diabetes, and weight management.
The glycemic index: How brown rice and white rice compare
The glycemic index (GI) is a scoring system that ranks foods from 0 to 100 based on how much they increase blood sugar. The lower the GI score of a food, the lower and slower your blood sugar climbs after you eat. Glycemic index is particularly important for people with diabetes, who are more likely to experience quick, high blood sugar spikes than those without the condition.
White rice has a high glycemic index, in the range of 73 ± 4. Brown rice is categorized as a medium glycemic index food, with a GI of 68 ± 4.
Eating white rice is also linked to a higher risk of developing type 2 diabetes, while eating brown rice is linked to a lower risk.
Calorie comparison
The calories contained in brown and white rice are similar.
The bottom line: Is brown rice healthier than white rice?
Brown rice, which contains more nutrients and fiber and has a lower glycemic index value, is a healthier choice for most people. But if you're experiencing a flare-up of a digestive condition that makes it harder to digest fiber, white rice may be a better option for you — at least until your symptoms improve.
Source: Harvard Health Publishing
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Approximately three million Americans have inflammatory bowel disease (IBD). IBD is an umbrella term for Crohn's disease and ulcerative colitis, illnesses marked by chronic or repeated bouts of inflammation in the digestive tract. Both types of IBD represent a complex interplay of genes, environment, and immune factors.
Current therapies for IBD suppress the immune system to reduce inflammation. But emerging research on the human microbiome may help scientists better understand and manage IBD. And some preliminary studies on cells, animals, and humans have investigated whether probiotics — which are sometimes called "good" bacteria — are beneficial for people with IBD.
The healthy microbiome: Building a barrier
The human intestinal microbiome is the vast community of trillions of helpful and harmful bacteria, viruses, fungi, and other microorganisms that inhabit our gut. Ideally, the lining of the gut acts as a barrier that prevents harmful bacteria and toxins from entering the bloodstream.
A healthy microbiome helps this lining block out harmful bacteria while enabling it to absorb nutrients. Beneficial bacteria in the microbiome promote a healthy, hospitable gut environment that limits inflammation and helps crowd out harmful bacteria.
Recent studies on human cells and in mice suggest that a healthy microbiome produces substances that
In animal studies, a healthy microbiome is essential to help build and maintain an effective barrier. Animals raised in the laboratory without a microbiome, or whose microbiome has been depleted by antibiotics, have intestinal linings that are easily damaged.
An unbalanced microbiome: Inflammation and damage
What happens if the microbiome doesn't have a good balance of helpful and harmful bacteria? The gut lining may become increasingly permeable. That may allow potentially harmful bacteria and their toxins to cross into the intestinal tissue and then into the bloodstream, triggering inflammation that can damage the gut.
An imbalanced microbiome is known as dysbiosis. And the inflammatory cascade linked to dysbiosis is a hallmark of IBD.
Probiotics: More promise than evidence
Probiotics — live microorganisms in supplements or in fermented foods like kombucha, kefir, yogurt, and sauerkraut — have been proposed as therapies for IBD. The idea is that by eating beneficial bacteria we can restore and maintain a balanced microbiome, reduce inflammation, and improve the gut barrier. But what does the evidence say?
Thus far, no probiotic therapy is routinely prescribed for IBD. Small randomized studies have compared specific probiotics with standard immunosuppressive therapies for IBD. The studies measured IBD symptoms, remission rates, or quality of life. Results were mixed at best:
Diet, fiber, and prebiotics: A role in IBD?
The makeup and activity of our microbiomes can be altered by diet. That's true even if the foods you consume aren't well-known probiotic stars like kombucha, yogurt, kefir, and other fermented foods.
Gut bacteria that break down dietary fiber are a cornerstone of a healthy microbiome. A high-fiber diet can boost the number of these bacteria, as well as their beneficial and anti-inflammatory effects.
Food ingredients that are not absorbed by the gut but are instead consumed by the gut microbiome are called prebiotics. We have limited — though promising — evidence supporting prebiotics for people with IBD. Currently, no specific prebiotic food or supplement is recommended for general use.
However, the Mediterranean diet, which encourages fiber-rich vegetables, whole grains, and legumes, may modestly reduce symptoms and markers of inflammation in IBD. While these effects are small and inconsistent, the Mediterranean diet improves overall health in people with or without IBD. Largely for this reason, the American Gastroenterology Association recommends it for people who have IBD.
The bottom line
Probiotics, and possibly even prebiotics, hold promise. But we don't yet know how to harness their full potential for treating IBD. While current evidence suggests probiotics may one day be an effective way to help treat IBD, the complexity of the microbiome means that a one-size-fits-all approach is unlikely to work.
Many questions remain: Which strains of bacteria in the gut should we study? How do we determine the best cocktail of probiotics to reap maximum benefit? Given that everyone's microbiome is different, is a personalized approach to probiotics the right strategy? How can we define ideal dosage and formulation of probiotics?
Delivery method (capsules, powders, foods), dosage, and duration of treatment all require more research. Until these questions are answered, probiotics and prebiotics remain complementary strategies in treating IBD alongside standard immunosuppressive therapies.
Source: Harvard Health Publishing
