I’m against all euphemisms to mask the word FAT, a word that doesn’t scare me. At all. I’m not an “overweight female”, I’m a fat woman and such is the term I use to refer to women like myself. There’s no hate here, no self-deprecation. I do love myself. Not easy, but that’s another story.
You’ve heard this many, many times: For years there were only slim models attempting to sell us clothing, shoes, all kinds of accessories, etc. I guess I didn’t even pay attention to fashion, as it simply didn’t represent me. Back then fashion didn’t attempt to dress a woman like me, so when these supposed “fat models” joined the industry, I was definitely paying attention.
And then I discovered Denise Bidot and Ashley Graham...
The first fat model I discovered was Denise Bidot, who I had the chance to interview a few years ago. At the time she was bigger than she is now and definitely represented me. Then I remember finding Ashley Graham. They both have a few things in common:
They’re fat, we can agree on that; they advocate for body positivity; and they have the neck and face of a skinny woman. And that’s where I become disconnected.
Are they natural, though...?
I always thought it couldn’t be natural to look like that. I’ve seen women who are very skinny from the waist up and fat from the waist down. Natural bodies. But this is another story. These women look photoshopped to me. It’s like a Funko Pop! figure, only backwards. It doesn’t look natural.
Now, think of all the fat women like me, taking them as an example to follow. Doing all the exercise they do to look like they do. And guess what… No fat woman turns into Ashley Graham by following the exercise routine she shows on social media. I am not a doctor, as I went to school to become a professional writer, so whatever I say about the issue is just my –ignorant– opinion.
This being the case, I decided to talk to a professional on the subject, so I interviewed Rafael Pérez Franco, a plastic, maxillofacial, and hand surgeon who went to school for General Medicine and then did a 4-year specialization. He’s a Bogotá-based doctor and the reason I met him is because two friends of mine came to Colombia from Miami to have cosmetic surgeries with him.
Let's Talk to an Expert...
Doctor, a woman with the body like plus-size model Ashley Graham, does she have any surgery on her face and neck to look so thin from the shoulders up, compared to the rest of her body, which is fat?
There are no absolutes here, but I would dare say she must have had surgery because adipocytes are present all over the body, including the neck and face. Therefore, a plus-size woman is likely to have more filled adipocytes in her neck and face as well. Adipocytes normally do not multiply when your body mass index (BMI) is below 30. But when you go above 30, they multiply, a process called mitosis. Mitosis is a cellular replication that starts in overweight conditions and leads to the appearance of those abnormal fat cells when one is obese.
What is the Name of the Surgery a Fat Woman Gets to Have a Thin Neck and Face?
The basic one is liposuction, or double chin liposuction. If one has extra skin, additional skin contraction can be done to help that skin adhere better and make it seem like no surgery was performed.
What about the face?
The face too. In the face, there is a small pouch called Bichat, located below the cheekbone and above the jawbone, behind the masseter muscle, which is the chewing muscle. When this pouch is removed, it gives the effect of sucking in your cheeks, creating a shadow there. This shadow effect is achieved by the extraction of the Bichat’s fat pad.
Is it possible for a woman to naturally have a fat body but a thin neck and face, or does that not occur naturally?
Many people have a condition called hereditary lipodystrophy, which makes them look like one person from the waist up and another from the waist down. They have large buttocks, legs, and hips, with a lot of cellulite on the legs, but are thin from the waist up.
But is There Naturally a Woman with a Fat Body like Mine or Ashley Graham’s and Just a Thin Neck and Face?
Well, her face seems too defined for the type of body she has…
Do you think these plus-size models who supposedly fight to accept themselves as they are naturally, in a context of body positivity, should reveal the truth, or is it valid for it to be a secret?
That is very personal, but I am completely and absolutely at ease saying they should reveal it. Why? Because they are an inspiration to many people who are overweight and want to achieve that body. Even in larger sizes, it’s not easy to have a harmonious hip and waist ratio in an XL woman. So, I tell you, sometimes this is also achieved surgically. I don’t know if that is the case with Ashley Graham because I haven’t really seen her body; I’ve only seen her on the runway with a dress on.
What do you think are the typical motivations behind a fat woman seeking facial and neck procedures like the ones you mention?
The face gives a person the most self-confidence; to wear a dress, to go to the beach, anything. Body confidence comes from the face. If your face looks good, with good definition and harmony, you have much more self-confidence.
How do you evaluate if a woman is a suitable candidate for these procedures?
I’ve been in this business for many years, 25 years, and I remember that sometime in my career, or when I was young, I said: I studied medicine to help people. I can make some adjustments to a patient so that when she sees her face improved, she feels motivated to exercise more or eat better.
What are the Potential Risks and Complications Associated with These Surgeries?
I always say, All of them. If you are overweight, for example, anesthesia becomes a major risk.
How do you ensure natural results, particularly for a fat woman undergoing this surgery? I mean, I wonder, what is deemed natural? Because when I see Ashley Graham, she doesn't look natural. So, how do you ensure it will look natural?
It’s difficult because, even among surgeons, some achieve natural results while others’ results look more artificial. I believe that well-done surgery is the one that doesn’t look like it. It also depends on what the plastic surgeon considers beautiful.
Are there any non-surgical alternatives to achieve the same results as this surgery?
They exist. They are certainly inferior to surgery, but much safer and much more economical. Radiofrequency treatments, slimming massages, etc.
Do these types of surgeries we're talking about require any continuous care or maintenance to preserve the results?
Any surgery, if not cared for, will deteriorate. Something has to improve from what they aren’t doing, like eating healthy or doing more exercise, because if not, they’ll come back in a few years saying: You didn’t do the surgery well.
What's Your Advice for a Fat Woman Considering these Face and Neck Procedures?
They must understand it’s a procedure that must be designed for each person because there are many structures in the neck and face that affect how defined you look. Let’s say each person needs a different surgery. Look for a surgeon who specializes in this. Also, see this as an encouragement; we always need psychological support. You should think about yourself. Do it for yourself and no one else but you.
How do you think the desire for aesthetic improvement balances with the importance of self-acceptance and body positivity?
In normality, everything has limits, even vanity. It’s normal to want to look better as we age within a normal society. And we will always have a justification when in reality we just want to look better. When someone is overweight, they definitely need to lose weight. Because when there is excess weight, all the joints suffer and get damaged because we are designed to have a BMI below 30.
Often, surgeries are a combination of functional and aesthetic needs. Look for a specialist who belongs to the plastic surgery society of the country you are in. Someone who also understands the importance of psychological support, to avoid the burden of undergoing surgery just because we want to look beautiful, because we are definitely going to take a risk. It’s about understanding that it will also benefit your health and give you peace of mind when you decide, without remorse: I’m going to do it, so what?
I Was Right!
I am going to conclude I was right. No natural fat body looks like Ashley Graham’s. So, fat woman, just keep doing exercise and eating healthy (if you want to, only if you want to). Try to love yourself just as you are, understanding that –just like the Kardashian/Jenners- the beauty standards imposed by these supposed “fat models” are a lie and unattainable. Let’s make that very clear and try to move on, shall we?
And to you, Ashley Graham: Shame on you. I guess –even having those big tits– they’re not big enough to admit you’re a product of cosmetic surgery. Which, by the way, you have all the right to. Just, don’t lie to the rest of us. Don’t underestimate our intelligence and stop lying to yourself!