Hi Ugly,<\/p>\n
I recently became aware of new cosmetic injectables derived from cadaver fat \u2013 as in, made of dead people. Apparently the fat is harvested from organ and tissue donors and used for procedures like Brazilian butt lifts and boob jobs.<\/p>\n
What is this? How is it legal? Even if it is legal, how is it ethical?<\/p>\n
\u2013 The Beauty Industry Is Killing Me<\/p>\n
A half-dozen dead, devastatingly gorgeous bodies float, naked, in 10ft-tall test tubes. They\u2019re preserved. Perfect. Ready.<\/p>\n
\u201cCalling them donors is crass,\u201d a plastic surgeon says. \u201cI call them epidermis angels: beautiful people who left the earth far too soon, and who were so generous as to pass along their good fortune to others.\u201d<\/p>\n
Soon, the surgeon will harvest their parts \u2013 smooth skin, symmetrical faces, asses with just the right amount of fat \u2013 and transplant them on to the living. Beauty, he says, should never be \u201cwasted on the dead\u201d.<\/p>\n
When this scene from FX\u2019s sci-fi series The Beauty<\/a> aired in January, it already felt dated. Real-world cosmetic doctors had been injecting patients with AlloClae, a filler made from donated human cadaver fat, for over a year.<\/p>\n This is probably the macabre material you\u2019ve been hearing about. Recent headlines include \u201cI Got My BBL From A Cadaver\u201d<\/a> and \u201cBack(side) from the dead!\u201d<\/a>. But while AlloClae has ignited a fresh cycle of disgust and debate over what I\u2019ll call necrocosmetics, the category isn\u2019t new.<\/p>\n The aesthetics industry has long harvested \u201ccadaveric materials from organ and tissue donors to reconstruct people\u201d, says Dr Melissa Doft, a plastic surgeon based in New York. \u201cWe use skin grafts to help repair burns and for breast reconstructions. We use rib grafts to reconstruct noses.\u201d<\/p>\n A little over a decade ago, the tissue bank MTF Biologics developed a method to repurpose donated human adipose tissue \u2013 AKA fat \u2013 which had previously been discarded after skin tissue collection. The injectable \u201callograft adipose matrix\u201d<\/a> treatment known as Renuva was born (or raised from the dead). The product can be used to plump cheeks, nasolabial folds, temples and cellulite dimples, and has the unique ability to merge with the recipient. \u201cThe body recognizes Renuva once you inject it,\u201d explains Evi Chnari, the vice-president of R&D at MTF Biologics. \u201cThe patient\u2019s own cells then convert it into their own fat.\u201d<\/p>\n Death, quite literally, becomes you.<\/p>\n More from Jessica DeFino:<\/p>\n AlloClae, a Tiger Aesthetics product, functions similarly. Donor fat is purchased, processed and purified of genetic material. Since AlloClae includes lipid molecules and has a thicker consistency, it\u2019s more suitable for use on the body: Brazilian butt lifts (BBLs), breast enhancements, hip dips.<\/p>\n It\u2019s possible to perform these procedures sans dead people, I should note. Hyaluronic acid fillers like Juv\u00e9derm and Restylane can add volume to the face. Autologous fat transfer, in which fat is removed from one area of the patient\u2019s body via liposuction and reinjected into other areas, is another popular option.<\/p>\n But beauty enthusiasts are increasingly opting to use human remains instead, mostly due to \u201cfiller fatigue\u201d<\/a> \u2013 traditional filler can cause problems such as puffiness and lymphatic issues \u2013 and the widespread use of GLP-1s. \u201cPeople who are on Ozempic or are dieting heavily are really thin, and don\u2019t have enough fat to transfer,\u201d Doft says. \u201cThey want their legs and their belly to be skinny, but want their breasts to be fuller.\u201d<\/p>\n Where\u2019s a patient to turn? A corpse, of course.<\/p>\n \u201cI thought everyone was going to get creeped out by it,\u201d says Dr Haideh Hirmand, a plastic surgeon based in New York, but \u201cless people than you\u2019d think even care\u201d. The creep-factor is apparently mitigated by convenience: Renuva and AlloClae don\u2019t require downtime or anesthesia like fat transfers do, making the 30-minute lunch break boob job<\/a> possible. (Thanks, donors!)<\/p>\n And yup, this is legal.<\/p>\n In the US, the Uniform Anatomical Gift Act (UAGA) authorizes tissue banks to collect voluntary donations from the dead for use in transplants, research, education and more. (Lobbyists for \u201cthe multibillion-dollar body parts industry\u201d helped rewrite the UAGA in 2006 to make it \u201ceasier for body parts to be harvested quickly\u201d, according to the LA Times<\/a>.) MTF Biologics and Tiger Aesthetics\u2019 products are FDA-cleared for use in the US.<\/p>\n Is it ethical, though? That\u2019s a little harder to parse.<\/p>\n Earlier this month, I surveyed more than 200 readers about necrocosmetics. Many registered donors expressed concern that their bodies would be used for elective cosmetic surgery rather than life-saving surgery, but this isn\u2019t an either\/or situation. A single donor can \u201csave eight lives and enhance 75 others through organ, eye and tissue donation\u201d, according to organ donation non-profit Donate Life. So your abdominal fat might end up in someone\u2019s cheeks \u2013 face or butt \u2013 but \u201cyou\u2019re not just a BBL\u201d, as Doft puts it. \u201cEvery part that can be used is being used.\u201d<\/p>\n Consent is another question.<\/p>\n The decision to become an organ and tissue donor can be made by the donor (pre-death) or their family (post-death). A 2012 NPR investigation<\/a> noted that tissue bank solicitors mentioned the possibility of being used for cosmetic surgery to potential donors only 29% of the time. \u201cIn convincing people to become donors, companies rarely mention that a growing part of the [procurement business] is cosmetic surgery,\u201d the LA Times reported in 2019<\/a>.<\/p>\n Forms vary from state to state<\/a>, but in some cases it\u2019s possible to designate your tissue donation for \u201clifesaving and reconstructive purposes\u201d<\/a>, although due to limitations in industry tracking, it\u2019s not clear if these wishes are always honored. You may also be able to specify your remains go \u201cto non-profit organizations\u201d only, but that doesn\u2019t guarantee non-cosmetic use either. (MTF Biologics is a non-profit.)<\/p>\n Chnari tells me MTF Biologics\u2019 donors do consent to cosmetic use. \u201cThat\u2019s the right way of doing it,\u201d she says. A Tiger Aesthetics representative has said the company ensures all its tissue is \u201cconsented to for aesthetic use\u201d<\/a> as well.<\/p>\n Some survey respondents were distressed by the idea of cosmetic companies buying and selling dead people for profit, consensual or not.<\/p>\n \u201cThat just falls down to a critique of capitalism,\u201d says Ryan Pferdehirt, the vice-president of ethics services at the Center for Practical Bioethics. The beauty industry has always been built on the commodification of dead bodies, both animal (millions of research animals<\/a> have died as a result of cosmetic testing; collagen supplements are essentially pulverized cow cartilage<\/a>) and human (child laborers die harvesting mica for makeup<\/a> every month; plastic surgeons practice facelifts on cadavers<\/a>).<\/p>\n In making this trade-off obvious, Renuva and AlloClae feel freshly disturbing.<\/p>\n Personal feelings about this practice may vary depending on cultural beliefs, but the field of bioethics is primarily interested in \u201cminimizing harm to patients\u201d, explains Pferdehirt. Cadavers technically aren\u2019t harmed by becoming injectables, he says, since \u201cthere\u2019s no person there any more\u201d, and recipients generally benefit from the infusion of beauty capital. Doft claims her AlloClae patients \u201cfeel better in their bodies.\u201d<\/p>\n Then again, one could argue that the proliferation of hyper-perfect zombie bodies perpetuates unrealistic and inaccessible beauty standards \u2013 which contribute to appearance-related anxiety, depression, dysmorphia, disordered eating and even suicide<\/a> in the wider population \u2013 and therefore constitutes a sort of collective harm.<\/p>\n \u201cTo me, organ donation is such a clear public good,\u201d as one survey respondent said. \u201cThis is the opposite.\u201d<\/p>\n Pferdehirt\u2019s biggest concern is the possibility that those who would rather not end up in a rich lady\u2019s ass might remove themselves from the donor registry.<\/p>\n \u201cI will be changing my donor status because of this,\u201d one survey participant shared with me. \u201cI would consider not becoming an organ donor if that\u2019s in the fine print,\u201d said another.<\/p>\n \u201cIf people start restricting their participation because of fear about this, the harm may outweigh the good,\u201d Pferdehirt says. \u201cWe need skin grafts. We need bone marrow transplants. We need organ donation. That is far more important, I think, than the cosmetic aspects.\u201d<\/p>\n Luckily, plenty of donors don\u2019t care what happens to their remains at all. \u201cI\u2019d be dead,\u201d was a common survey response. \u201cI wouldn\u2019t know.\u201d<\/p>\n \u201cI think a lot of people also like the idea of having a legacy,\u201d Doft adds. I ask if she would be happy as a BBL in the afterlife. The plastic surgeon laughs. \u201cIt wouldn\u2019t be my choice operation.\u201d<\/p>\n Share your experience<\/p>\n Ask us a question<\/p>\n Do you have a beauty question for Ask Ugly? Submit it anonymously here \u2014 and be as detailed as possible, please!<\/p>\n Your responses, which can be anonymous, are secure as the form is encrypted and only the Guardian has access to your contributions. 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