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You Lost the Weight. Why Is Your Face Still Puffy? (Some of It Was Never Fat)

If your face looks rounder at 7 a.m. than it does by lunch, what's left after the weight loss may not be fat at all.

Corinne is 46. She's a pharmacy technician at a grocery store in Dubuque, Iowa, and since January she has lost 41 pounds.

Most of it came off on a weekly shot. The rest came off on long walks after work. She went from a size 16 to a size 10.

Her face stayed a 16.

In September, Facebook showed her a photo from four years ago, when she was 41 pounds heavier. She put it side by side with that morning's selfie and covered both bodies with her thumbs. She couldn't tell which face was which.

"I did everything right," she told me at our first session. "I'm down three sizes, and from the neck up it looks like I never started."

She asked the nurse at her clinic about it twice. The first time, the nurse said the face can be the last place to go. The second time, she said to drink more water.

Corinne was already drinking a gallon a day. She had the bathroom trips to prove it.

Now she takes her progress photos from the chin down.

She showed me two selfies from the same Tuesday, one at 6:50 a.m. and one after her shift. "Which one is the real me?" she asked.

Both were real. The difference between them was water.

The shot did its job, and so did she. I see this in my practice every week, and I'd bet some of it is happening to you.

Check the ones that sound like you:

Tap the ones that sound like you.

Corinne checked all six.

If you checked two or more, a good part of what's left in your face may not be fat.

Fat doesn't change between breakfast and lunch. Fluid does.

Try it tomorrow. Take a selfie when you wake up and another at 3 p.m., by the same window. Nobody loses visible fat in eight hours, so whatever changes in your face is something else.

Your face doesn't have a drain of its own

Dieting works on fat. The shot works on your appetite. Neither one touches your neck, and your neck is how the fluid in your face gets out.

About a third of the lymph nodes in your whole body, roughly 300 of them, sit in your head and neck. The way out of your face runs down the side of your neck to just above your collarbone.

Lymph has no pump. Your heart moves your blood for you, but lymph mostly moves when you move, breathe and turn your head.

So the hours you spend lying flat are the hours your face fills up. That's why it looks roundest at 7 a.m. and better by lunch.

Add a tight neck and the route out gets narrow. Corinne spends nine hours a day bent over a counter, counting pills with her head tipped forward. Her neck was as tight as any I've worked on.

Losing weight doesn't loosen a neck, and neither does another liter of water.

So none of this means you did it wrong. You worked on your body, and nobody told you to look at your neck.

Why the usual fixes fade

It also explains why the things you were told to try haven't stuck:

• More water changes what goes in. It can't move the fluid already sitting in your face.
• Cutting salt and sugar helps the scale. The puff still settles every night you lie flat.
• Electrolyte packets and lymphatic drops go through your stomach. Your face drains through your neck.
• Losing ten more pounds works on fat. It can't move fluid that's sitting still.
• Ice and rollers push fluid around your face, toward an exit that's still tight.

Not one of them works on the place your face drains through.

Corinne had tried most of them. In August she paid $150 to ask a surgeon about buccal fat removal. He told her she didn't have much buccal fat to take out. She sat in her car for twenty minutes after that.

What lymph therapists do first

In my training, the first rule of lymphatic work was simple: clear the neck before you touch the face. If the exit is narrow, working on the cheeks just pushes fluid in circles.

Hospitals teach patients the same order. Self-drainage handouts start at the neck and collarbone, not the cheeks.

Everything that drains from your scalp, face and mouth passes through the nodes in your neck.

Studies after jaw and wisdom-tooth surgery found that drainage which started at the neck brought facial swelling down faster.^{1, 2}

So I've never started a session on a client's face, and I didn't start on Corinne's.

Since the weekly shots took off, more of my new clients look like her: smaller everywhere except the face, and puffiest first thing in the morning. Some got there on a shot and some on a diet, and almost all of them drink more water than I do.

But a session with me costs about what a nice dinner out costs, and the fluid settles again every night you lie down.

Corinne was already paying for a shot every week. She wasn't going to pay for me every week too.

What she needed was the neck step, at home, every day, without having to learn my technique.

The two-step routine

Do it in the morning before you get up, or at night before bed.

Ten minutes a day matters more than one long session a month, because the fluid comes back every night. A gallon of water on Sunday doesn't cover the whole week either.

"I did the strokes in the shower for about a week," Corinne told me. "Then I was running late one morning, and after that I was running late every morning."

Most people stop the hand strokes within a couple of weeks. They take good technique and two free hands, and at 6:30 a.m. you don't have either.

Why I started Hizoo

That's the reason I started Hizoo. It's what I sent Corinne home with.

It's a heated neck pillow. You lie back on it for ten minutes on the gentle setting, and it works the back and sides of your neck. Nothing touches your face, and there's nothing to learn.

Her first question was, "Will it help me lose more weight?"

No. You already did that part. It works on your neck, and what changes is the puff that comes and goes.

• It does the neck step for you every day, in ten minutes, lying down.
• It's built for the back and sides of the neck, where the tension sits.
• More than 3,000 people have reviewed it, at 4.9 stars. Here's what a few said about their faces.

What reviewers describe, week by week

• Nights 1 to 3Your neck feels looser. Your face may look the same.
• Weeks 1 to 2Your 7 a.m. selfies start to look like your 3 p.m. ones.
• Weeks 3 to 4Your morning photos start to match the rest of you.

It won't burn fat, change your bone structure or shrink a chin you were born with. It works on the part that comes and goes.

Corinne started the next Monday.

On day 12 she texted me two selfies, 6:50 a.m. and 3:15 p.m., with one word: "Same."

The next week, a regular at the pharmacy counter asked if she'd changed her hair.

Her cheeks are still round. She was born with them. What's gone is the morning puff.

Last Sunday she sent me her first progress photo with her face in it.

P.S. First Thanksgiving at your new size? Start this week, so you have a few weeks of mornings behind you before anyone says "everybody squeeze in."