When a person's face is so bloated and deformed that it's impossible to distinguish it from their ass. As it is, the ass
already resembles a hippopotamus face. For the poor
bastard sporting one of these, it also resembles theirs. It is a
synonym with "Ed Zachary Disease".
Yikes - look at that double hippopotamus. If he
ate with his ass and sat on his
face, I wouldn't know the difference.