For decades, cosmetic procedures – Botox, fillers, nose jobs, you name it – were considered the ultimate taboo. It was a great big secret, swept under the rug and rarely discussed. We associated it with the rich and famous, or ageing women desperately clutching onto the last signs of youth.
However, times have dramatically changed. In recent years, swarms of young women and girls in their late teens and 20s have been openly investing in non-surgical cosmetic procedures, namely dermal fillers and ‘baby Botox’: micro-doses of Botox used to achieve a more natural-looking result. Reasons for this include ‘preventative’ measures against ageing, but it’s also undeniably a response to modern beauty standards perpetuated online and in the media. What’s more, practitioners are now able to market and advertise these procedures on social media, seemingly opening up the conversation and removing some of the stigma.
For various reasons though, there are concerns about this new-found obsession with Botox and fillers among young women. Is it a sign of shunning stereotypes and shifting perspectives? Or another example of women being caught in the clutches of unattainable beauty standards?
Botox first gained widespread popularity in the early 1990s, and in the UK alone it’s now estimated that around 100,000 Botox injections are administered per year. But Botox was initially originally marketed towards middle-aged women, so how did it come to be used so widely by those as young as their late teens? “It’s been a big trend over the past few years and social media is one of the biggest factors,” says Dr Najia Shaikh, founder and Medical Director at One Skin Clinic on Harley Street. “Today’s young women have grown up with Instagram and Snapchat filters. They want a certain look – the big lips and brow lifts, which are popular because of people they follow online like Bella Hadid and Kylie Jenner.”
The lockdown effect
Whilst interest in Botox and fillers from young women has certainly increased over the past few years, there’s been a noticeable spike since the start of the pandemic. Last year, the British Association of Aesthetic Plastic Surgeons (BAAPS) found that doctors were reporting up to 70% increases in requests for virtual consultations. Dr Joshua Van der Aa, an aesthetic doctor also based on London’s Harley Street who specialises in cosmetic procedures, says most of his patients are “in their 20s”. But “the pandemic has only added to the situation”, he says. “And I’ll tell you why. Zoom calls. Let’s face it, when we’re on Zoom, we’re all looking at ourselves. It’s made people much more self-aware about their perceived flaws.”
Although, on the one hand, social media is helping normalise Botox and fillers, it’s undoubtedly a double-edged sword. Today there are hundreds of accounts on Instagram advertising these procedures, and some at alarmingly low prices. “There’s a worrying lack of regulation in our industry,” says Dr Lubna Khan-Salim, a Yorkshire-based surgeon who specialises in cosmetic aesthetics. “Botox is prescribed but fillers don’t have to be, so anyone can buy them. The before and after pictures on Instagram make it look so easy and achievable, but so much can go wrong.” In fact, one recent survey by Fabulous magazine found that 83% of fillers are performed by people with no medical training.
And younger women are particularly at risk of deception. 25-year-old psychology researcher Katie* recently got Botox as she’d “always been interested” in it, but working in healthcare meant she’d “already seen many botched jobs”. So finding a qualified professional was imperative. Others, however, haven’t been so lucky. Dr Van der Aa adds: “Far too often young women come to me with situations that need correcting. With filler, it’s fairly easy to reverse. But with other things, like the popular fox-eye thread trend, it’s very difficult. You can’t remove or dissolve that. You have to excise it surgically and it can leave long-lasting damage.”
The unknown benefits
For many years – and still now to an extent – Botox and fillers have been predominantly associated with cis, white women who’s reasoning is presumed to be pure vanity, with an implication of placating the male gaze. But what this increasing trend has helped to do is destigmatise these procedures, allowing people to realise the benefits that stretch far beyond simply achieving the ‘Kylie Jenner look’. In some cases, it can drastically alter someone’s quality of life. Dr Khan-Salim says: “I recently had a young girl in who had a cleft lip as a child. She had severe asymmetry and scarring which was affecting her confidence levels. But a bit of filler to help symmetrise her lips has made a world of difference.”
For Hannah*, a 24-year-old trans woman, having access to Botox is also vital. Along with the options of hormones and surgeries, Botox is offered to people within the trans healthcare system to help them achieve their desired look while transitioning. Hannah says: “There’s definitely still a stigma attached to Botox, which is rooted in sexism, misogyny and heteronormativity. But it can massively help tackle gender dysphoria and so for people like me it can be life changing.”
Although, if young women want Botox or fillers in the name of vanity, is that really such a bad thing? “I don’t see the problem with it,” Hannah adds. “Even if it’s purely aesthetic, that’s still entirely valid. Especially if you’re someone who’s struggled with self-image. There’s no reason to feel bad about it, and definitely no reason to make other people feel bad about it.”
Arm yourself with knowledge
Ultimately, whatever the reasoning behind the choice, the most important thing is finding a trusted practitioner. “Instagram is like a shopfront these days,” Dr Khan-Salim says. “That’s fine for buying clothes, but not these procedures. You have to go to somebody who's trusted, insured and qualified.” Dr Van der Aa adds: “The first thing you should do is Google who’s doing it. Are there reviews? Are they good or bad? Then look for before and after photos. Are they consistent? Remember you can do so much with photos just by changing things like lighting and zoom.”
Crucially, Dr Van der Aa says, people need to understand that what they see online isn’t reality. He adds: “It’s a conversation I have with patients daily. It should be about augmenting your own natural beauty rather than trying to create something dramatically different to what’s already there.”
*Names have been changed.
Written by Robyn Schaffer