Are we get­ting a lit­tle too lais­sez-faire about in­jecta­bles? Wing Sze Tang re­ports.

ELLE (Canada) - - CONTENTS - By Wing Sze Tang

It’s pos­si­ble we’ve got­ten a lit­tle

too ca­sual with in­jecta­bles.

EVEN THOUGH I’VE been a beauty writer for­ever, be­fore do­ing the re­search for this story, I’d never tried Botox, which makes me a di­nosaur in more ways than one. “I have been do­ing this for 25 years, and over the past 10 years, the av­er­age age of a Botox user has gone down about 10 years—from 41 or 42 to 29 or 30,” Dr. Stephen Mulholland, a Toronto-based plas­tic sur­geon, tells me. The fact that a younger gen­er­a­tion is flock­ing to aes­thetic tweaks is no sur­prise: Af­ter all, Kylie Jen­ner’s pre­co­cious pen­chant for lip plump­ing started at 15—in­spir­ing the still-get­ting­carded de­mo­graphic to con­sider cos­metic tin­ker­ing just an­other beauty choice.

Now, with the ca­su­al­iza­tion of Botox and other in­jecta­bles, there’s a sis­ter trend: the rise of laid-back, mil­len­nial-friendly clin­ics that make go­ing un­der the nee­dle as rou­tine and breezy as book­ing a blowout. At North Med­i­cal Spa, a re­cently minted modern medi-spa in Toronto, the vibe is more In­sta­gram chic than coldly clin­i­cal, com­plete with mid-cen­tury-modern vel­vet sofa, can­dle­light and plants ga­lore. I’m here to try “baby Botox”—sub­tle mini-doses of the wrin­kle smoother—but step one is a first-timer con­sult.

Amanda Mizen, the no-non­sense founder, is on a mis­sion to nor­mal­ize treat­ments like Botox, but she doesn’t take it lightly. “We’ve

be­come re­laxed about how we see in­jec­tions, like a blowout, but they’re still med­i­cal pro­ce­dures and they’re se­ri­ous,” she tells me.

As a sign of just how main­stream and read­ily at­tain­able in­jecta­bles have be­come, drug­store be­he­moth Shop­pers Drug Mart has got­ten into the game with its first stand­alone Beauty Clinic, in Oakville, Ont., where you can col­lect PC Op­ti­mum loy­alty points while try­ing ev­ery­thing from fillers to lasers. The state­side chain Alchemy 43, dubbed “the Dry­bar for Botox,” takes walkins. And there are even mo­bile ser­vices that will come to you, like Cal­gary’s Beau­tox Bar, which will host an in­jecta­bles “party” for three to 20 peo­ple in its pink trailer— turn­ing med­i­cal treat­ments into a so­cial oc­ca­sion. But as pro­ce­dures that once re­quired a doc­tor’s hand be­come widely ac­ces­si­ble, the old adage “Buyer be­ware” re­mains as rel­e­vant as ever.

With Botox, the risks of shoddy work in­clude eye­lid droop­ing (pto­sis) and mus­cle weak­ness. More likely to go se­ri­ously awry is Jen­ner’s fix of choice: der­mal fillers. “The way the artery runs through the lips, if you nick that and in­ject into it [known as an in­travas­cu­lar in­jec­tion], you’re look­ing at necro­sis [tis­sue death] and pos­si­bly los­ing your en­tire lip,” says Mizen. While this com­pli­ca­tion is treat­able if a prac­ti­tioner acts quickly, “it hap­pens all the time with peo­ple who don’t know what they’re do­ing,” she cau­tions. In her view, the scari­est pro­ce­dure in the wrong hands is non-sur­gi­cal rhino­plasty—a nose job us­ing filler. “You could make some­one go blind in a few min­utes,” she says. It’s cru­cial to choose an ex­pert who knows not only skil­ful tech­niques but also how to deal with mishaps.

In Canada, neu­ro­mod­u­la­tors (like Botox, Dys­port and Xeomin) and fillers (like Belotero and Ju­vé­derm) can only be given by a li­censed, au­tho­rized health-care pro­fes­sional who’s trained to do so—but what this means ex­actly varies by prov­ince. In On­tario, derms, plas­tic sur­geons and nurse prac­ti­tion­ers (NPS) can ad­min­is­ter in­jec­tions. (Shop­pers Drug Mart Beauty Clinic, for in­stance, is staffed by NPS, which means that clients aren’t re­quired to see a physi­cian, and they don’t.) In On­tario, you “We’ve be­come re­laxed about how we see in­jec­tions, but they’re still med­i­cal pro­ce­dures.” can also be in­jected by reg­is­tered nurses (RNS) and reg­is­tered prac­ti­cal nurses (RPNS) but only if they’re act­ing un­der the di­rec­tion of an au­tho­rized health-care pro such as a physi­cian or an NP. Un­der B.C. law, even den­tists are al­lowed to freeze your fine lines; in On­tario, they can use neu­ro­mod­u­la­tors and fillers but only for den­tal pro­ce­dures.

Sur­pris­ingly, what counts as suf­fi­cient train­ing for cos­metic in­jec­tions isn’t reg­u­lated, which means that some prac­ti­tion­ers may only have taken week­end cour­ses, says Dr. Diane Wong, owner and med­i­cal di­rec­tor of Glow Medi Spas in On­tario. “The com­mod­i­fi­ca­tion of med­i­cal treat­ments that have risks is con­cern­ing to many physi­cians be­cause we don’t want these pro­ce­dures to be triv­i­al­ized,” she says, point­ing to the avail­abil­ity of cos­metic in­jec­tions at hair sa­lons and Botox par­ties (never a good idea).

It’s key to know that the risks are real and to do your due dili­gence on who you’re trust­ing with your face—whether you’re at a der­ma­tol­ogy clinic or not. Red flags? “If you don’t see a med­i­cal di­rec­tor and there’s no men­tion of one, and if you don’t know the nurse’s cre­den­tials,” says Mizen. Like­wise, avoid too-good-to-be-true deals (bar­gain Botox at $5/unit could be ex­pired or wa­tered down) and in­jecta­bles done in some­one’s home.

Back at North Med­i­cal for my Botox, I meet with Sandy, an RPN with a chill chair­side man­ner who also works in a hospi­tal postanaes­the­sia-care unit. “At the hospi­tal, who in­jects ev­ery­body with ev­ery­thing? Nurses,” he says. We spend a solid 45 min­utes talk­ing out what I should know, and then we Facetime Dr. Colin Hong, a board-cer­ti­fied plas­tic sur­geon and the off-site med­i­cal di­rec­tor, who ap­proves my dos­ing. Fi­nally, Sandy does the needling, and it’s just as I ex­pected: fast (it takes two min­utes) and with less dis­com­fort than a flu shot. Within a week and a half, I’m pleased to see the fine lines that were start­ing to etch my fore­head are MIA but “the work” isn’t ob­vi­ous. No one, not even my hus­band, seems to clock the change.

With the ca­su­al­iza­tion of Botox and fillers, opt­ing into cos­metic pro­ce­dures no longer comes with a side of stigma. But ditch­ing the taboo shouldn’t mean book­ing with­out care, like they’re no big deal. A bad blowout lasts ’til your next wash, but Botox re­grets last way longer—and the dif­fer­ence isn’t a fine line.

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