Botox, fillers, cosmetic treatments
The new norm?
it’s January 2018 and Maggie*, 27, is at her best friend’s bridal shower. “Cheers!” cries the bride-to-be, in the centre of the room. But instead of quaffing a glass of bubbly, she leans back and closes her eyes as a woman poises a needle at the side of her forehead. Wait, what? “It was a Botox party,” Maggie* explains, adding that, since then, she’s had one additional Botox treatment at a clinic. “I wear sunscreen, I buy face creams. To me, Botox is the next step and it’s now part of my beauty routine.”
The new normal?
Maggie* isn’t alone. Research shows a huge upsurge in 20-somethings getting injectables in the form of Botox and lip augmentation, as well as nonsurgical enhancements, including dermal fillers and jawline reshaping. Over half (51%) of women aged 16-29 would consider getting cosmetic enhancements either now or in the future – and by 2020, it’s believed that almost 1.5million of us will have had a nonsurgical treatment such as Botox or fillers. “I consider getting Botox as just good grooming – it’s like flossing my teeth,” says Zandre*, 22.
Generation X may raise their eyebrows – or would, if their eyebrows could move. Because one of the reasons so many millennials are exploring nonsurgical procedures is because their moms are doing it or have it done it, too. “We see a lot of mother-daughter pairs in our office,” says plastic surgeon Dr Norman Rowe. And for some of the daughters, the motivation is getting a step ahead of the ageing process. “People start earlier,” agrees plastic surgeon Dr Tijion Esho. “In the past, you might not consider these treatments until your mid-40s, now women in their 20s are more aware of the ageing process and are doing things to halt it.”
Women like Laurie*, 26. “Instead of forking out hundreds on expensive creams that might not work, I know Botox can stop my frown lines getting any deeper. I don’t fear ageing but I also don’t accept that ageing has to mean resigning yourself to everything nature does to our appearance.” Not only that, but Gen Z and millennials who have grown up seeing a dermatologist, using skin creams and having spa appointments such as lash tints, facials, fillers and injectables have become the next logical step.
“Millennials are more open to cosmetic procedures than any other generational group,” says Jack Dickett, a senior consumer lifestyles analyst at a global market-research agency.
His most recent report found that 28% of 18- to 24-year-olds and 31% of 25- to 34-year-olds have had some form of cosmetic treatment. “This age group is more knowledgeable about nonsurgical treatments, and what can be achieved with them,” says Dr Rekha Tailor, medical director of health and aesthetics.
Advances in technology have also led to subtler results, which, in turn, means less stigma surrounding injectables. People are starting to realise that Botox and fillers can be done, and still give the person a natural appearance,” says Dr Rowe. Of course, it’s easy to pin the rise of interest in cosmetic tweaks on Instagram. “I feel social media has imbued this very specific, Barbie-esque aesthetic with big lips and a sculpted face,” says Kalani*, 43. But your feed might not be telling the whole story. Make no mistake; scrolling through a well-curated account can make us compare our looks, but experts point to a wider shift in cultural norms.
Airbrushing apps such as Facetune (R3.99 on IOS and Android), as well as the contouring makeup trend, can give people a glimpse into what fillers or Botox could do to their faces. “Contouring made me really aware of my angles and, to be honest,
getting fillers was a less labourintensive solution,” says Ntswaki*, 42. But Ntswaki* is quick to point out she isn’t turning to treatments to raise her self-esteem: “It’s just a look I prefer, the same as I prefer plucked eyebrows and straightened hair.” That, say experts, is the key change in attitude from earlier generations. “Patients used to bring in images of celebrities as a reference; now more and more patients show us airbrushed and retouched pictures of themselves as a guide to how they want to look,” says Dr Jean-louis Sebagh, a world-renowned cosmetic doctor.
Silicone = status symbol
In the ’90s and early parts of the millennium, cosmetic treatments were kept hush-hush for two reasons. First, the effect was often far less subtle. Second, plastic surgery procedures were sometimes seen as admitting failure; that your body didn’t live up to a ‘perfect’ look. Today, it appears perceptions have changed. The hashtag #Lipfillers has over 300 000 posts on Instagram (as a point of comparison, #Stretchmarkremoval has only over 6 000) and for some women, injectables have become another way to claim their body as their own.
Celebs play a part, too, in the way even conventionally attractive names, like Kylie Jenner and the Kardashian sisters have been open about their use of cosmetic enhancements. No longer do celebs ‘admit’ to having a procedure; they openly share their routine, which makes cosmetic augmentation seem simultaneously aspirational and part of the everyday beauty conversation. (‘If she’s already pretty and admits to it, then what’s the big deal in me trying it?’) “When super-confident people like Cardi B are open about cosmetic work, it stops being something ‘embarrassing’,” says Jamie*, 21. “It makes waves. It means someone like me feels empowered. If I want work done in the future, then I will.” It’s also less about the celebrity specific look that some young women aspire to, and more about their lifestyle.
While most of us may not be able to afford to live like a Kardashian, the face has become one thing women are using their money to invest in, if they so wish. At around R2 600-R6 000 per session, depending on the amount of product used and where in the country you have it done, Botox and dermal fillers have become “a normal activity for people with expendable income,” says plastic surgeon Dr Rian Maercks. Take Indrani*, 37, for example, who gets lip fillers every six months. “I’m not the type to buy an expensive purse that I won’t use in a year or so. For me, fillers and Botox are much more of a sure thing. I think it’s the same as paying for a gym membership; it’s something that gives you value every day.” Like Indrani*, many women consider nonsurgical procedures just another necessary expense, the same way women 10 years ago may have juggled their budget to pay for a Brazilian bikini wax. “I sometimes have to push all my bills around in that month to pay for it,” says Yolandi*, 25. “But it’s worth it and it’s my decision to make.”
While many women feel it’s had a positive effect, there is, of course, a dark side to the rise of cosmetic enhancements being performed. One thing practitioners stress to their patients, regardless of age? “Nonsurgical does not mean no risk,” warns Dr Mary O’brien, a consultant plastic and hand surgeon. Experts worry that the lack of regulation in the industry (Botox must be administered by a medical professional, but anyone
can potentially get their hands on fillers and there is no minimum age limit) could lead to negative results.
“There is, sadly, an increasing number of unscrupulous providers working in the aesthetics industry who are offering cheaper prices for counterfeit, unregulated or diluted products, which are then administered by untrained, unqualified people,” says Dr Shirin Lakhani. Dr Lakhani frequently sees patients dealing with complications from past procedures. “Often they have been naïve and opted for a cheaper price over quality.” Dr Lakhani and other plastic surgeons stress that procedures are generally safe, as long as you see a qualified practitioner. “If you’re considering anti-wrinkle injections and dermal fillers, make sure that you use a doctor or qualified practitioner who is fully insured and has the medical expertise to keep you safe,” says Dr Lakhani, who advises steering clear of discounts or vouchers and instead choosing accredited medical professionals.
But even with reputable doctors, there are potentially serious sideeffects: rare complications of Botox include temporary droopiness in facial features, blurred vision and breathing difficulties. Dermal fillers can cause rashes and infection and, in very rare cases, can move from the treated area over time or even block a blood vessel. Rare, yes, but enough to put many women off, including Harper*, 41, whose friend had to have her lip fillers removed. “Her lips were so swollen and painful for months.” Then there’s the thought of the chemicals involved. “I don’t smoke, I work out and eat well to stay healthy, so why would I put poison in my face?” says Georgia*, 20.
The bottom line
While the role of nonsurgical procedures in the everyday lives of Gen Z and millennials may seem dramatic, the motivation behind an individual paying for these kinds of treatment is age-old. People want to look and feel their best, and are using the tools and technology on offer to do so. But while the effects may be temporary, is their place in our beauty culture here to stay?