Content warning: references to body dysmorphia

The pervasive desire for “preventive” cosmetic procedures within the younger generations was brought to my attention during a recent visit to the dermatologist. My doctor expressed her concern for children as young as fifteen, most of whom were accompanied by a guardian of legal age, who were coming in to request facial fillers or body augmentations, such as lip and cheek fillers or rhinoplasties. Why are such young individuals seeking such procedures? 

Perhaps the obsession with appearing and staying youthful begins in childhood. As children, growing up, we often heard stories about wrinkly, malevolent witches preying on the young, naive and beautiful protagonists. Fairy Tales such as Hansel and Gretel, Snow White and Rapunzel, and the legends of the Philosophers Stone and Fountain of Youth, are only a few of the stories that have fuelled this flowering obsession with eternal youth and beauty. The actresses we watched growing up now run the risk of irrelevance the older they get, losing roles to a 20-something-year-old whose male co-star is a decade or two older than them. Sometimes it’s not even that obvious. Playful memes of Leonardo DiCaprio’s dating history and “Ok, Boomer”, as well as Olivia Munn and Jennifer Lopez attributing their youthful appearances to consuming copious amounts of Japanese sweet potatoes and olive oil, instead of cosmetic interventions, all contain elements of ageism.

We have been conditioned to antagonise what appears to be outdated, worn or used. 

Preventative Botox, also known as “Baby Botox,” has become one of the most in-style beauty trends within the last decade. The procedure entails only having a small or reduced amount of Botox injected per session. Clients wishing to maintain their appearance must regularly undergo these injections. Brands such as Botox and Juvéderm have become catch-all names for these injectable procedures, but there are considerable differences between the two. Juvéderm, a type of dermal filler, contains hyaluronic acid which can be used to plump lips and cheeks as well as fill fine lines, while Botox contains bacteria, a popular one being botulinum toxin A, which relaxes and temporarily paralyses muscles. However, continuous use of Botox comes with various possible side effects, such as muscle weakness and flatness. The weakening of facial muscles can have undesirable effects on an individual's ability to swallow and vocalise, and may cause difficulties with eye movements which can, in turn, result in double-vision. Some extended-use patients may even experience discolouration and textured skin. There is also the risk of patients being injected with subpar or illegal market acquired filler. The consequences of such could be dire and even deadly. Despite these ramifications, however, Baby Botox has never been more desirable as it is today. How has a product and procedure associated with an older demographic found a renewed interest within younger ones? How do Millennial and Gen Z fears of ageing affect their desire for preventative cosmetic surgery?

Doctors suspect “selfie culture” and the rapid growth of social media to be the leading culprits and primary driving forces behind younger people seeking preventative cosmetic procedures. Apps such as Facetune and Photoshop, as well as instant photo filters, make it easier for people to seamlessly edit their pictures. Through this process, however, they create an idealised, false reality for viewers to strive to achieve or recreate. The popularity of such a practice is attested by recent statistics revealing that Instagram and Facetune garnered their highest engagement levels during the pandemic, a time when many found solace online. Another motivating factor is the rise of “Instagram face.” Author Jia Tolentino describes the face as “a young face, of course, with poreless skin and plump, high cheekbones. It has catlike eyes and long, cartoonish lashes; it has a small, neat nose and full, lush lips.” A combination of features that, for the majority of the population, can only be achieved through cosmetic interventions. People are attempting to physically mimic an artificial filter or edited physiques through fillers, augmentations and chemical treatments. The saying “beauty is pain” has never been quite so relevant and literal.

Coupled with the shift to online school and work, people are spending more time looking at themselves through the lens of a camera than through a mirror. This is especially true for younger people who are more susceptible to believing everything at face value, and doctored images therefore come across as fact. Dr Helen Egger, a child psychiatrist, explains this phenomenon. She says, “What is taking it to the next level with these filters is it’s not just seeing an image of a celebrity who is unrealistic and measuring yourself against that person, it’s measuring your real self against a pretend image of yourself.” 

On a more nefarious note, there are countless social media accounts, with followers in the hundreds of thousands, dedicated to exposing and analysing supposed undisclosed cosmetic surgeries undergone by celebrities and influencers. Some of these accounts even encourage users to comment on what procedures they believe the celebrity in question has had done. Often, common courtesy is not afforded the subject, with commenters viciously critiquing their physical appearances. It is easy to aimlessly scroll and dismiss these criticisms and opinions, but regular exposure to such content can subconsciously affect the way we perceive ourselves and others, leading some to undergo the same procedures they ridicule online. The hypocrisy of the contemporary beauty industry generates a “damned if you do and damned if you don’t” relationship with cosmetic surgery and photo editing.  

In their annual statistics, The American Society of Plastic Surgeons reported that Botox procedures have increased by 28 per cent, while dermal fillers have increased by 32 per cent among the age group 20-29 since 2010. Furthermore, from 2013 to 2018, the use of Botulinum Toxin among people aged 19-34 increased by 87 per cent. The process of filler injections is becoming likened to applying and removing makeup at the end of the day. But unlike makeup, Botox does not completely come off after long-term usage.   

As cosmetic surgery loses its taboo and social media dominates our screen time, doctors expect this trend to continue to grow in popularity and especially with a younger clientele. Dr Craig Teller at Bellaire Dermatology has seen an influx of millennials seeking preventative cosmetic procedures at his clinic. In an attempt to describe Millennial motivations, Dr Teller says, “This isn’t about vanity as much as it’s about wanting to look and feel the best that I can… I want to feel good mentally, and I want to look good.” 

What’s more remarkable is that companies producing these injectables have changed their marketing strategies by targeting Millennials and Gen Z, instead of those from Gen X or Baby Boomer demographics. Carrie Strom, SVP of the company, Allergan, the makers of Botox and Juvéderm, said, “Millennials will have the most buying power of any generation, so we want to serve those clients in the channels they are using while also educating them and removing the stigma from Botox.”  A 2010 advertisement for ‘Juvéderm XC’ featured three women who were more representative of their original target audience: middle-aged women and older. Unlike today, the 2010 commercial did not correlate dermal filler with the young, wild and free. When you compare Juvéderm’s earlier advertisements to their latest iterations, the shift towards marketing to younger audiences is stark.  

This article does not aim to chastise those who do use Botox or fillers. Both have been used to treat a myriad of medical conditions, such as chronic migraines, hyperhidrosis and muscle contractures. Dermal filler, specifically Poly-L-lactic acid (PLLA), has been used to treat and fill areas of the face that have been hollowed by the effects of HIV. For some, Botox and filler are miracle liquids which enable them to live better lives. Even if one uses Baby Botox for its aesthetic purposes, it is not inherently problematic.

Rather, this article is shedding light on an age-old problem: body dissatisfaction. What is particularly harrowing about this growing trend of cosmetic procedures is how it could motivate a young individual, whose face and body may not yet be fully developed, to believe they need such injections to “correct” or alter what has not had the chance to completely form. Cosmetic products and procedures should be a means of empowerment, not a source of shame and anxiety. Before endeavouring to undergo these procedures, one would be well-advised to err on the side of caution and to conduct thorough research on the products and procedures used, and more importantly, to ensure that it is for the purposes of personal satisfaction and not the fear of being perceived as anything less than picture-perfect.