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Model Albert Cho was kissing someone when he discovered his dermal filler had hardened. His partner pointed out the strange feel of his face. “I touched his nose, then my own, and in comparison, mine was rock hard at the tip,” he recalls.
Cho had stopped getting filler injections two years earlier. After complications involving migrating and deflating, he thought the filler was finally out of his system. Instead, the discovery sent him back to the clinic, where he underwent the painful and costly process of dissolving.
Dermal fillers have become more common in recent years, particularly among younger people. Social media and the pandemic — during which many people were spending hours on Zoom staring at their reflections and others’ filtered faces — have spurred a normalisation. The American Society of Plastic Surgeons wrote in its 2022 Procedural Statistics report, released in September, that cosmetic surgery procedures rose 19 per cent from 2019 to 2022, with minimally invasive procedures like neuromodulator injections (such as Botox) and dermal fillers seeing a near two-fold increase.
With heightened use comes hyper-awareness of what’s become known as “filler face” on social media and the negative side effects of the procedure. Earlier this year at Paris Haute Couture Fashion Week, social media lit up over speculation of Kylie Jenner’s appearance, with many identifying it as a prime example of filler gone wrong: tear-trough or cheek filler migrating within the face, swelling or blocking glands. Personal stories of severely botched jobs and bad dissolving experiences went viral in response.
These concerns have been shared behind the scenes in the cosmetics industry for years, says Lauren Goodman, LA-based registered nurse and founder of Juliana Clinics. “Filler shouldn’t be used as a crutch,” she says. “It should be used as an adjunct,” she says. “It’s not a long-term solution. At some point, it’s going to stop yielding the same results because you’ll have loose tissue and skin.”
Does the backlash to filler mean cosmetic procedures are on their way out, ushering in a return to embracing our natural appearances? Not so fast, experts say.
Constant clinic openings have made access and availability to cosmetic treatments easier than ever. Some offer payment plans for those who can’t afford the total cost up front. Online information and ever-accelerating beauty trend cycles play a part, too. Recently, there’s been a shift from the full, puffy cheeks and lips baby-faced look Cho was looking to achieve, to more chiselled, angular profiles, seen in models such as Bella Hadid and Amelia Gray. Experts believe the trend has been fuelled by the rise of the weight-loss drug Ozempic.
“There is definitely a shift of younger and younger patients coming in for procedures across the board,” says Dr Michael Hakimi of Beverly Hills’s Hakimi Plastic Surgery. With young age comes impulsivity, which can lead to clients partaking in medical tourism — travelling overseas for specific treatments — and under-researching both the procedures and those administering them.
“When you’re 25 or 35, it’s hard for you to imagine that in 10 years, your body and face is going to change so much that you probably want to keep that fat in your face,” he adds. “That’s a whole new thing I have to keep explaining to these young patients.”
In response, Goodman has opened her Beverly Hills clinic in the same office as a plastic surgeon. Her clients can now have immediate on-the-spot consultations if a concern falls outside of her remit. Sometimes, she’ll advise people to consider specific surgeries — usually, Blepharoplasties, which removes under-eye fat, and upper bluff, removing skin on the eyelid — as a condition of continuing to see her for Botox.
Education allows for alternative solutions
To avoid falling victim to the unpredictability of filler, some are trailing procedures that yield subtler results. Goodman says Ultherapy, a non-invasive laser treatment that tightens skin, is one rising in popularity. There’s also stem cell therapy for smoothing, brightening and stimulating collagen to thicken the dermis “so that when you go to use a syringe of filler, you will get better results”. A new product called Renuva is designed to stimulate fat and replace volume loss under the eyes and in the temples. And then there’s Skinvive, a new hyaluronic acid injectable (approved by America’s FDA in May 2023) that improves skin smoothness and plumpness but with a less severe outcome than filler.
Since opening its Melrose flagship in LA last year, luxury Australian skincare brand Rationale has witnessed months-long waitlists for its Signature Skin Consultation, which utilises UV diagnostic imaging to show skin dynamics of both superficial and deep skin layers. A tailored prescription and treatment plan follows. This high-tech, bespoke approach is, in part, why Rationale has seen double-digit annual growth since 2016.
“It’s never made sense to apply a one-size-fits-all approach when it comes to treating the skin," says Katie Matten, Rationale’s global head of education. “Consumers are more aware of this than ever and are increasingly interested in personalised products and holistic treatment plans. This is where wellness and beauty meet science.” Awareness is on the rise of how instrumental a powerful, customised skincare regimen is to not only support but enhance the results from cosmetic work, too. “It’s all interconnected, and that’s why we have experts from naturopaths to dermatologists and plastic surgeons in our remit,” says Matten.
Further education and awareness can lead to better decisions, Goodman says. “People want to look good, feel good, and have it last,” she says. “They want to be smart with their investment. Instead of a girl buying a $500 pair of pants, she’s looking to spend that $500 on her face.”
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