The Cosmetic Aesthetic: Good or Bad?

Trigger Warning: This story contains mentions of Body Dysmorphia and body image.

Kylie Jenner’s use of lip fillers saw inquiries into the procedure increase in some clinics by 70% within 24 hours.

Jenner has continued to make her plump pout part of her signature look, building a billion-dollar company off the back of her wildly popular make up lip kits.

In a 2023 interview, Jenner said she had no regrets about the procedure and called her decision to get lip filler “the best thing I’ve ever done,”.

In a video posted on Vogue’s YouTube channel in September, musician and actress, Ariana Grande, spoke about getting a “ton” of filler and botox, detailing her decision to stop injections in 2018 as the process felt like “hiding”.

Whether or not people are satisfied with the procedures they undertake, there’s no doubting uptake of injectables is rising.

SPOTLIGHT ON THE COSMETICS INDUSTRY

Caption: Businesses offering injectables are becoming more and more commonplace (Photo Credit: Eliza Marlow).

Precise numbers tracking the rise of the cosmetic injectables industry are difficult to find, but the practice is seemingly booming across Australia.

In 2022, market researchers, Grand View Research valued the Australian facial injectables industry at USD $3.5 billion, with a projected growth rate of over 27% every year until 2030.

Injectables refers to non-invasive procedures including dermal fillers, anti-wrinkle injections, fat dissolving injections, thread lifts, and botox products.

In August 2022, the Australia Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia released an independent review into cosmetic surgery guidelines.

New guidelines for doctors delivering both invasive and non-invasive cosmetic services were introduced in July 2023.

Many stakeholders expressed concerns the injectables industry was largely excluded from this review.

In September, AHPRA responded to this criticism, announcing they will be shifting their focus to non-surgical cosmetics procedures, declaring an expansion of their crackdown into the cosmetics industry.

AHPRA says consultation on proposed new practice guidelines for registered practitioners performing and advertising aesthetic treatments will begin soon.

In clarifying their motivations for cleaning up the industry, AHPRA cited the case of Carly* who required surgical intervention after undergoing a botched cosmetic thread lift procedure.

Another complainant, Yasmin*, reported a practitioner progressing with fillers after she disclosed her history of mental illness, body image issues, and past dissatisfaction with the results of 10 prior non-surgical cosmetic procedures.

There are fears the casual approach to injectables undercuts the safety risks associated with such procedures.

Injectables can have side effects such as pain, bruising, and swelling, while more serious issues have been reported such as tissue necrosis, blindness, and death.

Fillers are also marketed as being dissolvable using a chemical called hyaluronidase, though anecdotal evidence suggests there are increasing reports of patients experiencing negative side effects from this procedure.

Some patients have described their skin as having a droopy or sagging look, prompting suggestions the hyaluronidase may be breaking down naturally occurring hyaluronic acid in the face as well as filler.

Filler is also marketed as lasting up to 18 months, but in a report by ABC News, Dr Gavin Chan said filler had been found to last from 2 to 12 years in some cases.

WHAT’S CAUSING THE RISE?

CEO of the Aesthetics Practitioners Advisory Network, Tina Viney, says the rise of injectables is twofold, people want to look and feel good.

“I think social media is projecting the impression that you can look really young and you can look amazing."

The Covid-19 pandemic has also been blamed for a rise in ‘Zoom Dysmorphia’ where people started to assess their appearance more critically while frequently looking at themselves onscreen.

“There are a lot of people that have become obsessed with these procedures and with their own self-image so they feel if I do a little bit of a lift here or there it’s going to make me feel better, but if you have a mental condition, you are addressing a symptom not the cause."

But balancing patient wellbeing without compromising a person’s free choice to do what they want with their bodies is complicated.

“It’s an area I think that the industry’s trying to come to terms with to make sure that the abuse is identified but it doesn’t go too far where it frightens people."

Ms Viney says candidates for non-surgical cosmetic procedures who have body image related conditions are unlikely to feel their expectations have been met through cosmetic changes, and practitioners are trusted to act in a client’s best interests.

“They’ll never be satisfied because their perception of themselves is distorted.

“In situations like that it’s really ethically important that the practitioner encourages them to go and see a psychologist."

While many people have staunch positions on whether non-invasive cosmetic treatments are a good thing, Ms Viney says reality is more nuanced.

“The pendulum swings to excesses but ultimately it finds its way into the middle ground so there’s got to be a conversation between what’s good for me and what makes me look good,” she said.

SOCIAL MEDIA ACCELERATING CHANGES

Caption: Young people are increasingly critical of their own appearance (Photo Credit: Eliza Marlow).

Dr Laini Burton, a body politics researcher from Griffith University’s Queensland College of Art says tools for body modification have been around for several decades but increased accessibility and affordability have combined with a rise in social media to boost their popularity.

“Digital tools like Snapchat filters, Instagram filters, and TikTok filters, all of this sort of stuff definitely contributes to the way in which people are seeing themselves."

Dr Burton says selfie culture has had a major impact.

“There’s so much more self-reflection through a digital lens that it actually distorts people’s vision of themselves oftentimes, and I think that has contributed to a rise in body modification,” she said.

The injectables industry has received criticism for putting profits over patient safety, with the opportunity to earn more than in other areas of medical or nursing practice often cited as a benefit.

Injectables clinics are often commission based, raising concerns that the upselling of unnecessary procedures to clients is a feature of the current business model.

Dr Burton says the commodification of people’s insecurities is cause for concern.

“Businesses prey on people’s vulnerabilities, they will sell you solutions for perceived problems.

“So many people fall prey to this and it’s terribly sad because it’s not to say it’s a problem with those people, it’s a problem with the system,” Dr Burton said.

THE RIGHT TO CHOOSE

Demonising injectables is unlikely to be the way forward.

Motivations for engaging in these procedures aren’t always clear cut.

Khloe Kardashian recently documented the powerful role fillers can have, using them to restore fullness to her cheek after having a skin cancer removed from her face.

“People tend to be very opinionated about this, about what other people do with their bodies.

“For some people it’s life changing and very positive for them,” Dr Burton said.

Dr Burton says people can be equally empowered whether they choose to alter their body or not.

“There is no one answer because there are so many different ways in which these technologies can have effects on people.

“There’s risks associated, and people have to know the risks so there’s a lot to weigh up but equally there is absolutely no black and white to this kind of thing for everybody."

Those contemplating any form of body modification are urged to carefully consider if they feel the change is right for them in the long-term.

*Names changed