Changing trends

In years gone by, it was widely believed that going under the knife or needle was largely reserved for the ageing population who wanted to stay youthful well into their 50s and 60s. And while this notion remains the same, young people are increasingly turning to procedures, but not to stop the signs of ageing, rather to keep up with the ‘Instagram look’ that is featured heavily on social media.

More and more people are favouring plumped up lips and sharper cheekbones, often to create the perfect selfie, and this airbrushed look continues to have a significant impact on the way regular people want to look. Celebrities including Kylie Jenner and other such high-profile figures have made the concept of altering appearance more accessible to a younger audience, which has resulted in the popularity of such procedures skyrocketing.

However, the term “filler fatigue” has been used in beauty communities to describe what happens when someone has had too much filler. Over time, filler stretches and weighs down the skin, which means that more filler is needed with every trip to the clinic, ultimately leading to further stretching issues.

What exactly are dermal fillers?

Before exploring the impact of filler on younger skin, we should first determine exactly what this product is and how it is utilised.

Dermal fillers are not the same as Botox, which "freezes" muscles to reduce wrinkles. Instead, dermal filler is an injectable implant, used to smooth the complexion and any signs of wrinkles. They are injected under the skin using a needle.

There are four categories of fillers that are utilised in beauty treatments:

• Hyaluronic acid is naturally produced by your body and already found in your skin and cartilage. Generally, fillers made with hyaluronic acid last between 6-12 months.
• Calcium hydroxylapatite is a mineral that is found in our bones. Fillers made with this material last up to 18 months.
• Poly-L-lactic acid is a biodegradable synthetic material that’s also used to make medical products like dissolvable stitches. These fillers may last up to two years.
• Polymethylmethacrylate beads are the only filler that can’t be absorbed by your body, meaning the results are permanent. They’re only used around the mouth.

In the right hands, dermal fillers are a safe and effective option for those people who prefer trying a temporary measure. With its reputation as a user-friendly option for those curious about the results, filler seems more like a throwaway beauty treatment than a risky medical procedure. And it doesn't hurt that many experts position fillers like they do Botox: as preventative medicine that stops the signs of ageing in their tracks. While Botox inhibits you from making the expressions that create wrinkles, some fillers claim to help spur collagen production.

However, undergoing dermal filler treatments is risky, particularly when considering the widespread availability of such procedures. Now, people can have fillers while visiting almost any beauty salon, hairdressers and dentist, while few checks are carried out to monitor whether or not practitioners have the qualifications and expertise required. Young, impressionable people looking to achieve the ‘perfect’ look are less likely to look for the best quality practitioner and more inclined to search for the cheapest price, which can leave them with undesirable results.

What’s more, an investigation carried out by VICE and Save Face in 2018 revealed that a significant proportion of clinics were failing to carry out age checks on potential clients, which has significant moral and ethical implications that should not be overlooked.

What’s the issue with fillers for young people?

Due to the temporary nature of dermal fillers, very little attention has been given to the lasting impacts that undergoing such treatments can have on young complexions. However, there are a number of longer term problems that can arise due to undergoing non-surgical procedures at a young age. For starters, young people who have undergone cosmetic procedures are often referred to as “ageing sideways”, which refers to them looking like they have undergone surgery, but making it more difficult to identify how young or old they are.

Speaking to Huffington Post, US-based plastic surgeon Andrew Jacono said: “Putting too much filler in the face to try and make up for the aging process, which tends to happen, starts to make people not look like themselves anymore.”

He added: “I see patients who have been doing fillers for five to 10 years and they’re coming to me for a solution, because they’ve already done all the injectables and lots of lasers, and now they’ve spent tens of thousands of dollars and the effects of the treatments aren’t working for them anymore.”

Distorting the face

Adding filler to a hollow area, such as by the eye area, can help the face to look rejuvenated. However, patients who undergo smaller treatments such as these very often fall down a slippery slope, whereby they become addicted to the feeling of undergoing treatment and start looking for different ways to alter their appearance.

Fillers can take months or years to fully dissolve, but seeking treatment before the effects of the last injection have worn off means that their appearance will be distorted.

Stretching the skin

Skin that has been stretched by surgery or non-cosmetic treatments needs to be continually stretched in order to make it appear more taught. This results in the need for more surgery in order to fill and form the skin to the way it once was.

It is important to ensure that you are using small amounts of filler to achieve the desired look and not using excessive amounts which will lead to the need for more surgery in the longer term.

Fillers migrate and cause sagging

While small amounts of filler can quite comfortably stay in place, any more than the absolute minimum has to go somewhere - and this can cause gravity to take effect. When you put in more filler than your body can hold in one place, the filler can cause sagging. The body cannot hold onto the weight of the injected mass so the filler sinks down, which can cause the appearance to look strange.

A change in the law

The accessibility of fillers, combined with the short recovery time and the instant results have resulted in them becoming one of the most attractive cosmetic procedures available. However, these benefits have also resulted in many people developing an addiction to the procedure.

Speaking to Buzzfeed in 2019, Dr. Kevin Brenner, a Beverly Hills doctor, said: “On my younger patients, [Botox and fillers] are the gateway drug to surgery. He added: “They come in and they get hooked on it, and eventually they start needing surgery because it doesn't really have the same effect anymore, especially on the filler side. I use fillers a lot in combination with surgery, but I also use it as a bridge to surgery for different things. So it's great for patient retention.”

This worrying impact has resulted in a recent change in the law, which banned the use of Botox and fillers among under 18s. According to analysis by the Department for Health, 41,000 botulinum toxin procedures were carried out on under-18s in 2020 and more than 29,300 dermal filler procedures may have been performed on under-18sover the past four years. These worrying trends have finally forced policymakers to take a stand. The new law passed through parliament will come into force in early autumn.

However, Michael Saul - Partner at Cosmetic Surgery Solicitors - is calling for stricter measures that would stop under 21s from seeking cosmetic treatments, unless there is a genuine medical need.

Michael Saul said: “We are currently in the midst of a body image crisis whereby our young people are bombarded with unrealistic and unattainable body image standards that start to affect their opinions of themselves.

“It only takes one cosmetic procedure for a young person to become increasingly critical of their appearance, escalating the risk of developing an addiction that can lead to seeking unnecessary treatments in the future. In particular, people suffering from mental health problems such as anxiety may find that they are particularly vulnerable to the impact of pressures about their appearance.”