As the number of people undergoing cosmetic procedures continues to rapidly increase across the globe, we explore the often-overlooked effects of unregulated and over-performed instances of the three most popular cosmetic enhancements: Botox®, dermal fillers, and BBLs.
A BATTLE AGAINST THE BIOLOGICAL CLOCK
Beauty has always been a matter of uncontrollable chance – either you are born having won the genetic lottery or not.
Regardless, to a certain degree, every individual utilises appearance-enhancing tools to wrestle with the inevitable signs of ageing and societal preference. Whether it be through tanning, teeth-whitening, eyelash extensions, or wearing spandex, the global effort to adhere to trending beauty standards is inescapable.
However, despite their evident rise in popularity and acceptability, many would not place these temporary tricks in the same categorisation as cosmetic surgery, which, up until recently, has been viewed as a drastic way to achieve the look of your dreams – and of social media’s daily output.
Within the past decade, cosmetic enhancement procedures have seen a monstrous increase in interest from the general public, with options like Botox®, dermal fillers, Brazilian butt-lifts (BBLs), and the all-inclusive ‘mommy makeover’ dominating Google searches worldwide.
The democratisation of cosmetic surgery is changing the way people view their own biology. No longer is the gradual decay of youth an obligatory part of life, but rather, the body is now a project that can be constantly improved through cheapening, bloody, and often unregulated procedures.
The most popular non-surgical cosmetic enhancement continues to be Botox®, which had over nine million treatments administered globally in 2022 alone and is predicted to have a total market value of USD$15.2 billion by 2030. Botox® consists of botulinum toxin, a neurotoxin produced by the bacteria Clostridium botulinum that temporarily paralyses the muscle.
However, it is important to note that in addition to cosmetic procedures, Botox® has an indispensable role in modern healthcare and is used to address various neurological disorders. Its ability to selectively paralyse muscles relieves debilitating symptoms for patients experiencing chronic migraines, cervical dystonia, spasticity, and more.
Nonetheless, the growing number of people seeking Botox® treatments for aesthetic improvement raises a plethora of ethical concerns, as profound social implications begin to emerge in people’s pursuit of physical perfection.
The ubiquity of social media and celebrity culture amplifies the demand for quick and easy solutions such as Botox®, as directly observed through the continued increase in non-invasive plastic surgery in young people between the ages of 18-34 who received approximately 2.2 million Botox® treatments in 2022.
This surging normalisation and ready accessibility not only magnify the tendency to equate self-worth with one’s external appearance but also results in the reinforcement of ageism and socioeconomic privileges, as continuous cosmetic treatments are not inexpensive.
INJECTABLE BEAUTY
Alongside procedures involving Botox®, the injection of dermal fillers has skyrocketed in popularity, primarily due to its increasing affordability, accessibility, and normalisation on TV shows, social media, and Hollywood.
Dermal fillers are soft, gel-like substances injected beneath the skin to add volume to under-eye circles, lift the appearance of cheekbones, plump lips, smooth nasolabial folds, and rejuvenate hands, in addition to other benefits.
Traditionally, dermal fillers are composed of hyaluronic acid – a naturally occurring substance found in the skin that plays a major role in the hydration and volumisation of facial features.
However, too much hyaluronic acid has been found to block the body’s lymphatic channels, a key part of the immune system. Even more distressing is the risk of an accidental injection into a blood vessel. When filler enters the bloodstream, it can cause skin necrosis, strokes, embolisms, and even blindness.
Despite these very evident risks, the irresistible marketing from social media, the glamourisation of fully plump features, the trivialisation of the various side effects, and the incentivisation of the end result are like a siren song to those desperate to achieve such an idolised outward appearance.
It is important to highlight that on many occasions, these procedures are conducted safely when carried out by medically trained and licensed clinicians. However, both the price point and limitations on the amount of filler professionals are willing to inject have driven some consumers to turn towards do-it-yourself kits and even the black market.
These options can result in deadly complications, as there have been reported instances of fillers purchased online containing non-sterile substances, such as hair gel. Equally, these self-injecting kits and unlicensed professionals can also lead to swelling, lumpiness, and facial pain.
As such, the overuse of fillers has become a serious problem that professionals are seeing the effects of in repeat clients.
One study from the British Association of Aesthetic Plastic Surgeons (BAAPS) found that approximately 80 percent of surgeons noticed an increase in intraoperative and preoperative anatomical distortion due to the overuse of fillers. Additionally, former BAAPS President, Dr Marc Pacifico, commented that many surgeons have detailed how anatomical structures are more tethered and scarred when fillers have been previously used.
As dermal fillers have only been around for about 30 years, there are no long-term studies on their safety and impact. Recently, however, issues of filler migration have become documented via X-ray and MRI scans.
Filler migration is the unintended movement of injectable dermal fillers from their initial placement to other parts of the face. When an area is treated with hyaluronic acid, tension in the tissue can result in the filler moving to a place of less pressure. This can ultimately lead to, among more serious issues, less desirable aesthetic features, such as overinflated lips, lumpy eyelids, and exaggerated cheeks.
The problems with migration are compounded by the recent discovery that dermal fillers last inside the body much longer than previously thought. Traditionally, it was said that filler lasts between six to 12 months on average, however, after further testing, it was found that dermal fillers were still present in patients after eight years, having migrated throughout the face.
A BODY WORTH DYING FOR
Buttock enlargement surgery, more commonly referred to as a BBL, is the fastest-growing cosmetic surgery procedure in the world.
According to a survey conducted by the International Society of Aesthetic Plastic Surgery, the number of BBLs performed globally has grown by 77.6 percent since 2015.
However, despite its soaring popularity, the procedure carries the highest fatality risk of all cosmetic surgeries – with more than one death per 4,000 procedures.
During the operation, the danger occurs at a very specific moment: the insertion of the cannula deep into the muscles of the buttocks. As the instrument enters beneath the skin, it has to remain above the gluteal muscle. If it goes below, fat droplets may coalesce in the bloodstream and travel through the body’s circulatory system to cause a pulmonary embolism – a blood clot in the lungs.
The procedure can also result in additional complications, including severe bacterial infections such as MRSA, necrosis, scarring, wound ruptures, and abscesses.
Equally, the risk involved in performing a BBL is not just about unsafe amounts of fat being injected into a person’s body, but how it is inserted and whether or not it is actually fat being inserted at all, as a number of recent deaths occurred since the patients were being injected with silicone.
Despite these very real and fatal dangers, the BAAPS has cited that the procedure is being performed with a 20 percent increase year-on-year.
Many attribute this growing trend to the allure of celebrity culture and seductive advertising for cosmetic surgery clinics abroad.
One country that continues to be incredibly popular for medical tourism is Turkey, where the surgery prices are significantly lower and regulations not as strict.
In the UK, a BBL can cost between £6,000 and £12,000, whereas in Turkey, pricing typically ranges between £3,500 and £5,000. Similarly, advertisements plastered all over social media platforms like Instagram showcase glamorous portrayals of women lounging on a pool deck promoting the surgery and offering special discounts for patients willing to undergo multiple cosmetic procedures at once.
Whilst these images of a relaxing escape combined with a seemingly effortless surgery (or even surgeries) come across as irresistibly alluring, it is an illusion. These procedures are considered a major surgery with a multitude of potential complications attached that are conveniently not shown on the same social media accounts.
Although they may address the physical insecurities that protrude from peoples’ reflections in the mirror, they are unable to wrench the scalpel deep enough to slice out the primary motivator behind these surgeries: a lack of self-worth and identity in an increasingly egotistic society.
Even though medical science has advanced to the point of being able to physically change a person’s biological traits, essentially backhanding evolution, the question must be asked as to whether these dangers and the lack of responsibility in addressing underlying issues are worth the temporary aesthetic reward.
