This blog was inspired by my preparation for a panel discussion on “Modern Beauty Culture: Empowering or Toxic?”
Beauty is fluid and has many identities and layers.
Beauty can be a source of power, rebellion and self-expression. It can signify change, allowing one to cross economic and social status. It can also be fuel for healing, acceptance and love.
Beauty can also easily become toxic if we continually “lose ourselves to the system”. If we follow the trends or crowd by continually ignoring our inner gut feeling. If we are using it to escape ourselves or to fill a void. If we spend proportionately more time, energy and resources than we have, leaving us depleted.
Beauty can be both empowering and toxic.
For years, women are bombarded by messages and images of what is considered ideals of beauty and attractiveness. This has become more prevalent in the last decade with the rise of social media, influencer marketing and sponsored post.
As an emerging feminist, there are some practices in my industry that I have reservations with (some I do not agree with) and I feel could feed into the toxic cycle of beauty.
Here they are in no particular order.
Practice 1 – Everyone needs Botox.
You may have seen this on social media. A top picture with deep lines on the forehead and a bottom picture that is smooth and wrinkle free. A caption reads “No amount of gua sha, facials, face yoga or face taping will get rid of these lines. Everyone needs Botox”.
I disagree with this.
First of all – forehead lines are not a problem. They are not bad, ugly or unattractive. Not everyone are bothered by it and not everyone wants to get rid of them.
Not everyone is suitable for Botox and not everyone likes the feeling of Botox.
If it bothers you, Botox is ONE OF THE OPTIONS you can take.
Gua sha, facials, good skin care and skin treatments CAN HELP REDUCE the lines.
Botox can help take it to the next level if the lines really bother you. Otherwise you don’t need it.
Practice 2 – Full face rejuvenation with 8 syringes of dermal fillers or more.
I see this trend gaining popularity the last 5 years.
In the early days, treatments were more focused on softening single areas (like laugh lines, lines around the mouth, frown line and crows feet) and enhancing single features (like nose or lips).
Now women seeking aesthetics are younger, wanting to balance their profile, create more contour, sharpen their features and rejuvenate in their 30/40s.
The artist in me celebrates the versatility of using dermal fillers to resculpt, reshape and rejuvenate. For some, the results can be life-changing.
However, the doctor in me questions the long term effects of so much dermal fillers in the face. Here are my reasons why.
a) Although dermal fillers are made of hyaluronic acid, naturally found in your skin and joints, it has to be stabilised using what we call G-primers and cross-linking. These can create delayed hypersensitivity reactions where there is inflammation and swelling. The risk gets higher with more dermal filler. To treat it, we prescribe steroids, antibiotics and sometimes dissolving the filler.
b) The filler can potentially block lymphatic drainage which can reduce immunity of the skin, leading to dullness, puffiness and breakouts.
c) There is a risk of migration and the face not ageing naturally, given the hyaluronic acid breaks down at different rates.
d) The before and after pictures will definitely look impressive but I’m mindful pictures are only 2D and the face can look different when it moves in 3D. Dermal fillers naturally will expand and sometimes does not get properly integrated into the tissues so it moves differently with the face.
The ability to achieve results with minimal downtime, non-invasively and at a fraction of the cost of surgery makes it attractive to women.
The feminist in me feels this is progress as it makes it available to more women, and not just the rich who can afford surgery. On the flip side, it reduces the barrier of getting it done which has its pros and cons as I highlighted above.
Practice 3 – Removing all negative shadows on the face.
Negative shadows on the face are areas that can make one look more tired, aged or unhealthy typically caused by a loss of volume. For example hollowing in the temples, cheeks, under the eyes and corners of the mouth.
Think of where you naturally apply highlighter when you put your makeup on so it reflects the light to give a more refreshed, youthful and healthy glow.
One of the treatments we can do in aesthetics is restore volume loss by adding dermal fillers and change the light reflection. If done right, it can look subtle and still natural.
However, if we chase and remove all the negative shadows on the face, this comes back to my previous point about adding too much dermal fillers. The face can look a little “moon-face” and you lose the unique features that makes you YOU.
Practice 4 – Using social media influencers to promote treatments
This is often done by the clinic/practitioner inviting an influencer to visit their clinic and have free treatments in exchange for content and exposure in front of their followers. This can look like an IG/ TikTok live feed, stories and post sharing their experience and results.
Social media can be a great marketing strategy and a way for people to “test” these treatments out through their influencer which can be seen as service to the people.
But my reservations with this is majority of influencers are young and many do not need aesthetic treatments. The legal age for aesthetic treatments in UK is 18 years old. At this age, the emotional brain is still leading the way and it can take up to late 20’s before the full logical brain is developed. You may have read or even know women who regretted doing treatments when they were younger. Often due to peer pressure, outside influence and low self-esteem. I put my hands up on this too.
As a social media influencer, the barrier to having treatment is lowered because it’s free, it gets attention from their followers and the more sales they can generate, the more attractive they become to the brand.
So the question I can imagine often asked is not “Do I need this?” but rather “What else can I do?”. This can be a slippery slope with the constant use of filters, having to look “curated”, driven by vanity metrics and pleasing their followers.
Procedures are downplayed, making it more entertaining rather that educating, especially when the practitioner is good looking. Risk and potential complications are not highlighted as not to “scare” the followers. The after “glow up” is often glamourised, drawing their followers to be more like them but we forget, adding makeup, styling, good lighting and camera shots increases the attractive factor.
As we are learning to navigate the landscape and use of social media in this industry, we are starting to see how it can equally benefit and harm patients.
Tighter and stronger regulations are needed to crackdown on dangerous practices and to protect the public. Some of the regulations below have been taken from the Australian Medical Board who has been cracking down on cowboy practitioners the last few years. I hope to see the UK board take a similar route too.
a) Having a higher age limit when an influencer can “advertise” cosmetic treatments on social media.
b) Use of before and after images should only be posted by the practitioner and have similar lighting, camera angles, backdrops, framing, makeup, posture and clothes. No lifestyle pictures by the influencer.
c) Being transparent about risk and recovery sharing detailed information about the processes and potential complications on all advertisements (even on social media post).
d) Videos and images should not contain “entertainment” features such as music , singing, dancing or comedic commentary. Any voice-overs must be purely educational in tone and content. Captions and image descriptors must not glorify cosmetic procedures, nor can they downplay the serious nature.
e) Social media influencers must not promote an unrealistic expectation of results and must not detract from the possible negative repercussions of engaging in an elective cosmetic procedure.
f) No promotional discounts, encouraging competitions, votes or guessing games.
g) No bundling of treatments since they can inadvertently encourage patients to undergo multiple procedures they may not truly need.
h) Advertisers should consider the frequency of their online posts and avoid bombarding their followers with daily or multi-daily post as frequent posting online can erode a person’s self-image.
i) Emojis and emoticons should be avoided. These adorable icons are too light-hearted for something serious as cosmetic procedures.
j) Labelling the content as “adult content” to avoid targeting minors.
k) Using negative body language should be banned e.g. “post-pregnancy body”, “unsightly bulges”, “flabby”, “bingo wings”, “problem area”, “trouble spots”, “thigh gap”, “hip dips”, “flat buttocks” which suggest certain body parts or aesthetic concerns are unattractive. This is to avoid exploiting insecurities or vulnerabilities for the sake of getting viewers to consider a cosmetic procedure.
l) No claims regarding psychological or social benefits. Practitioners must not insinuate that a patient’s life will change for the better after a cosmetic procedure. Words such as “healthier”, “happier”, “more youthful”, “new and improved you”, “better version of yourself”, “the body you deserve” should be avoided.
It’s easy to blur the lines between personal and professional with social media. But it’s important as a professional in this medical field, we need to uphold responsibility in the content we share to avoid misleading advertising that downplays the risk and over exaggerates the benefits of elective cosmetic procedures. The goal is to educate our patients so they can make reasonable choices about their health and safety based on facts alone, without being swayed by false promises or idealistic circumstances that differs with everyone.
With the rise of demand for aesthetic treatments, there is the downside of demedicalising it which we have seen in UK where non-medical professionals administer injectable treatments like Botox and dermal fillers for a markedly reduced price. We have seen a rise in complications in patients who may not have needed the treatment, not suitable, treatment was not safely carried out and complications not properly addressed.
Aesthetic medicine has been officially recognised as a specialty by the Royal Society of Medicine (RSM) as a distinct medical specialty, forming the Section of Aesthetic Medicine and Surgery (SAMAS) on 19th September 2024.
The recognition will help standardise training, improve patient care, and further professionalise the field. This is seen as a major step forward in protecting patients and promoting ethical practices.
I hope the regulations will come sooner than later.
Dr Terry