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Changing Faces - rise of injectable use in Millennials

To successfully carry out my role as a medical aesthetics nurse, it's a vital that my patients can be open and honest about their appearance concerns and, as such, this puts me in the privileged position of knowing what drives them to seek treatment and provides me with an insight into changing trends.

Aesthetic treatments have traditionally been sought by the 30 plus age group wanting to delay or remedy the signs of ageing and for treatment of facial and skin imperfections, with younger age groups much less likely to seek treatment. Over my 16 plus year career in aesthetics and skin care, dermal fillers and Botox have become more mainstream with a gradual rise in younger people having treatment. However, over the past few years I have noticed an explosion in the levels of discontent voiced by the mainly 18-25 age group regarding their appearances, accompanied by an increase in requests for aesthetic treatments aimed at altering their features to mirror those seen on celebrities in social media and popular reality TV programmes. It seems many young peoples perception of beauty has been greatly influenced by these current trends and with them, a growing demand for dermal filler "beautification" treatments.

Unfortunately, as they compare themselves unfavourably to the "perfect" images they see on Instagram and other social media platforms, their self-criticism rises while their self-confidence plummets creating a strong social pressure for them to conform to these new beauty ideals. Sadly, many of these images show young people who have had so much "work" done they have lost their individuality and often look oddly unnatural, even appearing much older than their young age. It is disheartening how those who possess the beauty and freshness of youth seem to have lost the ability to view their reflection in a positive way and have difficulty acknowledging that their uniqueness alone can be just the thing that makes them attractive.

Although appearance has always mattered to young people, the modern bombardment of idealised images and availability of quick-fix procedures is helping to fuel a mental health and anxiety epidemic in this age group. Obsessions in obtaining unrealistic levels of perfection could indicate potential Body Dysmorphia Disorder (BDD), where sufferers become distressed over perceived flaws in their appearance and the NHS has recommended that healthcare professionals providing aesthetic treatments should be competent in spotting and diagnosing BDD in order to ensure safeguarding of these patients. I routinely screen for this disorder and have rarely come across it in it's most complete form, however, there is definitely an increase in young people seeking treatment spurred on through the perceived need to achieve idealistic facial features.

While I take great pleasure in helping people look their best, and especially love using restorative treatments to reverse the signs of ageing and correct facial irregularities, I think as a culture we really need to gain some perspective on what true beauty is and where aesthetics treatments fit in this picture. I genuinely believe that our collective ideas of beauty have become so flawed that it's increasingly rare to meet someone who recognises the positives of their own appearance. Beauty doesn't mean looking like clones or altering your features beyond recognition or trying to look like an airbrushed photo or Snapchat filter, it means accepting you are unique and recognising that best results from aesthetic treatments will be achieved by working with your natural features and not against them.

Skillfully using medical aesthetic treatments to effectively enhance appearance means consideration of each persons attributes and using these as a measure of what can be done to compliment these - successful, natural looking results requires both the practitioner and patient to have realistic expectations. The majority of my patients seeking to correct irregularities and restore a glow to their faces have healthy, positive mindsets - they're not hoping for miracles, or even wanting to look younger but to look more refreshed and to soften the natural ageing process. Younger patients can benefit from subtle enhancements or treatments which will delay the signs of ageing but, due to misconceptions created through their exposure to social media marketing, may need more guidance to know whether their concerns can be helped better by other means rather than injectable treatments. For example, if a young person has got into the habit of burning the candle at both ends, dark under eye circles are likely to respond to a change in lifestyle rather than jumping in and treating the tear troughs with dermal fillers.

An important part of my role as a healthcare professional and specialist aesthetics nurse is to inform and educate patients in my practice and only make ethically based recommendations in their best interests which will result in positive changes for them. So what are the considerations for the younger age group seeking treatment? Potential problems stemming from having facial injections and knowing how to avoid these, can be applied to any age but those which are especially relevant to the younger age group as follows:

1. Having cosmetic injectables done "on the cheap"

Safe, high quality procedures can be expensive and as many people below the age of 30 don't have a huge disposable income, they may opt for cheaper treatments unaware of the associated risks these carry. Studies show they are more likely to choose someone to inject them who isn't properly qualified or experienced and who potentially cuts corners and uses cheap, poor quality filler products. Finding an experienced medical practitioner providing safe and high standard injectable treatments requires a degree of research but many young people are enticed by offers and cheap deals they see on social media, completely unaware of the potential hazards of this.

Avoid being tempted by cheap offers and ensure you do your homework, look at the qualifications and experience of the injector, the quality of the products being used and whether they offer after care and are easily contactable should you have any concerns following treatment. Additionally, as dermal fillers are only temporary,consider the financial implications of needing to repeat treatments in the future to maintain results.

2. Treatment on demand: over-filling can age young faces

Sadly, there are an increasing number of cosmetic injectable providers who are either unscrupulously motivated by profit or lack the training and experience to know better, who will inject every person that walks through their door whether they are suitable for treatment or not. Risks include badly administered injectables and over-filling of the face, both which can make younger faces actually look older. Extreme chiseled jawlines and huge lips are currently the "thing" but following fashion may mean having treatment that ultimately does nothing to enhance your natural looks but simply leaves you looking over-done.

If you're a social media addict who compares yourself to all those perfect Instagram photos, try having a break from your daily scrolling especially if doing this makes you feel "less-than" or self-critical. The majority of these photos don't reflect how these people look in real life, so chances are, you're possibly just chasing an illusion. Avoid thinking that just because someone you know has had a specific treatment that you will get the same results as them or that it's actually suitable for you - you're face is unique and your treatment needs will be too. If you are choosing a new practitioner, don't walk straight into treatment without having a separate consultation appointment first - give yourself time to decide if this injector and treatment is right for you.

3. Trivialising a medical procedure: not knowing the risks

A recent poll of over 1,000 UK women aged between 18 and 30 has highlighted how this age group perceives non-surgical aesthetic treatments, such as dermal fillers and Botox, as being akin to having your hair or nails done, just another "beauty" treatment. It's seriously worrying that facial injections are being trivialised by the younger generation, with an accompanying lack of awareness of the potential risks and complications these procedures can bring, especially in unsuitable hands. Although there is a current drive to regulate the non-surgical cosmetics industry due to increasing incidents of botched procedures, the UK remains one of the only countries that allows non-medically trained people to provide aesthetic injectable treatments. Due to the current lack of regulation, there are a rising number of aesthetic treatments being offered at beauty, nail and hair salons, often by injectors who have undergone as little as a single days training before being let loose on the public. It seems the current lack of restriction of where and by who injectable procedures can be performed has only encouraged people to be blasé about seeking treatment and given credibility to the idea that they are a quick-fix anyone can have. However, medical aesthetic procedures involving injecting substances into your face should never be taken lightly. Botox, for example, is a prescription only medicine and requires a face to face consultation with a prescribing nurse, doctor or dentist and dermal fillers can cause complications that cannot be treated by non-medically trained injectors. They are often complex procedures which require a great deal of knowledge and skill if they are to be undertaken safely and effectively.

Choose an experienced medically qualified injector who is registered with a governing body such as a prescribing nurse, doctor or dentist and who is, preferably, practicing from their own permanent premises so will be easily available should you need to contact them following treatment. If wanting Botox treatment, ensure you have a face to face consultation with a prescribing professional prior to booking for the procedure (which will preferably be performed by the same practitioner). As Botox is a prescription medicine, it cannot be openly advertised in the UK and this includes posting before and after pictures on social media. If an injector is doing this, they are acting illegally and you should ask yourself what else don't they know?

4. Unrealistic expectations: banking on aesthetic treatments improving your life

Whilst many young people may have valid and well thought out reasons for wanting aesthetic procedures, they shouldn't be expected to alter your life in a big way. Plumping your lips or creating high cheekbones similar to social media stars you may admire will not ultimately transform your life. Having too higher expectations of what you can gain from altering your looks by having Botox or dermal fillers will only set you up to be disappointed and often, once you have "fixed" one issue, you'll simply find another one to be dissatisfied with. Sadly, Body Dysmorphia and other appearance based mental health issues are becoming more prevalent in the younger population and no amount of aesthetic intervention will help in these

Think carefully about your reasons for wanting treatment - do you have a genuine correctable concern or are you simply following a current trend and hoping it will bring unrealistic change to your life? Are any insecurities about your looks due to a generally poor self-esteem? If this is the case, Botox or dermal filler treatments are unlikely to make you feel better in the longer term.

I really hope today's blog post has been a useful one as I'm genuinely passionate about the safety and well-being of my patients and raising standards in aesthetic medicine. In addition, as a mother to young adults myself, it's a subject close to my heart. If you're interested in finding out more about how to keep safe when having non-surgical aesthetic procedures, the Department of Health has recently started a public awareness campaign and I'll be reposting some of them on my DC Aesthetics Facebook page

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