It was almost something of a game we'd play while perusing the pages of a trashy tabloid at lunch: "Do you think they've had work done?" I'd ask my mum, pointing to a celebrity with carved cheekbones, a plump pout and smooth forehead sans the merest hint of a wrinkle.
"Probably," mum would say, before probably sending back her coffee because it wasn't hot enough.
'Getting work done' is no longer hush-hush, a topic shrouded in secrecy and reserved for the models and luminaries plastered in the pages of magazines. Going under the needle is now arguably a cornerstone of many people's 'maintenance' routines across the globe, like a 12-weekly haircut or bi-annual teeth cleaning - instead, it's a quarterly top-up of Botox.
Injectables such as Botox and dermal filler are minimally invasive, non-surgical cosmetic procedures that are becoming increasingly popular in today's world. Unfortunately, social media has now become the barometer for what is considered 'beautiful' by the masses - criteria that were historically set by mainstream media and magazines. Beauty 'trends' popularised on the likes of Instagram and TikTok include full, pouty lips; lifted, cat-like eyes; chiselled bone structure; pert, 'ski-slope' noses; arched, feathered, but not overgrown eyebrows; and of course, smooth - apparently poreless - skin.
Of course, many people are not naturally born with these suddenly 'sought-after' facial features, yet they have become something of a touchstone for what is considered 'conventionally attractive' - according to social media, anyway. This is where 'tweakments' come in.
According to a study by the American Society of Plastic Surgeons, Botox injections became the most popular non-invasive cosmetic procedure in 2020, with 4.4 million procedures performed that year in America alone. A global report released by Allergan in 2019 projects that the worldwide medical aesthetic market will be worth US$26.53 billion by 2024, and notes the demand for facial injectables has been rising in particular. The same study notes that 82 percent of US consumers aged 21 to 35 are using Instagram as their biggest source of information for aesthetic treatment.
With the popularity of injectables on the rise, it's important people - particularly those who are young and impressionable - are doing their due diligence and know what they're getting into before going under the needle.
First of all, there are three main types of injectables. The first category consists of neuromodulators, which are used to weaken and paralyse the muscles in the face. The most common one is Botox, but other options include Xeomin, Dysport and Jeuveau. It is commonly used to smooth frown lines, wrinkles on the forehead and crow's feet around the eyes, and possible side effects and complications can include pain, swelling or bruising at the injection site.
Secondly there are dermal fillers, which sit under the skin to provide volume and support in multiple areas of the face, such as the lips, cheeks and under-eyes. Facial fillers typically consist of hyaluronic acid (HA) and common types include Restylane, Refyne, Defyne, Juvederm, Vollure, Volbella and Belotero. Others are non-HA, which feature different consistencies and typically last longer: these include Sculptra (poly-L lactic acid), Radiesse (calcium hydroxyapatite), Belafill and silicone. As per the FDA, common risks include bruising, redness, swelling, pain, tenderness, itching and rash.
Thirdly, there's Kybella, or Belkyra: a deoxycholic acid that dissolves small quantities of fat. It's currently approved for use beneath the chin.
While beauty and lifestyle editors have become somewhat blasé about the likes of Botox, not everyone is a connoisseur on cosmetic procedures. Outside of professions where beauty is your bread and butter, there's many frequently asked questions about injectables and what you need to know before scheduling that first appointment.
To clear everything up, Newshub put several FAQs to Jan-Maree Baughan, a registered nurse cosmetic injector at OFF & ON, New Zealand's leading laser hair removal experts who also specialise in injectables and microblading. So if you're one of the many considering a little lip filler or something for that furrowed forehead, give this guide a read-through first.
What are the most common 'tweakments' in New Zealand and who are the people getting them?
Over the years we've seen injectables increase in popularity: it's no longer the taboo conversation it may have once been. I feel like it's become an acceptable part of looking and feeling your best, like going to the hairdresser and getting your hair done.
I see a wide age group and range of people with different concerns and issues come for treatment and it's becoming more popular by the day. Botox is our most popular injectable service, and that's no surprise: anti-wrinkle injections are one of the longest standing and most popular cosmetic procedures worldwide, which significantly reduces fine lines and wrinkles.
Ultimately cosmetic injectables come down to personal choice, and if someone has made the decision to explore injectables, we want to ensure they're getting the best treatment possible that's tailored specifically for them. Everyone has a different reason or journey. Our goal is to help you get to and maintain your best believable self, and walk out looking fresh - and not frozen - and full of confidence.
What should you look for in a reputable provider, and what are some red flags?
We're very fortunate that the injectables market in New Zealand is tightly regulated, so while backyard or black market operators are uncommon here, it's still possible.
Red flags may not be so obvious, so instead I'd recommend looking for the following to identify a reputable provider. A reputable provider will:
- Only have registered nurses that have been fully trained in cosmetic medicine administering injectables. You can identify a registered nurse either by their registered nursing badge (I ensure that I wear mine so my clients are at ease), or they have their certificate on display. When in doubt, you're completely within your right to ask where your injector was trained and how many years' experience they have
- Give you time to give informed consent before you are given treatment. This means a proper consultation prior to treatment that includes a full review of your medical history, and time for the nurse to explain what they're about to do and any safety aspects. You should also never feel rushed and have the opportunity to ask any and all questions before choosing to proceed. This consultation should also include aftercare recommendations, including holistic recommendations
- Have proper infection control measures, such as a sharps bin and strict hygiene standards. I always ensure my clients can see me washing my hands before treating them. It's the little actions we make as professionals to ensure you feel in safe hands. Some councils will even require that you display a certificate to show you adhere to infection control, so feel free to keep an eye out for that prior to treatment too
- Show you the product they'll be using and check the expiry date of the product with you. Feel free to check for the registered trademark symbol if you're unsure
- Finally, all reputable providers will have emergency equipment close by in the very rare care of any adverse reactions and will also inform you of what to do if you have any adversities once you leave the clinic. Your safety is paramount to a trained professional.
How long does Botox and filler last and how often do people typically need top-ups?
Botox in general lasts between three and four months, but we see customers generally coming in at the three-month mark for a check-in to see if they still have the results they desired.
For filler, this depends on the product. For lip filler we use Juvederm (a dermal filler made from hyaluronic acid used for volumising to correct wrinkles and lines), which can last between six and 12 months, but our lip clients tend to come back to us at around the six to eight month mark. The filler product for the cheeks is Voluma (an injectable gel indicated for deep - subcutaneous and/or supraperiosteal - injection for cheek augmentation), which is guaranteed to last 18 months to two years.
What areas can you get filler and Botox in, for what results?
General areas for Botox treatments are frown lines, crow's feet and forehead lines. Under special circumstances and after discussion with our client, other areas may be considered for treatment.
For filler, this tends to be either the lips or cheeks. With lips, OFF & ON is passionate about helping you walk out of our clinics looking pouty and not trouty: we want to keep within our client's aesthetic borders to help them look refreshed.
Cheek fillers are a great option for facial-lifting (while once again keeping in those aesthetic borders) and for the appearance of defined cheekbones and facial structure. This can also help reduce under-eye wrinkling and jowling around the mouth.
However, there are a few people that we would not recommend injectables for, and this comes down to your medical history - this is why this part of the consultation is so important. We can't treat you if:
- You have a bee sting allergy, as the antidote to the hyaluronic acid comes from the bee venom family. This also applies to the other ingredients in our injectables too: a full outline of your allergies are very important
- You have autoimmune diseases such as diabetes, irregular thyroid functions or Crohn's disease
- You're on certain medications which are known to have a reaction to injectables.
What can you expect to pay?
Many salons and clinics have competitive pricing. At OFF & ON, A unit of Botox ranges from $12.90 to $17.50 depending on the area and the packages purchased: we also have an OFF & ON bank where clients can purchase units of Botox and reserve them for future use. It's a smart way to commit to a treatment plan while keeping prices down, but ultimately the more units you buy, the less you pay per unit.
Filler is generally around $600 for lips. For cheek filler, you're looking at approximately $1400 for a full face.
Which people might want to consider getting injectables (as in, what results can they produce that might help specific concerns?)
For Botox, I'd say anyone over the age of 30. Botox is great for boosting confidence and feeling good about yourself, especially if you're self-conscious about the appearance of fine lines.
Are there any ways you can maintain your injectables to make them last that little bit longer?
Yes, definitely. Your nurse will give you tailored advice on your skin type and the aftercare that you'll require: this should always be a part of your appointment to ensure you're getting the best treatment possible. This is likely to include the following recommendations:
- Avoid exercise, alcohol or blood thinners for 24 hours post-treatment
- Avoid lying down for three hours afterwards: you don't want the product to shift as it needs to stay in the muscle that's been treated
- Avoid facials, massages or any other similar procedures for two weeks post-treatment. We'd also recommend avoiding dental work for four weeks before and after a filler appointment, as we don't want any interactions with their medicine and the movement of the lips and face can affect the settling of your injectables post-treatment
- Keeping up healthy lifestyle choices such as using sun protection, maintaining a healthy diet and exercise routine, staying hydrated and getting enough sleep, These are always going to be good for the elasticity of your skin, so are always part of our recommendations
- We also tend to ask our clients to avoid long-distance flying for three weeks after fillers, as the product can move in-flight and should something go wrong, we obviously wouldn't be in a position to help you.
What is your top advice to someone considering starting their injectables journey?
Dip your toes by heading in for a consultation. My clients have told me there's something really empowering about being your best, believable self.
Reputable providers will allow you to have no-obligation consultation so you can ensure you're getting a treatment plan tailored specifically for you, and importantly, that you have a good rapport with your practitioner. Trust is really important, and you should feel in control at all times.
Mandatory statement: Botox is a prescription medicine for the treatment of frown lines, horizontal forehead lines and crow's feet around the eyes. Botox has risks and benefits. Ask your doctor if Botox is right for you. If you have side effects, see your doctor. You will need to pay for Botox and clinic fees will apply. For details on precautions and side effects consult your healthcare professional or the Consumer Medicine Information (CMI) at www.medsafe.govt.nz.
Botox treatment lasts about four months and further courses of treatment may be necessary. Botox should only be administered by trained medical professionals and contains botulinum toxin A 50,100 & 200 units (Allergan NZ Limited, Auckland).
Juvederm Ultra and Juvederm Ultra Plus are medical devices Class III for the filling of medium size and deep facial wrinkles by injection into the skin and for creating definition and volume in the lips. Contains 24mg/mL. Cross-linked hyaluronic acid Juvederm has risks and benefits.
Cautions: Use in an area that has been treated with another dermal filler; people with autoimmune disease, or who are pregnant, breastfeeding, under 18 years of age or have an increased susceptibility to keloid formation and hypertrophic scarring; people on blood thinning medicines.
Possible side effects: injection site inflammatory reactions (redness/swelling, itching/pain on pressure) induration or nodules; discolouration; weak filling effect. If you have side effects or concerns, speak to your doctor. Product and treatment costs will apply. Note: Juvederm treatment lasts about 12 to 24 months. For product information check with your doctor or product information at Allergan NZ Limited, Auckland.
