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Botox and filler are the new craze for people in their twenties – but are they aware of the risks?

Why are so many twenty-somethings obsessed with getting Botox and filler? A look at the transforming demographic of young adults getting these aesthetic treatments, the risks involved and the rise of unregulated practitioners


Dermal filler and Botox procedures are becoming increasingly popular for the younger demographic. Everyone seems to be fixated on smoothing their wrinkles, plumping their lips, or getting their jawline sharpened. Currently, the most popular trend is dermal filler – a hyaluronic acid-based injectable substance used for filling lines and wrinkles, as well as enhancing facial volume and highlighting specific features. Amid the snowballing influence of harmful beauty standards, those in their twenties are increasingly resorting to non-surgical cosmetic procedures and there is a concern that these treatments could have dangerous consequences.


In 2020, the Department for Health approximated that around 41,000 procedures involving botulinum toxin may have been conducted on individuals under the age of 18. Additionally, in the four years prior, it is suggested that over 29,300 dermal filler procedures might have been undertaken on those in the same age group. While it is now illegal for minors to receive these treatments under The Botulinum Toxin and Cosmetic Children Act 2021, there is little to stop those above 18 from injecting and plumping their faces. Nor is there legislation in place to ensure practitioners are qualified or licensed. 


Currently, specific age-related data does not fully illustrate the extent of the unfolding trend for those in their twenties. Still, healthcare experts are observing instances of this trend anecdotally. Founder and director of Save Face, Ashton Collins stated: 


“20 years ago, when these treatments first came to the UK, they were very much reserved for the wealthy and were carried out largely on middle-aged women. I guess as time passed and with the advent of social media and reality TV, they’ve become more mainstream. It’s opened the door to a whole new audience of young people”. 

I undertook a recent survey concerning women aged between 18-25. It discovered that 52% of the 70 surveyed were planning to get Botox or dermal filler treatments in the future and 92% of those admitted that this was influenced by social media pressures. While it is easy to blame reality TV stars and Instagram influencers for actively promoting face-altering procedures as though they are as trivial as getting your hair done, there appears to be a broader, more cynical picture of emerging insecurities in young adults which potentially calls for education and regulation.  


Alongside the increasing prevalence of non-surgical procedures, there is a corresponding uptick in unlicenced and unregulated practices. Currently, no legislation in place ensures that aesthetic practitioners must be licenced to inject others with dermal filler– causing serious concern for young adults hunting down cheap deals and scouring social media to find practices. Numerous beauty practitioners are capitalizing on this surge in demand for filler treatments, taking inadequate training courses to provide more affordable services targeted at individuals with tighter budgets. Ashton Collins stated that 


“80% of the people that come to us find their practitioner on social media, mainly Instagram, where they’ve seen a £99 lip filler deal and they think they’re just snagging a bargain”.

There appears to be a two-tiered structure in the UK. There remain reputable healthcare providers who obtain high University degrees and qualifications to further their expertise and practice in this field. Yet, opposingly, Ashton Collins believes. 


“You have people that have done a one-day training course, even a half-day training course and because these courses are not regulated in any way, what we often find is that the content of that course is extremely poor”

Like a chain reaction, those who undergo this ‘training’ subsequently disseminate their newly acquired skills to others. Collins is concerned by the potential for misinformation to spread between individuals, who might then proceed to administer dermal fillers to unsuspecting consumers using potentially hazardous techniques. It is most commonly these insufficiently trained practitioners who receive customer complaints regarding botched procedures. 


Save Face was set up by Collins in 2014 in response to the Bruce Keogh report which was commissioned by the Government on the back of the Pip breast implant scandal. The Pip breast implant scandal compelled the Government to thoroughly assess the aesthetic industry, revealing the unregulated nature of non-surgical treatments and the limited consumer safeguards in cases of mishaps. Save Face is a Government-approved register, signposted by the NHS which is home to hundreds of practitioners and clinics who have passed a rigorous 116-point assessment process. 


Save Face receives and deals with thousands of complaints regarding substandard treatments annually. I conversed with Collins regarding their approach to managing these complaints, the reasons behind their high frequency, and the dangers that numerous young adults should consider before succumbing to the allure of contemporary trends and getting injected.



The hazards of unlicensed non-surgical practitioners are irrefutable. However, despite dermatologists and MP’s best efforts to crack down on the unregulated administration of treatment, the Government’s promised licencing regime remains to be implemented. The Government first announced its intention to introduce a regime in February 2022. Yet, in February this year, the Government rejected a call by MPs to speed up the introduction of the promised licences for non-surgical cosmetic procedures and a call for filler to be prescription only. Furthermore, in the official response to the Department of Health Social and Care Committee (HSCC) 2022 report it was stipulated that new mandatory standards for aesthetic practice, education and training would be available in England by July 2023.


Collins claims this was “ridiculously short-sighted” and too big a task. Whether new legislation would be beneficial to those affected by failed treatments can also be disputed. In the same document, the Government noted that there were “no current plans” to medicalise these treatments and make dermal filler prescription only. 


Regrettably, even with a concerning surge in reports of inadequately performed filler and Botox procedures, the enactment of effective regulation doesn’t look to be implemented any time soon. This is incredibly concerning for the younger demographic who are becoming fixated on changing their appearance, surrounded by social media pressures and who remain unaware of the potential risks.




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