(Excerpt) Dr. Lisa Kellett still remembers her first. The first time she ever injected a little something known as Restylane, that is. “It was a total game-changer,” says the founder of DLK on Avenue, a skin care clinic in Toronto.
Before then, practitioners like herself had but two options when a patient came in seeking to, say, soften their naso-labial folds (those lines connecting the nose and mouth): animal-based collagen injections or a full-on facelift. The issue with the former was that because the collagen wasn’t human, there was an increased risk of reaction. “And then, to say to someone who was 35 or 40, ‘If you really want to get rid of that fold, you need a facelift,’ just wasn’t appropriate for such a young patient,” says Kellett.
Restylane changed that. Launched in Europe in 1996, the product consisted of hyaluronic acid, a substance naturally occurring in the body, which greatly reduced the risk of adverse effects. It was designed to be administered under the skin for aesthetic purposes—add volume here, smooth out a crease there—and became the first injectable of its kind approved by the FDA. It would go on to transform the face of cosmetic dermatology—not to mention the face of legions around the world: over 50 million treatments and counting.
The results were astonishing. Patients could appear refreshed in a single session without having to endure the risk of surgery or the associated cost or downtime. “It was fantastic,” says Kellett. “You’d hand them the mirror and you’d see right in front of you how happy they were.”
In those early days of fillers, the dermatologist says she mostly treated mature patients looking to restore the facial volume they’d once had. See, as we age, the fat pads in our face begin to shrink and shift downward, which can lead to more sunken eyes, thinner lips and sagging along the jawline. Fillers could counteract the phenomenon.
But over the years, their use expanded beyond solely correcting signs of time. For many, it became not about looking younger but rather pursuing a certain look. “Now you have young patients whose lip size and volume are normal, but from a purely aesthetic point of view, they just want more,” says Kellett. “That’s quite common now for Millennials.”
The rise of this trend is often pinned on reality-TV-star-turned-makeup-mogul Kylie Jenner. In 2015, some clinics even reported a 70 per cent increase in enquiries for lip fillers after the then 17-year-old confessed to plumping her pout.
That’s around the time Shelby Hall first got her lips done. Until Jenner’s much publicized enhancement, she hadn’t even been aware that “fillers were a thing,” she says. “There wasn’t anything wrong with my lips per se, but I was like, ‘What’s the harm in a little extra volume?’”
Enamoured with the results, Hall began a regimen of twice-yearly top-ups, eventually getting injections in her cheeks, chin and jawline, too. The thing was, though, that the filler wasn’t completely disappearing after six months, contrary to what she’d been told, so every new treatment added more volume to her face, further transforming her appearance. “Over a span of four years or so, I found myself with all this filler, and I was like, ’I’m not really looking like myself anymore.’”
So she made the decision to have it all dissolved with an enzyme called hyaluronidase, which can be injected to break down hyaluronic acid. Actor Courteney Cox famously discussed doing away with her fillers in the same way after finding she “looked really strange.” “I feel better because I look like myself,” she told New Beauty magazine at the time.