Some might point to Kylie Jenner as the catalyst for our growing fascination surrounding injections, but in truth, it looks as though we've been heading in this direction for some time. If I had to play beauty anthropologist, I'd estimate that our collective obsession with "no-makeup makeup" played an even more profound role—we all want to say that we #wokeuplikethis, even if our dirty little secret is that we got a little outside help. Ideally, you wouldn't be able to tell the difference.
And boy, has the industry complied. As more and more practitioners become skilled in Botox and dermal fillers, women (and men) are seeking out tiny enhancements that the average bystander wouldn't be able to discern. The goal is not to freeze the clock—and in turn, the face—but to slow it, to refresh your features rather than replace them entirely. Even as a beauty editor with a relatively trained eye, I'm constantly shocked when a friend or industry cohort cops to having had a little something done.
And that's how you can spot a well-done procedure—when you need to be told where to look.
"So really, everyone is doing it, right?" I recently asked Nicci Levy, founder of Los Angeles injectable destination Alchemy 43. With an extensive career in beauty, followed by several years as a development manager for Allergan (the parent company of Botox, Juvéderm, and Latisse), Levy saw where the market was headed and knew that it was time to capitalize on that trajectory. Since it opened its doors last year, Alchemy 43 has attracted celebrities and mere mortals alike with quality Botox and dermal filler treatments, all in a highly personal, boutique-like setting.
The concept has been so successful that Levy is already working on expanding across the country.
In addition to the concierge-like service and highly knowledgeable staff, Levy credits Alchemy 43's success to its treatment aesthetic—the boutique specializes in extremely natural, barely-there results. And an unlikely crowd is taking notice. "I expected the majority of our clientele to be women in their late 30s, 40s, and 50s," she says. "It's been a surprise to see that roughly half of the customers who visit are under the age of 35."
But this also speaks to Levy's true passion project, which is educating the masses about Botox and injectables. A huge part of that is dispelling the all-too-common myths surrounding the treatments—like, say, the idea that they never look natural. Suffice to say that Alchemy 43 has already done a lot to debunk that notion, but there are still many other misconceptions to address.
So no matter if you've been deeply considering lip injections for some time or if the idea of Botox has always freaked you out (isn't it technically poison?), read on for some surprising truths about injectables.
1. More young people than ever are trying them out
As mentioned above, even Levy has been surprised to see that about half of her clientele is under the age of 35. And it's actually a good thing because many experts actually advise trying Botox in particular sooner rather than later. Since wrinkles and fine lines are typically caused by muscles that are tensed over and over again, relaxing those muscles with Botox in your late 20s and early 30s is a great preventative measure (and helps you avoid that telltale "frozen" look, since you aren't even letting those wrinkles form in the first place).
2. A plastic surgeon or dermatologist won't necessarily administer better injections than any other practitioner
You don't need to be a plastic surgeon to be licensed for Botox or dermal fillers, which is why it's ultimately up to you to do your research when looking for a practitioner. Levy advises polling friends, checking online reviews, and perusing before-and-after photos at different locations before settling on a destination.
3. How long the results last depends on the treatment
Botox typically lasts three or four months, while fillers can last a little longer. Jenna Piccolo, a physician's assistant and "alchemist" at Alchemy 43, notes that first-time clients tend to see their results disappear the fastest—for lip injections, it might only be four to six months. This also depends on the type of filler, since some are "finer" than others. (They offer a more natural-looking result but tend to dissolve at a quicker rate. Piccolo notes that for this reason, many people who start with these finer fillers like Restylane Silk actually end up switching to those with a little more oomph, like Juvéderm.)
4. But you may actually need less maintenance over time
Piccolo says that if you're looking to keep up your fillers, you'll actually be able to stretch out your maintenance appointments more and more over time, and she also notes that experts believe that this is due to a natural buildup in collagen with each new injection. She adds that many lip injection clients only need to freshen them up once a year or even every 18 months after the first few times.
5. Bringing in a picture of a celeb you admire is not necessarily the best strategy
Asking for "The Angelina" is a fast track to an unnatural-looking pout—the idea is that you want to subtly enhance and correct your features so that you ultimately look like a more refreshed version of yourself. "The goal is for your friends to say, 'You look great,' not, 'Did you get work done?'" says Levy. During consultations, Alchemy 43 offers 3-D imaging technology that plastic surgeons often use to preview a client's results before going under the knife, allowing the practitioner and the client to agree on a final result beforehand.
Levy says that it's just as useful for dermal injections, since many clients have misunderstandings about what they need done.
6. That being said, there are countless ways to inject your lips
Do you want to enhance your already-defined cupid's bow, or are you looking to fix an asymmetrical top lip? Is pillowy volume your aim or subtle hydration? From the type of filler you use to the injection site, there are many ways to shape a better version of your pout. Levy notes that one popular treatment at Alchemy 43 is lightly filling the vermilion border—that's the natural ridge around your lips. An ultra-defined vermilion border is a sign of youth, which is why it's a really subtle yet effective enhancement.
You and your practitioner can also decide on the best filler for the results you're looking for. Juvéderm, a hyaluronic acid-based formula, is one of the most popular options and comes in different variations of thickness. Meanwhile, Restylane Silk has also grown in popularity since its approval by the FDA—its particles are smaller, which allow for a subtler effect.
7. The "problem area" might not actually be the problem
While undergoing a 3-D imaging consultation at Alchemy 43, I pointed to my nasolabial folds (aka my smile lines) as one place I would potentially consider fillers. Piccolo informed me that filler in that exact spot actually wouldn't do much to improve the area—instead, it would make more sense to lift the cheek above it, since a separation in the fat pads of my cheeks is actually what's pressing on that line.
The same goes for Botox—since it all comes down to strategically relaxing muscles, your practitioner might get creative with her technique for doing so, depending on the area. If you're looking for a subtle way to prevent forehead lines, for example, you might receive injections along your hairline or at the top of your scalp. (Coincidentally, scalp Botox is also an effective solution for sweating.)
8. Botox and fillers are (much) safer than you think
Levy cites the "Botox is poison" adage as one of the most oversimplified myths surrounding the treatment. It's true that Botox and botulism are related, but they are not one and the same. "In the same way that penicillin was derived from mold by Alexander Fleming in 1928, botulinum toxin type A was derived from clostridium, the bacteria that is known to cause the infection known as botulism," she says. "Like penicillin, botulinum toxin type A, (the cool, science-y name for Botox) is merely derived from the same parent bacteria." Botox is essentially a very diluted component of a toxin, and it's totally safe.
Plus, you might be surprised to learn that Botox itself actually only stays in your body for up to 24 hours. "Once it's injected, it works its muscle-relaxing magic and is metabolized through your body—the four months of wrinkle-free goodness that follows is its parting gift," says Levy.
Meanwhile, the main component of many fillers like Juvéderm and Restylane is a non-animal-derived form of hyaluronic acid, which, as we know, happens to be one of the buzziest topical skincare ingredients on the market. Hyaluronic acid has the ability to hold up to 1000 times its weight in water, which is why it works so well for fillers—by injecting it into your lips, for example, you're attracting a huge amount of available moisture, leaving your mouth voluminous and hydrated.
9. Yes, it hurts
Your practitioner will probably start with a numbing gel on the injection area, and the injectable itself typically contains lidocaine, which is a local anesthetic. That being said, since the lidocaine is being injected with your Botox or filler, it'll take a few pricks for it to kick in, so the first few injections are typically the most painful. You'll feel a pinching, and certain areas (like your sensitive lips) will be more painful than others—though the numbing agents help offset this a little.
10. There's no downtime after injections, but you will probably experience some bruising and swelling
Depending on the area and treatment type, it can take up to two weeks for swelling and bruising to completely disappear, though most of it typically dissipates within 24 to 48 hours. Levy and Piccolo advise their clients to ice the area immediately after the treatment and to use arnica gel and pellets to help stave off bruising. It's also recommended that you avoid exercise for the first 24 hours, since getting your blood pumping can exacerbate black and blue marks. You'll also want to avoid ibuprofen, blood thinners, and alcohol for the same reason.
11. Botox doesn't paralyze your muscles—it relaxes them
"Market research has shown that [fear of a frozen face] is the number one reason that people who are interested in trying Botox don't," says Levy. In truth, "Botox, by definition and via the findings of thousands of published scientific and medical studies and millions of actual treatments, temporarily relaxes the muscle under the skin that causes the skin above it to wrinkle, thus causing the wrinkle to smooth out." This is why Botox has a variety of other uses, from preventing sweating to stopping acne in its tracks—it temporarily relaxes the muscles responsible for the issue.
And while an overly-relaxed face might interfere with your ability to emote, a skilled practitioner will know how to easily avoid this result. "When a Botox treatment is administered in the correct dose to the correct places, it should NOT interfere with your ability to animate your face," says Levy.
12. If you don't like your filler results, you can reverse them in minutes
If you're unhappy with your outcome, temporary hyaluronic acid fillers like Juvéderm, Voluma, and Restylane can easily be removed if you wish—your practitioner will simply inject an enzyme that dissolves the filler. That being said, it's best to wait until any swelling has gone down to make a decision since during the days immediately following your initial treatment, you'll likely see more volume than you anticipated. (And that's very temporary.)
13. In the grand scheme of things, it's actually more affordable than you think
Yes, the upfront cost can be hefty: On average, Botox costs about $300 to $500 per treatment, and fillers typically start at $500. But given the length between treatments, the annual cost is surprisingly doable if you consider budgeting out smaller expenses. "If you're spending $5 on coffee per day, it comes out to $150 a month, or $1800 a year," says Levy. "Your annual Botox bill will be about two-thirds of that." For fillers, it could be even less.