Slightly over a year ago, Ms Caitlin Lim noticed the circles around her eyes were getting darker. She visited an aesthetic clinic in the hope of a solution and took up the doctor’s suggestion to use fillers.

“I had never considered injectables because I’m scared of needles, but I thought that I’d just try it,” said the marketing executive, now 28. “The lack of fat around my cheeks created shadows under my eyes, and the fillers really made a difference.”

A small volume of gel-like substance, injected just above her cheekbones, settled her concerns and made her face look fresh and plump, she said.

Like Ms Lim, a growing number of people in Singapore in their 20s and 30s are getting injectables to improve their facial appearances.

Some of these cosmetic enhancements have long carried the stigma of creating an unnatural appearance, partly because of the use of Botox by Hollywood celebrities who experienced less-than-desired results due to a range of factors.

These may include incorrect techniques or over-treatment, dermatologists told The Straits Times. A loss of muscle and decrease in their strength, reduced effectiveness over time, and even addiction or over-reliance on injectables are some other concerns that have been raised over such treatments.

Yet dermatologists and aestheticians told ST that they have observed an increase of between 10 per cent and 20 per cent in Singapore among those in their 20s and 30s using injectables for cosmetic reasons since 2020.

This mirrors a global trend: A report from the American Society of Plastic Surgeons showed that from 2022 to 2023, there was a 9 per cent increase in the number of people aged 20 to 29 who received botulinum toxin – commonly known as Botox – or similar treatments, and an 8 per cent increase in those who received hyaluronic acid fillers.

These treatments include the use of fillers and collagen boosters, which replenish skin moisture and firmness.

They do not have permanent effects, and injections are administered quarterly or yearly, with the frequency varying across procedures.

The costs of these treatments vary widely, depending on factors such as the amount of substance used and location of the injection. Botox treatments typically cost from $300, while fillers usually range between $600 and $1,000.

While getting the fillers done, Ms Lim also received shots of Botox into her jaw and forehead. The doctor had told her the treatment would help her achieve a tighter facial appearance, she said.

“After Botox and fillers, the results were so good that I wanted to try more procedures,” said Ms Lim, who tried Rejuran, an injectable skin rejuvenation treatment, at a following session.

These days, Botox is no longer used by just older people to melt wrinkles or frown lines, or by celebrities desperate to “freeze” the ageing process.

Younger patients often receive Botox jabs to make tweaks to their appearances, said Dr Sean Leong, a consultant dermatologist at Livingstone Dermatology clinic.

For instance, some of his patients get Botox injected into the muscles of their jawlines to achieve a slimmer face shape, said Dr Leong.

“A little Botox can also lift one’s mouth shape for a friendlier appearance, so the person doesn’t look angry all the time,” he added.

Dr Joseph Toh, a dermatologist at the Parkway MediCentre Dermatology Clinic, said Botox might delay the formation of deep wrinkles by relaxing and reducing the movement of facial muscles.

It can also be used to alleviate teeth grinding, he added.

Dr Evelyn Tay, founder and consultant dermatologist at Lumine Dermatology & Laser Clinic, said that collagen boosters such as Rejuran and Profhilo can be used to lighten the appearance of depressed acne scars and give one’s face a lifted appearance respectively.

Injectables are also less invasive – and less intimidating – than cosmetic surgery. A smaller face is achievable with shots of Botox, and a higher nose bridge can be created with fillers, added Dr Tay.

Ms Serene Tan, 25, who first had Botox injected into her jaw in 2024 as she wanted a V-shaped face, appreciates the impermanence of these treatments.

“Surgery is irreversible, but if you do Botox or fillers and you don’t like it, you can wait for it to dissolve,” said Ms Tan, who gets Botox injections every four to six months.

Social media has raised the awareness of the availability of these options as alternatives to skincare or cosmetic surgery, said doctors.

“When young people look at influencers who are promoting these treatments to achieve an appearance of glowy and glass-like skin, they are usually more receptive and want to start early,” said Dr Tay.

Fitness instructor Mandalyn Tan, 28, first received shots of Rejuran in 2023 and goes for boosters every three months.

She said that she was “desperate for a solution” to stop her acne breakouts. “My bad skin affected my self-esteem quite a lot.”

The injections have reduced the appearance of her acne scars and dark eye circles, and smoothened her skin, she said.

Although she was initially afraid of judgment from the public, Ms Tan went on to review her experiences with different skincare procedures on social media platform Lemon8.

“There are so many influencers and celebrities paid to market skincare products, which I used to spend a lot of money on in my early 20s,” she said. “I feel that I have the responsibility to be transparent and share what works and what doesn’t with the people around me.”

Moderation, research is crucial

While dermatologists say such treatments can be safe and give patients a confidence boost, they also caution against being excessive.

As with any injection, these treatments run the risk of side effects such as bruising, swelling and bleeding. In rare and severe cases, fillers might also cause blindness, said Dr Leong.

Patients must be mindful to exercise moderation.

People who start getting Botox and fillers may find it hard to stop, said Dr Tay. “Sometimes you might forget what you originally look like – this is called perception drift – and you keep thinking you need more fillers.”

Younger people, who are frequently on social media, might also chase a standard of beauty perpetuated online – a sharp face, and full lips and temples. “It’s quite sad, because beauty is a very diverse thing,” she said.

Dr Toh said too much Botox at a young age may lead to a loss of muscle and a decrease in muscle strength.

One’s body may also develop antibodies against Botox and its effectiveness may be reduced over time, although such cases are rare, he added.

Dr Leong said injecting too much Botox and fillers may also result in an unnatural-looking face.

“Too much Botox might make your face look frozen, or make you look shocked all the time,” he said. “Patients who get more fillers than they require might end up looking puffy.”

Dermatologists noted that some patients travel abroad – mainly to South Korea or Thailand – to get these treatments and warned that due diligence in ensuring that the clinics are reputable and have qualified professionals should be done.

“The last thing you want is a non-medical person injecting fillers in your face,” said Dr Tay, adding that research on relevant substances should also be done beforehand, as some might not be approved in Singapore due to safety reasons.

While injectables may produce almost immediate results, they should remain a supplement to good skincare practices, said Dr Tay.

Sun protection, using active skincare ingredients such as vitamin C or retinol, cleansing your face thoroughly and a healthy diet and lifestyle are integral to maintaining good skin, she said.

“If you get all these treatments but don’t maintain your skincare routine, you’re back to square one.”

In association with ANN