Botox no longer for old, wrinkled

A few years ago, Kenya’s cosmetic surgery market was thin. The medical aesthetics industry which includes surgery, injections, and skin treatments, felt shameful and underground and was dominated by older, wealthy, secretive, well-travelled women and expatriates as customers.

But now pretty much all impressionable young women and men are seeking Botox and dermal fillers, face treatments which help them “have a fresh face, full of energy, soften the frown lines and improve a variety of perceived imperfections.”

The age bracket of botox and filler users is dropping from 40 to 70 years old, to 30.

“Most of my younger patients want to maintain a more youthful appearance. They want to look fresh, well-rested and good for their age,” says Dr Jyoti Bahra of 32Dental Studio.

Dr Bahra developed an interest in aesthetic dentistry, but it became evident to her that aesthetics involved more than just the teeth.

This led her to pursue a course in botox and dermal fillers with Medics Direct Training in Manchester, UK, to cater for a growing clientele in Kenya.

Before the Food and Drug Administration approved botulinum toxin, which is sold here under the brand name botox, for cosmetic use in 2002, the muscle-relaxing toxin was used as a medical treatment for neuromuscular and eye disorders. Now, globally, take-up among younger women is growing as they use it for jawline shaping, to smoothen any signs of wrinkles, or for a more youthful look.

“When this neurotoxin is injected into the muscle, it relaxes it. This means that the overlying skin, fine lines, and wrinkles created by muscle action will appear smooth and even, giving a youthful appearance,” Dr Bahra explains.

“On the other hand, dermal fillers work very differently to botox. As we age, we lose collagen and hence the skin starts sagging. The fillers replace this lost volume creating a more youthful appearance.”

No stigma

Non-invasive cosmetic treatments were something that the older women did not talk about, partly because complications were many, arising from botox which was not injected properly leading to bruising, facial asymmetry and drooping.

But the younger generation and middle-class have no qualms admitting to getting the injections. This has fuelled demand among their peers.

Dr Bahra, whose clinic has also seen an uptake of the services by men, says that awareness about these treatments on social media by celebrities and different clinics, means they are no longer taboo.

Dermatologists and cosmetic specialists say they are also seeing younger Kenyans coming in for preventive reasons, hoping that botox will halt the development of facial creases and wrinkles.

“The younger patients seek treatment procedures at the first signs of ageing,” Dr Bahra says, adding that a good treatment does not make one look “plastic” or artificial.

The signs of aging include loss of volume in the cheeks, loss of skin elasticity, spots, dark wrinkles, among others.

“Early to mid-30s is when skin cells begin to replenish slower, and you lose some elasticity. As a result, the signs of ageing start to show,” says Dr Neha Shah, an aesthetic medicine practitioner at Skinworks Kenya and Apples and Sense Medical Centre in Nairobi.

“As we learn more about how and why the signs of ageing appear, there is a growing trend to start treatments earlier,” adds Dr Shah who uses microneedling treatments regularly, having battled acne in her 20s. 

These sentiments are echoed by Dr Michael Rebeiro, a plastic and reconstructive surgeon at Apples and Sense Medical Centre.

“As women age, the state of their faces becomes an issue because it gives away their age,” he says.

The medical centre has more women seeking anti-ageing and rejuvenation treatments. In the past year, a few men have made inquiries about rejuvenation procedures.

“Lip augmentation is huge among the young population especially those in college and in late 20s,” he says, adding that many do it because they will look good with lipstick.

More treatments

In recent years, the tool kit for warding off visible signs of aging has expanded to include mesotherapy, chemical peels, micro needling, topical skincare and thread lifts. 

Microneedling, a procedure that experts say is safe for all skin types, has become quite popular in Kenya. This is because there is little downtime and results are visible after three to four treatments.

The procedure helps improve the appearance of acne scars, opens pores, and gets rid of dark spots.

Mesotherapy, which is the introduction of skin rejuvenating compounds through injections, is also gaining popularity.

“We use a gadget that has needles that go between 0.5mm to 4mm deep into the skin to deliver products like vitamins, hyaluronic acids, and minerals that stimulate skin rejuvenation and enhance the production of elastin and collagen. It leaves no scars. Only remarkable results,” says Dr Rebeiro.

Notably, there has been an increase in the number of people seeking both non-surgical and surgical treatments, especially during the pandemic.

“You may have heard of the Zoom Boom. As professional meetings and social interactions moved online, people started scrutinising their faces more which led to patients enquiring about cosmetic surgery and correcting lines caused by facial expressions,” says Dr Shah, adding that the lockdown also gave people more time at home to heal after cosmetic surgery.

Others are opting for the treatments for career reasons. Models and news anchors want to look always primp and proper. One such woman is Fiona*, 34, an entrepreneur in the beauty industry. She decided to use botox injections because the industry demands it.

“I cannot be selling skin-care products with ordinary-looking skin,” she says.

Botox costs Sh1,000 per unit with most treatments requiring 20 to 50 units. The cost of each microneedling treatment ranges from Sh15,000 to Sh20,000 depending on the area being treated. The average cost of dermal fillers can vary from Sh90,000 to Sh100,000.

Long-term fears

The face injections use among younger Kenyans has been fuelled in part by influencers on social media and advertisements.

Dr Rebeiro says some young people come to his clinic with photos of celebrities in tow, wanting to look like them, not realising the photos are technologically enhanced.

“Agreeing to give them any facial treatment without properly assessing their core reason might not be the correct approach,” he adds.

To start these cosmetic injections at a young age might mean tying yourself to a lifetime of facial treatments. However, experts say when you understand how the face ages and where the fat depletes, you can rejuvenate the targeted areas.

Dr Shah points out that there is no set age for starting professional skincare treatments. For example, with botox, the ideal age to start is when one notices wrinkles when the face is at rest.

However, one should start to follow a good skincare routine in their 20s and follow basic principles such as wearing sunscreen, eating well and getting adequate sleep.

“Ageing is inevitable, however ageing gracefully is achievable,” she says.