Commentary: Do Botox and fillers belong in a self-care routine?

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SINGAPORE: This month, details emerged of a woman in Singapore who was injected with more than three times the annual limit of dermal filler in one session. She suffered prolonged facial pain, high blood pressure and weight loss. She underwent nerve surgery to manage the pain and lost her job because of the ordeal. 

Fillers and Botox used to be discreet solutions for patients seeking to look younger. But this has changed in recent years. 

More celebrities, influencers and consumers, particularly women, are opting for such procedures and sharing their experience. As a result, injectables are not only increasingly normalised but entwined with the language of self-care. 

It may sound like female agency and empowerment, but one wonders how much autonomy there is in a marketplace that sells beauty and self-improvement by the millilitre, and what it really costs women.

ARE FILLERS THE NEW FACIALS?

The other day, a friend mentioned that she is going for some injectables in Seoul with friends. She said this as casually as someone talking about a girls’ spa-cation or facial. 

That has become the language of aesthetic injectables today. Clinics call it “lunchtime fix” and “baby Botox”. Patients have likened it to a gift to themselves – the same way one picks up a new outfit for a special occasion.

Broader shifts in attitude have taken place over the years.

In 2010, Kim Kardashian sparked controversy by undergoing Botox on her reality TV show Keeping Up With The Kardashians and experiencing bruising afterwards. Some viewers questioned her decision to get cosmetic Botox at the age of 29.

Since then, growing openness around Botox and fillers has reframed these treatments as regular beauty maintenance, though they remain medical procedures.

Aesthetic injectables come with a different set of risks compared to routine products such as sunscreen, retinol and facials. Singapore’s Health Sciences Authority classifies dermal fillers as Class D medical devices – its highest risk category. Serious complications, though relatively rare, include infection, tissue death and blindness. 

Botox, meanwhile, is regulated as a prescription-only medicine. Potential complications include drooping eyelids and eyebrows, an uneven smile and muscle weakness. 

UNREALISTIC BEAUTY EXPECTATIONS

You might have read recent critiques of actors being unable to emote because of their uncannily smooth foreheads and eye areas. Actress and filmmaker Olivia Wilde said in June: “As a director, I now am constantly searching for actresses who can still move their faces. And it’s not easy.”

She conceded that actors face pressure to get work done, and many celebrities have spoken out about this scrutiny as well.

Not all celebrities are happy with the results of injectables. Some have done it and then quit it.  

Actress Courteney Cox had her facial fillers dissolved because she felt they made her look “fake”. Fashion model Linda Evangelista said she dissolved her facial fillers but continues to use Botox.

With the shifting baseline for youth and beauty, women who avoid Botox and fillers, such as director and actress Justine Bateman, have been criticised for ageing naturally. Though Bateman considered these procedures, she ultimately decided against them, saying: “I like feeling that I am a different person now than I was when I was 20.”

Yet women are commencing aesthetic treatments at a younger age, as early as their 20s. Doctors told CNA that one factor contributing to the boom is the normalisation and proliferation of such treatments on social media.

How freely do patients make these choices when societal expectations of beauty and youth are so deeply rooted in our culture and constantly reinforced online?

WHERE DOES LOOKSMAXXING END?

“Looksmaxxing”, an internet trend centred on the idea of improving one’s appearance through beauty, fitness and cosmetic routines began in male online communities. However, one could say women have been culturally conditioned to “looksmaxx” way before this term was coined.

Botox and many fillers require repeat treatments every few months to maintain their effects. In a 2025 global survey of 1,600 cosmetic injection patients, nearly two-thirds reported receiving treatments every three to six months.

Patients are also targeting more areas. An international study of 194 Botox patients found that they typically began treating frown lines, then moved on to crow's feet and forehead lines.

When injectables are fused with the idea of self-improvement, might it become a slippery slope?

One of the great privileges of living in this day and age is that medical advancements have enabled us to feel and look younger. Women and men alike should have the freedom to choose from available options without fear of judgment.

However, if we increasingly seek beauty in a syringe and at a younger age, it is worth examining trade-offs, risks and what fuels this pursuit. Whose ideals are we pursuing, and are we moving towards an ever-shifting goalpost of youth and beauty for ourselves and others?

Annie Tan is a freelance writer based in Singapore.