The cruel paradox of cosmetic tweakments now being deemed ‘ageing’

This piece was originally published 12 February 2024.

Lately, just existing on social media will leave you feeling like there’s no correct way to age. 11-year-olds are stocking up on Drunk Elephant retinol, as Gen Z are told they’re “ageing like milk”. Simultaneously, teenagers are berating the 28-year-olds brave enough to post their “raw faces” on TikTok, telling them they should have slathered their faces in sunscreen and retinoids to avoid developing any fine lines. The climate for growing and looking older may have never been this rough, so, unsurprisingly, some people have turned to filler and Botox in an attempt to maintain a youthful appearance. Unfortunately, creators are now pointing out that having cosmetic work done might be the very thing that is making some young people appear older than they are. It’s a cruel paradox – but is it true?

In October last year, TikTok skincare creator Chloe asked the question: “What Stinks?” Referring to new photos of Kylie Jenner and Kim Kardashian where their resting face looks as if they’ve just had a whiff of something bad, the video went viral and the internet declared the expression “stink face”. Users speculated that it’s a result of cosmetic procedures, and that it was contributing to the impression that certain celebrities were ‘ageing’ more rapidly thanks to the emphasised nasolabial folds. Some have even hypothesised that Gen Z is “ageing poorly” because of an uptick in filler use itself.

Dr Melissa Doft, double board-certified plastic surgeon in New York, says that “stink face” is mostly likely a result of “excessive filler combined with a neurotoxin [like Botox] around the lips.” Despite this, she says the filler and Botox equals ageing faster equation is devoid of all nuance (like so many things on TikTok). For example, Botox itself isn’t ageing but can cause a decrease in expressions. “There are areas of Botox that won’t change your look but having no motion in the forehead on a young person could give the association of ageing,” she says. As for filler, Dr Doft says a build-up of chin filler or lip filler can “age” some people, as it draws attention to the lower half of the face. She also says that overdoing filler can result in some people reaching a bizarre “ageless” category. “When it’s overdone, you can just look like a filled person and it’s sometimes hard to know what your exact age is,” she says.

Joshua Zeichner, MD, associate professor of dermatology at Mount Sinai Hospital, says the plastic surgery trends that are currently popular can have an ageing effect. “The extreme contours that people are looking for, where there is a high cheekbone with a hollow under it, is not naturally seen in women in their 20s,” he says. “In your 20s the face naturally tends to be rounder and less angled.” But the angled shape is “in” which means having buccal fat is frowned on now (apparently). Zeichner says his younger patients usually come in wanting to create something new, while his older patients are looking to regain what they used to have. “The problem with trying to create something new in a young face is that it needs to fit the patient's natural shape and proportions,” he adds.

When it comes to the quality of the skin itself, Dr Zeichner says the overuse of injectables could also cause you problems. “When it comes to fillers, less is more,” he says. “Too much filler under the eye can actually lead to puffiness, but unless you are using extreme amounts of filler it is unlikely that the skin will be stretched to a point that it will become loose in the future.” There’s also a small risk of thinning skin through the overuse of Botox, especially if you start using it at a young age (as a “preventative” treatment), and overdoing Botox in one facial area can cause the surrounding muscles to go into overdrive, causing new wrinkles.

The reality is that even if the type of cosmetic work being done isn’t necessarily “ageing”, if the work is visible people are programmed to assume the person is older. Dr Anthony Youn, a holistic plastic surgeon and TikTok’s resident doctor with over eight million followers, says the use of fillers, Botox and other cosmetic work as a “preventative” ageing method can leave some young people looking “like an older person trying too hard to look young” Instead, he recommends that ageing-obsessed Gen Z creators should “get outside a bit more” (with sunscreen on, of course). “Fresh air and exercise are great ways to naturally auto-juvenate your skin and body,” he says.

“Looking older has become a moral failing – similar to how people treat acne or how diet culture has convinced us that a person’s weight determines their health.”

Genetics, a core factor of ageing, is also getting left out of the conversation, says board-certified dermatologist Consuelo Veronica David. “There’s an increased pressure to remain youthful now, more than ever,” she says. “The two biggest factors that play a role in ageing are genetics and sun exposure so, while one can’t change their genetics, there is lots of control over how someone protects their skin from the sun.” Young people catching on to wearing sunscreen then, is a good thing all around. Stressing over ageing, however, is another cruel paradox. “Stress can increase cortisol levels and result in insulin resistance,” says Dr David, noting that both of these have negative effects on the body.

We live in a time where however you age, whatever you do, it’s your fault, as we increasingly view anti-ageing as a personal responsibility. Under this lens, looking older (through natural means or as a result of having work done) becomes a moral failing – similar to how people treat acne or how diet culture has convinced us that a person’s weight determines their health. “‘Ageing badly’ implies there’s a good and a bad way to grow older, aesthetically speaking, which is implicitly absurd,” says Sarah Unger, president and founder of the cultural insights and strategy advisory company Cultique. But for Gen Z, who has had more direct, easily accessible documentation of their facial evolution than prior generations, fighting ageing with proactive wellness measures has become “a perceived responsibility”, says Unger.

One way to approach ageing is through the acceptance that – whether or not you get Botox and fillers  – you’re eventually going to look older. After all, “preventive” anti-ageing methods can leave you stranded in an age-less abyss – which, to some people, is still preferable – and ageing gracefully might leave you scolded. Whatever way you do it, living in fear at the prospect of ageing is going to have the opposite effect than intended. “Perhaps one of the most potent long-term approaches for good skin would be to work towards reducing anxiety about skincare,” Unger says.