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Laura Gabor, a 33-year-old operations manager in the tech industry in Toronto.Tijana Martin/The Globe and Mail

Jodi Echakowitz loved her family’s trip to Israel 12 years ago. She loved all the photos they’d taken together. But what she didn’t love was seeing the thick, deep line in the centre of her forehead.

“I hated the way it looked in photos, it always looked like a permanent squint,” says Ms. Echakowitz, a public relations professional in Thornhill, Ont., who attributed her “frown line” to growing up in South Africa and spending years squinting to shield her eyes from the sun.

A fear of needles kept her from doing anything immediately. But seven years ago, she decided to go see a dermatologist, and started receiving Dysport, an injectable treatment designed to help smooth out lines between the eyebrows. The $800 price tag shocked her, but she says the result was worth the cost.

“For me, I love that when I see myself in photos [the line] is not the first thing I see any more. That’s what I wanted,” she says. Ms. Echakowitz has gotten injections every four or five months ever since, and now also gets injections on the outer edges of her eyes to soften some of the wrinkles.

Cosmetic injectables such as Botox and other medical aesthetic procedures have moved into the mainstream in recent years. The trend has been driven by significant improvements to techniques that have made the final result look much more natural, the expansion of treatment options for a range of skin tones and cost decreases that have made procedures more widely accessible. The rise of social media “skinfluencers” – from dermatologists to everyday beauty bloggers – has also helped to normalize getting injectables and medical aesthetics, and even made them fashionable.

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“There’s been a big boom in the awareness of skincare products and treatments with the reach of TikTok, and Instagram has always been strong for this,” says Amanda Mizen, the owner of North Medical Spa. Ms. Mizen opened North in Toronto in 2018 and now has additional Ontario locations in Oakville and Collingwood. She added that months or years of Zoom calls has caused many people to question whether “the way they look matches the way they feel.”

Data on how many Canadians are getting injectables and other aesthetic procedures is hard to come by. But a report from the Aesthetic Society, a California-headquartered group of medical professionals who perform cosmetic procedures in the United States and Canada, found they are rising rapidly.

In 2021, more than 5.4 million injectable procedures were performed in the U.S. and Canada, including treatments that use neurotoxins such as Botox and Dysport and dermal fillers like Juvederm. That’s up sharply from just over 2.5 million procedures in 2019. The number of facial cosmetic procedures such as chemical peels, hydrafacials, laser skin resurfacing and photorejuvenation had also significantly increased, to more than 1.8 million procedures from just over 276,000 in 2019.

Women accounted for approximately 94 per cent of all procedures in 2021, the report says.

While aesthetic treatments aren’t quite the luxury expense they once were, they also aren’t cheap, and they aren’t covered by provincial health care or private health benefits. Botox costs roughly $10 per unit, but common applications such as forehead and frown lines require between 15 and 30 units, and achieving a long-term change requires going every three to four months. Dermal fillers range between $400 and $600 per treatment, and microneedling – which helps reduce the appearance of scars and acne – between $200 and $700 per treatment.

Prices can vary significantly from one clinic or spa to the next – some even marking up the standard $10-per-unit cost of Botox to as much as $25 — and can depend on how many treatments are purchased at once. Dermatologists, doctors, nurses and in some cases dentists can give Botox and other injections, while dermatologists and licensed medical aestheticians are qualified to perform treatments like microdermabrasion and chemical peels.

The procedures aren’t just about the money, they’re also “a massive investment in your happiness,” says Bridget Casey, a personal finance expert and the founder of Money After Graduation, who jokes that she “burn[s] my face off once a month” at the spa.

For people with insecurities, having the option to get a procedure that makes them feel more comfortable about how they look can free up their mental energy to focus on the things that matter, she says.

“What people have to get past is the guilt and shame of doing it, and that ties into that a lot of these are for women and we tend to devalue what women spend [on] as frivolous and unnecessary,” she says.

Ms. Casey says studies have found women are paid more when they conform to conventional beauty standards. “For a lot of women … it can actually be an investment in getting a higher income.”

Given their higher costs, Ms. Casey recommends making aesthetic procedures a basic part of their budget, and saving for bigger-ticket items, such as more expensive laser peels. Some med spas will offer treatment packages at a reduced cost, or a monthly membership that can come with free facials and discounts on other procedures and can work out to be a less expensive option for people who get treatments frequently.

Some clinics will offer loans or lines of credit to finance pricier procedures, but Ms. Casey says they tend to come with high interest rates and are better avoided.

Laura Gabor, a 33-year-old operations manager in the tech industry in Toronto, says she started incorporating aesthetic treatments into her budget once she was earning enough to afford them, and has gradually invested in more expensive procedures as her salary increased.

She spends $295 per session roughly twice a year on microneedling, an intensive procedure that requires two to three days of recovery time, to reduce the scarring on her cheeks from cystic acne in her teenage years, and has seen a noticeable change in the smoothness of her skin. She also does hydrafacials – a more gentle type of facial to exfoliate and moisturize the skin that have recently become popular on TikTok – to look “glowy” before big events.

She says it’s also about being happy with what she sees in the mirror.

“There’s a boost of confidence for me when I wake up in the morning? My skin looks great and clear and I have no desire to put on makeup and cover myself up,” she says. “I’m a big believer in, if you can afford it and you’re upset about something that makes you self-conscious, change it. There’s no point sitting there looking at every picture of yourself, forgetting about the happy memory and hating how you look instead.”

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