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At a recent dinner party, conversation turned to Botox, and it came to light that four of the six women at the table, all under 40, had indulged in injections. It wasn’t so long ago that any talk of “getting work done” was conducted in hushed tones. But in 2019, medical cosmetic treatments such as Botox and fillers are NBD – that’s millennial speak for “no big deal" – and it seems like they’re available everywhere. You can get them on your lunch break. You can get them at your dentist’s office. You can even watch a stranger get them on YouTube.

Medical cosmetic procedures fall roughly into two categories: the non-surgical and the surgical, such as a facelift. Non-surgical cosmetic procedures include treatments such as injectables (think Botox and fillers), peels and laser resurfacing. Because of their relative simplicity, some can be administered by a nurse practitioner, others by a medical aesthetician. In the realm of anti-aging – a term that’s come under fire for supporting ageism – these procedures can give patients the results they desire with little to no downtime, making them attractive to both users and suppliers alike. Lately, their availability has expanded to some surprising new venues, including Shoppers Drug Mart.

“We’re trying to demystify and make it open and accessible for people who have considered it but don’t know where to start,” says Sarah Draper, Shoppers’ senior director of health care partnerships and innovation, of the drugstore’s new offerings. Staffed by nurse practitioners and medical aestheticians, Shoppers’ Beauty Clinic location in Oakville, Ont. offers cosmetic dermatology services including injections, dermal fillers, microdermabrasion, peels and laser services. “This market is really growing and becoming much more normalized. We estimate it’s about a billion dollars right now, probably going to two in the next five years,” Draper says. As an added bonus, members of the PC Optimum program can also earn and redeem points on a variety of services at the Beauty Clinic.

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When getting a Botox injection has become as mundane as picking up a new tube of toothpaste, it’s worth asking why. For some, medical cosmetic treatments are simply a means to looking like you’re not exhausted, a state that would be frowned upon if frowning didn’t cause wrinkles. Maggie Cummings, assistant professor of anthropology at the University of Toronto, is quick to point out the irony of this expectation in our current culture of overwork. “On the one hand, there is certainly a destigmatization of these treatments and mainstreaming of them,” she says, but there’s also a stigmatization of any visible form of aging. While beauty standards vary from culture to culture, Cummings explains that people have the tendency to take whatever look is valued the most to the extreme. “Now, it’s a youthful skin that doesn’t show any signs of having lived in it, of not looking tired, not looking like you ever aged. That’s where a lot of the stress and anxiety lives, and that does seem to be tied to selfies.”

Ah, the selfie. In today’s image-focused environment, never has success seemed more dependent upon being photogenic. Your photos are judged by potential mates on dating apps, they’re judged by potential employers on LinkedIn and they’re sometimes even judged by your existing community of friends and acquaintances on Facebook and Instagram. It’s easy to point a finger at social media, where a specific version of flawlessness – smooth, pore-less skin, plump lips, a contoured jawline – is being presented by influencers as something anyone can attain. Cosmetic treatments lure people in with the promise of bringing that filtered version of yourself into real life.

They can also pose some real-life safety concerns. Normalization of medical cosmetic treatments has increased demand, which has some unqualified players trying to get in on the action. Stories regularly surface in the news of treatments gone wrong, like the British woman whose lips ballooned after a filler injection she received at her friend’s house in November, or the 2017 headline of a woman from Brampton, Ont., who was found guilty of fraud, assault and assault with a weapon after misrepresenting herself as a nurse on Kijiji and providing Botox injections to three people.

“We end up seeing a lot of problems that you won’t see on social media,” says plastic surgeon Marc DuPéré, who has been called upon to repair facial damage due to medical cosmetic treatments that were administered incorrectly by other providers. The founder of Toronto’s Visage Clinic, he cautions strongly against trivializing these treatments as just another beauty commodity. “Because patients don’t value the safety or they’re not aware of the problems that can happen, they often see it now as an extension of nail polish and manicures and hair colouring, but it’s not. It’s a real medical act that has beautiful benefits but that should be done properly.” NBD or not, it’s always important to be informed before going under the needle.

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