From traptox to lip flips: The risks and rewards of the tweakment boom

This article is part of our Vogue Business Membership package. To enjoy unlimited access to Member-only reporting and insights, our NFT Tracker, Beauty Trend Tracker and TikTok Trend Tracker, weekly Technology, Beauty and Sustainability Edits and exclusive event invitations, sign up for Membership here. Business is booming at New York aesthetics clinic Plump. Launched in 2018, it set out to make treatments like botox and filler more accessible. Its colourful spaces have open entrances to invite people in, and there’s no sign of clinical white coats. Pricing is transparent, with minimum spends of $300 for botox and $400 for filler. Its social media presence is millennial and tongue-in-cheek, with quips like “he’s a 4 but he supports your botox addiction”. As demand has swelled, Plump has opened seven clinics in rapid succession across Manhattan, Brooklyn, New Jersey and Miami. There are plans for more in 2024, says partner and director of operations Richelle Oslinker. Legions of women — and increasingly men — stop by for procedures and facials. “We just keep growing,” says Oslinker. “It’s a busy time for injectables.” Aesthetic treatments (or “tweakments”) like botox, filler and laser are rising steeply in popularity because they are cheaper and less invasive than plastic surgery, appealing to a broader group of consumers, says Suzanne Scott, global associate beauty director at beauty consultancy Seen Group. Tweakments surged in lockdown as people stared at their own faces during Zoom calls. Short-form video platforms like TikTok and Reels fuelled their rise, becoming recommendation forums for everything from lip filler and botox to laser facials. “Doctors would always post before and after images on Instagram. But now you can watch brow lifts or fillers take place on TikTok, from start to finish,” says Scott. “People take you on the journey of getting ready for the appointment, during the appointment and post treatment. It’s compelling content.” Soon enough, aesthetics became part of the TikTok trend cycle, driving unprecedented demand for new procedures over the last year, aestheticians and doctors agree. The US aesthetics industry was worth $9 billion in 2022, and Boston Consulting Group (BCG) expects it will grow 11 per cent annually from 2022-2027. The variety of treatments on offer is also expanding. Following the Barbie movie, #traptox — referring to botox in the trapezius muscle for a more streamlined shoulder and neck — hit 38.3 million views on TikTok. Plump added traptox to its menu in response to demand. Masseter botox, previously used to reduce jaw stiffness and pain, has been adopted as a way to slim the lower half of the face, driving similar but less pronounced results to buccal fat removal, which swept through Hollywood at the start of this year. Lip flips (where botox is used to flip up the lip slightly for a fuller look) are also popular in New York, Oslinker says, as the lowest cost tweakment available at a lot of clinics. At Plump it's $200. It’s not just botox. Laser and radiofrequency face treatment Morpheus8 and body treatment Morpheus8 3D, which involve needles that go as deep as 7mm into the skin to tighten skin and reduce scarring, have also gone viral. The hashtag #morpheus8 has 280 million views on TikTok, with people sharing their positive (and negative) experiences with the treatment. (If not done correctly, the procedure can produce side effects like long-lasting needle marks and extreme redness over the face or body.) With new options popping up every month, high-end clinics are grappling with responding to demand while operating responsibly. They are also having to work hard to differentiate from beauty salons, dentists or hairdressers offering aesthetic treatments for half the price, often by low-qualified aestheticians who can deliver damaging results. Aesthetics as part of a luxury lifestyle Tweakments used to focus on anti-ageing. But now, people see botox, filler, laser or radiofrequency as part of a holistic skincare routine and luxury lifestyle, says Seen Group’s Scott. “It’s no longer just about luxury skincare for anti-ageing, but a combination of topicals and tweakments to achieve the desired result.” Clinics are selling a lifestyle, too. “Some are stunning, they’ve got curated art on the wall. Custom made furniture. It makes you feel part of a luxury experience before you’ve even sat in the consultation chair,” says Scott. High-end clinic Montrose, for example, which opened in London’s Belgravia in September, has gilded gold and black gates as well as a waiting room filled with art and plush furniture — a far cry from some of the more sterile spaces on Harley Street. To further this take on aesthetics, some clinics are aligning with fitness or fashion brands. Plump regularly promotes pilates studios near its clinics. Montrose, shooting for the high-end consumer, hired luxury PR firm Karla Otto, which typically works with fashion and beauty brands in the same market (rather than clinics), to connect to fashion journalists. The clinic held a dinner at its opulent waiting area in partnership with luxury brand Roksanda during London Fashion Week this September. “We wanted to do things differently, because we’re a high-end brand,” says Montrose co-founder Dr Shaimaa Jamshidi. “We look to fashion for inspiration and it’s how you portray yourself, being put together starting from your hair, your clothes – aesthetics plays a huge role in that as well.” A new opportunity is arising as people seek out higher-tech treatments they can do at home, such as LED masks and facial toning tools, aestheticians agree. Some treatments, like advanced facial Skinstorm, which incorporates microneedling, microdermabrasion and radiofrequency, now has its own skincare line to complement the treatment that’s purchasable at clinics in London or LA. Beauty brands could lean into this, Scott says. “It’s been challenging for some skincare brands that don't like to be associated with aesthetics,” she says. “But it’s fairly clear now that women in particular are shopping for their skincare [alongside] their tweakments. Clinics and brands that understand this will do well.” Resisting trends Alanda Keet Earlle is an aesthetician who runs a London clinic frequented mostly by clients in their 20s and 30s, including fashion stylists and editors. She warns of the dangers of trends, which are pushing clinics to carry out procedures that may not be safe or well-tested. Increased accessibility is also leading people to make rash decisions about face-altering treatments. “Over the last few years, the trends have gone crazy,” she says, “10 to 15 years ago, there was less regulation but also people weren’t aware of how to get into aesthetics. Now, [aestheticians] feel they have to keep up with trends in order to keep their salon busy versus the competition.” Montrose co-founders Dr Jamshidi, Dr Georgina Williams and Dr Jonathan Dunne worked together at NHS hospital Imperial, where they dealt with rising cases of botched procedures such as thread lifts (lifting skin and brows with threads under the hairline), filler or fat dissolving injectable Kybella. They note a growing trend of “prejuvenation”, where younger customers look to prevent ageing with a combination of aesthetics and skincare. “We see young patients in their 20s come in who are ready to invest in aesthetics,” says Dr Williams. “They ask for preventative botox or some say ‘I look at my mum and think that’s going to be me in 30 years — how can I prevent that?’” Parents will march young patients into Montrose after a botched lip filler job, from a hairdressers or local beauty salon. “People come in [to Montrose] and show us snapchat filters or trends they’ve seen that just don’t work for their anatomy,” Dr Jamshidi says, “so we are really careful about the treatments we offer and trends we see.” She describes the “dangerous” butterfly lip trend, where people dissolved and added lip filler at the same time, as one that Montrose avoided. While traptox, which had been used medically to relieve shoulder tension for some time, was one they were happy to add. Dr Costas Papageorgiou, who runs luxury aesthetics clinics in New York and London (the latter within the Harrods Wellness Clinic), recounts similar experiences. “Sometimes I get emails like ‘I want to have the fox eye treatment’, from a patient that’s 25 years old,” he says, referring to a thread lift that raises the outer eye. “But for me there are two types of younger patients. Those who go for trends usually are not part of my clientele.” He focuses instead on those using injectables or lasers to subtly prevent ageing or naturally enhance their appearance. Both Dr Papageorgiou and Montrose’s doctors say they consult with every patient on what they need for their specific anatomy and age, and they will typically refuse to conduct treatments if they’re premature or won’t deliver a more natural look. Dr Papageorgiou does a 3D scan of patients’ faces to ensure he advises the right treatment. In the UK, the British Beauty Foundation is cracking down on the aesthetics industry to better protect its growing consumer base from damaging their faces. The proposed regulation will seek to restrict specific higher-risk procedures to regulated healthcare professionals and place a licensing requirement on any practitioner or business premises wishing to offer non-surgical cosmetic procedures to clients. “We believe the regulation will help to raise the reputation of the aesthetics industry by creating a level playing field of high standards and ensuring public safety is the number one priority,” says Victoria Brownlie, chief policy officer at the British Beauty Council. “We are therefore doggedly determined to ensure it succeeds.” This is crucial, says Scott. “Particularly when we see people getting so excited about thread lifts and things like that because the potential for truly damaging your skin, affecting your mental health, affecting your self esteem because it's not what you expected, is massive. TikTok doesn’t always show that.” More from this author: Gen Z is obsessed with shower routines. Brands are riding the wave The Vogue Business TikTok Trend Tracker Superwomen endorsers? Beauty brands tap WNBA players Comments, questions or feedback? Email us at feedback@voguebusiness.com.

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