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The Controversy of Fillers and Cosmetic Medicine: Myths and Truths

Many celebrities, such as Anitta and María Becerra, have declared themselves fans of cosmetic medicine

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It’s no secret that cosmetic medicine has always been a ‘must’ in the entertainment industry. The spotlight and the media pressure, which particularly affects women, have made it commonplace for celebrities to undergo various cosmetic procedures.

Icons like the Kardashians have significantly influenced the global perception of surgery and cosmetic medicine. Kylie Jenner (26), in particular, surprised everyone during her popular ‘King Kylie era’ in 2015 by appearing with a completely different face from what we were used to seeing on Keeping Up With The Kardashians. She showcased a defined jawline, round cheeks, and most notably, significantly fuller lips. This is without mentioning other obvious surgeries, such as breast augmentation.

Kylie quickly became an inspiration for millions of girls worldwide (the ‘Kylie Jenner Challenge,’ based on inflating lips by suctioning them into a glass, even became popular), normalizing cosmetic medicine and procedures like fillers and hyaluronic acid being done at increasingly younger ages.

Kylie Jenner is announced as Brand Ambassador for Nip + Fab at the W Hollywood on December 15, 2015 in Hollywood, California. Frazer Harrison / Getty Images

This trend has been followed by many female artists. While it is often evident who has undergone these changes, it is not common for them to admit it. However, some celebrities, like Anitta (31) and María Becerra (24), have spoken about the benefits of such procedures.

«I am not a defender of plastic surgery, but I am a defender of doing what we want. If you want to do something, don’t be afraid just because people will talk. I designed my own face,» the singer of ‘Aceita’ revealed in several interviews, explaining that she brought a Photoshopped portrait to the surgeon to achieve her current look.

Anitta is seen performing during NBC’s «Today» show Citi Concert Series at Rockefeller Plaza on May 31, 2024 in New York City. Gilbert Carrasquillo/GC Images

«Who made my face? A surgeon, though I don’t have surgeries, but I did get a breast augmentation. On my face, it’s all hyaluronic acid injections in the lips and some other areas,» María Becerra mentioned in an Instagram live.

Given the questions surrounding cosmetic medicine, especially considering that patients are getting younger, LOS40 interviewed plastic surgeon Dr. Pilar de Frutos from the Pilar de Frutos Clinic (Madrid, Spain) to learn more about the most common procedures.

What positive and negative effects can hyaluronic acid injections have? Does it vary depending on age?

Hyaluronic acid is a biocompatible product that is thoroughly approved and tested for medical use in aesthetic procedures. Among its most notable positive effects is its high biocompatibility, as it is a compound found in our body, making it highly tolerable. It allows us to replenish volume, correct folds and wrinkles, and it has a high water retention capacity, which hydrates the tissue around the injection area. This hydration also stimulates collagen and elastin production, keeping the tissue in a better, more youthful state. There are also different density products for various applications. The effects do not vary with age, but the type of product applied must be adapted to the treatment area and the patient’s age.

Does hyaluronic acid eventually dissolve, as commonly believed? Or is it permanent? Can it form encapsulation?

We must differentiate between product absorption and encapsulation. Encapsulation is an adverse reaction where the body treats the product as a foreign body, leading to a reaction. Normal absorption of hyaluronic acid depends on the type of product, the area, the amount, and the frequency of treatments. The more treatments and product used, the harder it is for the body to absorb it. Some people may not fully absorb it due to metabolic factors, or certain areas may absorb it very slowly, or not at all.

Thus, despite being marketed as a resorbable product, certain parts may not fully absorb under some circumstances. However, encapsulation is a rare adverse reaction, and if it occurs, it needs to be treated by dissolving the product.

Maria Becerra performs during the 63rd edition of the Viña del Mar International Song Festival at Quinta Vergara on March 01, in Viña del Mar, Chile. Lucas Aguayo/Getty Images

What positive and negative effects can Botox injections have? Does it vary with age?

Botox is not a filler but a neuromodulator protein that modulates muscle contraction. It has both aesthetic and medical applications, even in pediatric conditions. In cosmetic medicine, it helps improve expression wrinkles caused by muscle contractions in the upper facial area. Most effects are positive and temporary, with muscle function returning to normal after a few months, leaving no lasting effects.

Proper use has few side effects, but overuse can lead to muscle atrophy if no recovery periods are allowed. A disciplined approach with appropriate rest periods avoids negative effects. The results vary with age, as stronger muscles due to age require higher doses.

Are you seeing a demand for aesthetic treatments from increasingly younger people? If so, why do you think that is?

It is undoubtedly true that younger patients increasingly seek aesthetic treatments, driven by social pressure for an ideal of perfection seen on social media, which is often unrealistic. This creates a sense of dissatisfaction and lack of self-confidence among young people, pushing them to seek the perfection they see in the profiles they follow. While this is the social reality, as medical professionals, we must advise them wisely, as they have a long life ahead to care for their appearance.

Karol G has also spoken openly about her cosmetic procedures, such as a breast augmentation. Jason Koerner/Getty Images
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