Filler Will Make Us All 'Perfect'. You'll Just Need Lots, Everywhere

Everything I learned about the future of injectable filler at a major cosmetic treatment conference.
Hannah Ewens
London, GB
lip fillers cosmetic non-surgical procedures trends 2020
Images via VICE and by Gilberto Santa Rosa; CC 2.0.

The charismatic doctor prepares the audience for a woman with a masculine profile (“she won’t mind me saying that”). A conventionally beautiful woman in her thirties walks to the stage, gets onto the procedure bed and explains the problems with her face. I absolutely hate photos of myself, she begins. My chin is masculine, my cheeks are too full, my nose is too wide, and the problem with my face is mainly the wideness. My lips are too thin. I tried lip filler but couldn’t get it to look right. Holding a ruler to 35-year-old Megan’s face, Dr Bob Khanna, says cooly, “What we’re going to do is balance all of these proportions.”


Khanna inserts cannulas expertly through her face like they’re tiny snakes, and injects the smallest amount of product all over, even in the tip of her nose. This is the future. As Khanna and other industry professionals explain over the course of the day, fewer people are likely to get lip or cheek filler but the whole face will be considered. In other words, it’s all about using filler sparingly but across the face or multiple features to build a brand new profile.

On a damp October weekday in west London, the 2019 CCR Expo (standing for Clinical – Cosmetic – Reconstructive) brought together clinicians, dentists and GPs, all looking to share trends, promote new products and improve their skills. Whether noses, cheeks or butts, the unifying theme is clear: consumers will be looking for more gentle cosmetic work done to more areas. Surgery will become less normalised. When GP Dr Kannan Athreya began in the cosmetic world only five years ago, most cosmetic options were surgical. “You can now produce similar results on the face, non-surgically,” he would tell me later that day. “These are lunch hour treatments now… people like the idea of something being non-permanent.” With non-permanent procedures you can sculpt and transform yourself slowly, in relative secret.

lip fillers expo face filler future trends

I follow Dr Khanna offstage into a side room where Megan is sat on a collapsible bed and holding a hand-mirror, delighted. Her face looks notably different, perfect – undeniably, she looks to me more beautiful still – but the changes are somehow muted. This ‘total facial sculpting’ method was developed by Khanna in 1996, and he's been promoting it ever since. Naturally, he's pleased it’s finally about to explode in the cosmetic world. “I’ve always been a believer that you can only treat the face as a whole,” he tells me. “You cannot isolate features. Feature isolation has never been on the cards for me. You have to respect a woman’s face as a whole.”


But, why not just get lip or cheek filler if that’s the area you want to change, I ask. “It’s a bit like painting a front door in isolation to the house, the windows,” he replies, holding my shoulders. “It’s like waxing the bonnet of the car and not doing the rest. That’s not to say you do a whole lot of treatment on the car, the face. It means you respect it carefully, you balance everything.”

This issue of disproportionate features is seen by industry insiders as a serious problem within the cosmetic world. With the rise of Love Island and cheaper non-surgical procedures, people are currently focusing on one or two areas they’d like enhanced and, since the industry in the UK is woefully unregulated, people are frequently being injected with a lot of product and in only one sitting. Concerns about safety aside, this look has attracted valid criticism that it makes white women blur racial lines; that it fetishises the sort of features that would naturally be more full on black people of African descent. At one point in the demo, Dr Khanna had half-joked, “If you put volume here you’re changing her racial background; put some here and you’re probably changing her species background.” As he nods to Megan in the back room, he looks impressed with his work. “In this case we’re redressing the balance, so she looks better than she did when she started.” On the one hand, this look works with what individuals have already got: their assigned gender profile, race and natural face shape. On the other, it openly cops to a constant revising and improving of the face.


The intricacy and extent of the work I see over the course of the expo echoes an essay in Jia Tolentino’s recent essay collection Trick Mirror about the ideal woman, who is always optimising. She writes, “If women start to resist an aesthetic, like the over-application of Photoshop, the aesthetic just changes to suit us; the power of the ideal image never actually wanes.” And so while enhanced or oversized body parts may come to seem ‘too much’, society's roving eye will still run over the entire face, leading to something more subtle but just as potentially insidious. As procedures require less intervention, money and time to perform, women – and increasingly, men – will come to view our beauty and bodies in micro-detail.

lip fillers expo

Just a few months before the expo, in May 2019, Juvederm – the leading filler brand – hit a landmark moment. They launched the first facial filler specifically for the lower face. Other filler product had been used in that area previously, however, ‘Volux’ promised to change the shape of the chin and jawline for up to 18 months. It quietly indicated the biggest trend for 2020 and onwards.

Jade Potter, the product manager for Allergan, the company that owns Juvederm, explained the birth of Volux, while next to her, a young woman lay back serenely pretending to get the fat on various parts of her body frozen. “In the UK, there’s a big need, if you like, from men and women to address lower face concerns – 43 percent of people in the UK have said they want to address them. It’s an ‘area trend’ to build a strong jaw and help with a recessive chin.”

Across at the other side of the expo, a young doctor was demonstrating a full facial transformation on a man using Volux and Juvederm product. She was showing the ‘nine-point shape’ method, a scaled-back version of Khanna's. Quickly, she injected small amounts of product at nine points over the lower face to reshape and contour. Volux, another older doctor explained, lifts as it shapes, and the man's face began masculinising quite impressively before the audience.

The second doctor explained from the side-lines what she'd seen in her own clinics over the past year or so: women coming in wanting filler to create a square-like jaw. “It’s exactly the shape from taking a selfie down here for Instagram,” she says, holding a pretend phone from below. However, this isn’t always achievable just by giving someone jawline filler, and might not actually look good without working holistically with the entirety of the face. The audience nodded in agreement.

Halfway through sculpting Megan’s face with filler, Dr Khanna told the audience that the anaesthetic cream would’ve worn off. Megan’s face had filler being slid into her nose and the delicate petals of both under-eyes, but she remained straight-faced. Later she’ll sit up with a beautiful and chiselled face that looks untouched by a needle or even a particularly rough exfoliator. Over the coming months, it’s clear that beauty is evolving and nothing will hurt.