People all over the UK undergo non-surgical treatments like fillers every year, but the industry operates almost completely unchecked. Fill Me In is a VICE UK editorial series in collaboration with Save Face, the national register of accredited aesthetic professionals, that aims to raise awareness of the dangers of unregulated procedures. Read all our stories here.
In retrospect, £700 was probably too little for Sam Ward to spend on a full facial remodelling. But the woman she found via Facebook seemed reputable, and Sam, a 50-year old cleaner from Benfleet, Essex, wasn't exactly flush with cash. The therapist sent photographs via Facebook to let her know what to expect – it was Sam's first "Kylie Jenner package" – and her handiwork looked fine. Good, even.
Alarm bells should have started ringing when the therapist told Sam she'd visit her at home, rather than giving her the address of a salon. But Sam had never had fillers before, and she didn’t suspect anything was wrong. But it did go wrong. Very wrong.
"She did the filler in my lips, my cheeks and around my chin," Sam remembers. "A day or two later, the lumps hadn't come down in my lips, and one cheek was higher than the other. I looked a mess. I didn’t go out for two weeks. I was in tears."
She phoned the therapist, who told her not to worry – the lumps would dissolve – but they didn’t. "I felt like the Elephant Man. Everyone was going, 'It's not that bad.' But when you look in the mirror at yourself, and you see it's not what you wanted, you think the worst, don’t you?"
Twenty-two-year-old billionaire and Kardashian scion Kylie Jenner doesn’t know who Ward is. She’s never heard of her, or – you'd assume – Benfleet. But Jenner is, indirectly, the reason that Ward messed up her face. The popularity of so-called "Kylie Jenner packages" is testament to how the youngest Jenner is at the vanguard of an aesthetic that's swept through British towns and cities faster than a listeria outbreak in a hospital cafeteria. Search "Kylie Jenner package" on Instagram and you'll see over a thousand posts, many from disreputable online practitioners, promising you a fast, cheap, dermal-filler-enabled look.
Loosely speaking the 'Instagram Face' look can be characterised as the following: thick, arched eyebrows; full cheeks; eyes weighed down with enormous false eyelashes; and a large pout. It's a look heavily reliant on injectable filler, contouring and add-ons like false eyelashes.
Arguably, Instagram Face appropriates and fetishises black culture. "Kim Kardashian enhanced her curvy shape in order to make links to the stereotypical image of black femininity – as curvy, hyper-sexual, deviant and dangerous," says Dr Katherine Appleford of Kingston University, an expert in the relationship between body image, race and celebrity. "However, because she is not black, she is able to inhabit a space between black femininity and white femininity, and is able to be 'exotic', sexual, but not dangerous or threatening."
Women adopting the Kardashian aesthetic are able to appropriate the appearance of black culture, Appleford says, "without the burden of racial discrimination, and also in the knowledge that they can shift and reconfigure the notion of beauty, in a way that women of colour are less able to".
Celebrities at home and across the pond were early adopters of Instagram Face: the Kardashians, of course, but also public figures like Iggy Azalea and Farrah Abraham, both of whom have transformed their appearance since becoming famous.
But reality TV offered the fertile loam in which Instagram Face took hold. You can watch it grow in popularity over successive seasons of MTV’s Geordie Shore. In season one of the show, none of the women have had cosmetic procedures, apart from Holly Hagan's magnificently large (and much-talked-about) breasts. By season 10, in 2015, the influence of Instagram Face is unmistakably present in Charlotte Crosby's enlarged lips. By 2018's season 18, Hagan – the only original cast member left on the show – has the full Instagram look and is more or less unrecognisable.
Where reality TV goes, the rest of us follow. Although reliable data on how many Brits are using fillers doesn't exist, because the industry is unregulated, the British Association of Aesthetic Plastic Surgeons confirms they've seen an increase in the use of non-surgical fillers in patients approaching their members.
Ashton Collins of Save Face, a register of accredited practitioners who provide non-surgical interventions, has watched the Instagram look spread through the UK. She provides a potted history of the practice. "Since Kylie Jenner came out with her lip kits and admitted to having lip fillers, the look became so popular," she tells me. "It started trickling along, down to Geordie Shore and The Only Way Is Essex, and then young girls went crazy for it."
Social media helped disseminate the look to the masses, with independent providers marketing themselves primarily through Instagram and Facebook, and offering fillers for low prices. For many young women today, having fillers is as much a part of their regular beauty maintenance as manicures or spray tan: an affordably priced treatment they view with scant concern.
"It's become a sort of status symbol," Collins says. "Whereas people used to want to own designer handbags or a pair of designer shoes, the latest thing is having fillers and hair extensions. They’re perceived as one and the same."
"I've always taken care of myself and looked after myself," says 24-year-old Devon-based personal assistant Rebecca, whose surname we have withheld at her request to protect her privacy. Rebecca recently spent £350 on a Kylie Jenner package. Four milligrams of dermal filler were injected into her jaw to add definition; another one milligram to straighten her nose, and half a milligram spread between each cheek to make them look fuller.
In addition to the Kylie Jenner package, Rebecca estimates she's had about 4 milligrams of filler injected into her lips over the last two years. She doesn’t view it as much of anything; all of her friends get their lips done. "I just see it as, you know how I get my hair done at the end of the month? I see it as that. I don't see it as being a big thing, because it is so affordable now."
Practitioners of the Kylie Jenner package will fix any manner of facial complaints. Don’t like your nose, or think your cheekbones lack definition? Filler will sort that out – and for just a few hundred quid. A skilled technician can dramatically change the shape of your face, using only injectables. Cheree Leon has been offering the Kylie Jenner package from her Essex salon for two years. It’s been hugely popular: "A lot of young girls are very self-conscious about their faces. They believe, you know, that they're not pretty," she tells me.
The women coming to her all reference the same famous family: "Everyone wants to look like the Kardashians. It's very, very current. It's a look that’s massive at the minute. Everyone wants big lips, everyone wants a big bum – it's the look these girls are seeing on Instagram, and this is what they want to look like." Cheree is able to use filler to make ordinary women resemble Kardashians: "You can change someone’s face just from putting filler in it. You can give them that sharp, defined look."
Without Instagram, of course, this specific look might not exist. The social network has helped popularise, and normalise, the look among a generation of young women. Rebecca can't remember what motivated her to first get fillers – it was more of a gradual decision; people she followed kept coming up on her newsfeed with new lips, or noses, or cheeks.
"I kept seeing all over social media the 'Kylie Jenner package', and I'd already had those kind of insecurities about my face, so I thought it would be perfect for me," she says. Rebecca didn’t like her nose. She thought her face lacked a defined shape. Plus, her lips curved to one side. "Now, they're just really even and plump and how I wanted them to be," she says.
Rebecca tells me she doesn’t feel pressure to use fillers to achieve a certain look, but understands why other women might feel that pressure – especially "if they didn’t have the money to look a certain way; you’d feel kind of left out".
When some of your peers on social media are getting identikit facial remodellings, the pressure to conform can be huge. But if you don’t have the money to go to an accredited practitioner, the results can be disastrous. "It's hugely concerning," says Collins, adding that she's heard of packages involving seven or eight different filler treatments at once, being offered for a few hundred pounds. "They're literally sat there in a room with four or five other girls, with numbing cream on their lips. They're called in, there's no medical history, they're not told of risks or side effects – they’re just injected and out they go."
A VICE investigation revealed that 90 percent of filler providers in London and Essex failed to check the age of a child client. It comes as no surprise to Collins. "We've seen people being injected at 16 because people don't ask their age," she says. "They don’t care – they’re just shipped in and out like it's a conveyer belt."
But how dangerous is the Instagram look, really? According to a report from Save Face, 934 patients complained about unregistered practitioners offering fillers and anti-wrinkle injections in 2017-18. Sixty-eight percent of those complaining didn't have a face-to-face consultation with their prescriber prior to the procedure, and 37 percent didn't know if the person injecting fillers into their face was qualified to do so. Complications included bruising, swelling, eyebrow drooping and, in a few cases, blurred vision.
Because Cheree won't offer the package to most people aged under 28, she often turns away very young girls who come to her asking for filler. Sometimes, those girls go to less scrupulous providers. "They end up with disfigured faces," she says.
Even if you haven't had your lips literally explode because you over-injected them with filler, subtler forms of damage can also be wrought. The more you become used to your face with filler, the easier it is to overdo it. An over-injected face is easy enough to spot.
Collins tells me that she spoke to one young woman recently who'd had seven milligrams of filler injected into her lip. Even though she couldn’t speak or eat properly, and had lost sensation in half of her mouth, she refused to get the filler dissolved. She liked how it looked too much.
The problem, explains Chris Hill – a consultant plastic surgeon and member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons – is that many practitioners of Kylie Jenner packages aren’t medical professionals with an obligation to act ethically. "[They] are motivated solely by financial gain, and are not acting in the interest of the patient," says Hill.
He tells me that reputable practitioners will refuse to over-fill a patient's face, but – considering there are plenty of disreputable ones who have no such qualms – is fearful that the long-term consequences of filler overuse will be seen in the faces of Kardashian acolytes in the decades to come. "You see people with their lips filled, and they do shrink back down again, but then they go and do it again and again and again," he says. "Actually, we don't know what the long-term effects are, because your tissue stretches."
But the look could potentially become harmful because, in the way you grow accustomed to spicy food or loud music over time, it's become so normal.
Once upon a time, cosmetic surgery was reserved for older women, the very rich, or famous people. The rise of non-surgical interventions such as fillers and Botox at affordable price points has revolutionised how young women view beauty. In addition to the onerous obligations society already places upon women, we now require them to edit their faces, using needles and filler, to fit in. And with the Instagram Look comes the death of individuality, because when everyone’s trying to look like Kylie Jenner, they end up looking the same.
"I think if you took a sample of 100 18 to 24-year-olds, they’d all pretty much look the same," says Collins.
"It's a bit like a sheep thing," Rebecca says. "You see one person doing it, then you kind of think, 'Oh, I should be doing that as well.'"
After several tearful weeks spent indoors, Sam Ward managed to get her face fixed at Cheree’s salon (she injected filler into the other cheek to even it out). Remarkably, the experience hasn’t put her off, and she's subsequently had more work done. For the foreseeable future, it looks likely that Instagram Face is here to stay.
If you have been affected by any of the issues raised in this piece, please visit Save Face, email firstname.lastname@example.org or phone their hotline for advice on 01495 239261.