The history of facial aesthetics in dentistry
From the Botox boom to the selfie generation, Manrina Rhode takes a look at the history of facial aesthetics and its ever-growing industry today.
Dentistry.co.uk is 25 years old. Well, that flew by.
My relationship with facial aesthetics started a little after that. Twenty-five years ago I was starting dental school and I don’t remember facial aesthetics being on my radar. Although it is for many dental students now.
Some dental students these days go on courses for facial aesthetics before courses for basic cosmetic dentistry. Here lies our first insight into facial aesthetics evolution.
Once I graduated 20 years ago, I came to work in a high end dental spa in Knightsbridge, London, and I saw ladies with large lips filling the nearby stores. To me they seemed very sophisticated with their oversized lips.
My boss at the time, Surinder Hundle, was very forward thinking and decided we should offer facial aesthetics in our dental clinic, although this wasn’t common place back then.
We hired a medical nurse who would come in to complete our facial aesthetic procedures and we also learnt all about them so we could treatment plan and treat some patients ourselves.
I remember asking her to inject my lips at 23 years old, 20 years ago, so I could look like these sophisticated ladies in Knightsbridge. She refused as she said my lips were good as they were.
Jump forward 20 years and so many 23 year olds now have overfilled lips emulating celebrities style now. I was obviously ahead of my time.
I trained in injectables with Qmed at the time back in 2004. Then it was just a one day course to learn botox and fillers.
We were shown a technique and then given a patient to practice on. This went on throughout the day until we were shown all there was to show and then encouraged to treat our patients with these procedures.
It’s no wonder so many celebrities and members of the public had overfilled faces and sky high eyebrows. I call it the ‘ab fab brow’. We just didn’t have the training or knowledge back then for subtle, natural-looking results.
Paving the way
Around this time Bob Khanna was paving the way for facial aesthetics to have its place within dental practice. He was at the forefront of developing facial aesthetic concepts and techniques since 1996 and encouraging dentists to train and start offering these treatments.
As dentists we now believe we are amongst the best to deliver them as we are so well-trained in head and neck anatomy, and also very comfortable with needles.
He opened the Bob Khanna Training Institute in 1997 and developed his courses as new techniques were discovered. He trained other dentists to be comfortable offering these treatments.
Some years later I went and completed each of his modules to learn his current techniques, feeling comfortable knowing he had dedicated his career to being at the forefront of current research.
Botox was being used unlicensed around the world until 2002 when FDA and MHRA announced regulatory approval of botulinum toxin type A to temporarily improve frown lines between the eyebrows. This allowed the Botox boom to begin.
FDA also approved use of hyaluronic acid fillers around the same time, making these more acceptable and common practice.
However the industry is still shockingly unregulated. With some beauticians still purchasing filler from the internet, learning their skills from YouTube and offering their services at discounted prices – often with devastating results.
2013 Advertising Standards Authority (ASA) published guidelines on marketing cosmetic procedures. This was updated in 2016. They wanted to protect the public from being encouraged to have these cosmetic procedures.
Results from facial aesthetics started to look more natural. Celebrities who used to hide the treatments they had, started openly talking about them. Filler brands started increasing the range of materials they offered.
In 2015 Crawford told InStyle: ‘I’m not going to lie to myself, past a certain age, creams work on the texture of your skin but, in order to restore elasticity, all I can really count on is vitamin injections, Botox, and collagen.’
She added: ‘I have a very simple, healthy life, which works miracles. I drink a lot of water, watch what I eat, and exercise…but I owe the quality of my skin to my cosmetic surgeon.’
While Nicki Minaj hasn’t directly addressed getting injectables in person, she insinuated it in her and Big Sean’s ‘Dance (Ass)’ song lyrics: ‘I don’t know man, I guess those ass shots wore off’.
After famously getting fillers, Courtney Cox later decided to reverse them. ‘I’ve had all my fillers dissolved. I’m as natural as I can be. I feel better because I look like myself,’ Cox told New Beauty in 2017.
‘I think that I now look more like the person that I was – I hope I do. Things are going to change. Everything’s going to drop. I was trying to make it not drop, but that made me look fake. You need movement in your face, especially if you have thin skin like I do. Those aren’t wrinkles—they’re smile lines. I’ve had to learn to embrace movement and realise that fillers are not my friend.’ Judging by the 2021 Friends reunion, she then had them placed again.
Celebrities talked about fillers and talked about getting them dissolved and a trend was created for both.
The use of camera phones and Instagram brought about a selfie generation, with more and more patients coming in wanting to look like their filtered faces on their phones.
Then in 2020 Covid hit. Before this point most of us hadn’t even heard of Zoom.
Very soon most of us were spending eight hours of our working day on it. Hence the rise of the Zoom face.
Whereas before 2020 we may have looked at out face for three minutes in the morning when getting ready, we were now faced to stare at our own faces all day and not from the most flattering angles.
After the first lockdown, around 80% of my patients referred to the way they looked on Zoom and what they didn’t like about what they saw.
New innovative techniques
The exciting thing about facial aesthetics is it’s a massively booming industry.
Every year there are new discoveries and research on ways we can look healthier, younger, more attractive. It’s human nature to want to look better.
As a clinician it’s exciting as we can continually improve our skillset and offerings to our patients as new products and techniques are released.
For patients it’s exciting as they often ask me ‘what else can I do?’
When Dentistry.co.uk started out, the use of facial aesthetics in dentistry was also still in its infancy. We were trying things out.
Patients weren’t very forthcoming about what they had had done. It was a taboo topic into the early 2000s.
Slowly, treatments became licensed and celebrities started opening up about treatments. In 2022, the vast majority of my patients have some sort of injectable procedure with me. It’s a booming industry.
I’ll look forward to seeing what procedures we are offering at Dentistry.co.uk’s 50th birthday in this quickly evolving industry.
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