Last year, Dr Asma Qureshi attended an influential Memon

client’s wedding. According to her, almost all the women there

had had their lips filled.

“Girls as young as 16 were walking around with visibly plumped up

lips,” the Karachi-based dermatologist says.

Shortly after, the Covid-19 pandemic swept the country and the
government shuttered all non-essential businesses. But even during
the lockdown, Dr Qureshi was getting calls from people wondering if
she’d make an exception and see them for their routine Botox
appointments.

“I was thinking ‘who is even seeing your face right now?’"

When she was finally given the green light to reopen, Dr Qureshi did
her best to be careful. But in June a client failed to mention that he
had traveled right before his appointment.

“He was so desperate to get his injections, to look more chiseled, that
he basically came straight to my clinic from the airport. Because of
that I had to close for another two weeks,” laughs Dr Qureshi.

Every person I spoke to for this article told similar stories: of dedicated
patients willing to overlook the pandemic, lockdown restrictions and
their fear of needles, all in the name of eternal youth.

All this begs a necessary question: what are injectables and why the
hype?

Commonly known as Botox or fillers, injectables are chemical

substances that are inserted into the skin with a needle. And while the
two words are frequently used interchangeably, Botox and fillers
accomplish very different things.
Botox is a neurotoxin that temporarily paralyses a muscle preventing it
from contracting. Fillers, on the other hand, help reduce facial wrinkles
and folds (such as smile lines), contour the body (such as reducing
the appearance of a double chin) and restore facial volume to the
areas of the face that, with age, tend to lose volume (like the cheeks
and lips).

To better understand this, put down the device you’re reading this on
and take a look at yourself in the mirror. Scrunch your eyebrows
together. The lines that appear between your brows are a muscle that
a Botox injection can help relax and smoothen out. Next, look at
yourself in selfie mode on your phone camera using one of
Instagram’s filters. The plumped up lips, foxy-looking eyes and lifted
cheeks looking back at you? That is the sort of thing that can be
achieved with fillers.

Put your best face forward

The physicians I spoke to for this story unanimously agree: social
media apps (like Instagram) are behind the uptick in cosmetic
procedures, including injectables. And although revolutions are
typically driven by the young, this revolution is not confined by age or
gender.

“Everyone is doing it now. It’s become normal,” says Dr Qureshi. “I am

half Iranian. And with Iranians it was always common [to have work
done] at a young age. In their early 20s, girls would get a boob and a
nose job. Sometimes they even had liposuction or put in gastric
balloons for weight loss purposes. Mothers would bring in their
daughters. In Pakistan, it’s a mix. Some mothers are progressive or
proactive about it. But the majority of patients hide it from their parents
and husbands and generally don’t want people to know.”

The rise of filtered reality has opened up a chasm between our digital
and real selves. And savvy and skilled dermatologists, plastic
surgeons and nurse injectors have rushed to fill the void.