As someone who works in the beauty industry, I always prided myself on being attuned to the latest cosmetic trends and procedures, despite feeling on the periphery at times. In the beauty industrial complex, Black women have historically been excluded from the non-surgical enhancement conversation, particularly injectables, due to systematic racist ideologies reflective of the industry at large. For centuries, Eurocentric beauty standards have been celebrated as the ideal, making the needs and desires of women of color an afterthought. Similar to the hair care and color cosmetics space, these inequities are pervasive in the medical field, including dermatology.
Factors such as financial, educational, and psychological hurdles on top of not being the intended consumer contribute to this dearth of inclusivity. Cosmetic enhancements, formerly a tight-lipped secret afforded to affluent white women and celebrities, are now pervasive among women of color with increased entry to beauty capital. Thanks to social media, the fourth wall is broken, and their interest is greater than ever. Until recently, what once was a taboo subject is a hot topic that has transcended into a larger discourse about body modification, self-care, accessibility, and the evolving standards of beauty.
Ahead, three experts reveal the reason behind the spike in tweakments for Black women, and what you should know before taking the plunge.
What’s The Difference Between Botox & Filler?
Botox and fillers are oftentimes confused because both cosmetic treatments are injectables. Dr. Sherwin Parikh, M.D., a New York City-based board-certified dermatologist, founder of Tribeca Skin Center, and co-founder of A.P Chem explains, “Botox is a catch-all word for neurotoxins. It freezes muscular activity that causes lines and wrinkles allowing areas to look smoother.” Filler, on the other hand, is entirely different. Most often made from hyaluronic acid gel, it's used to fill lines, reduce creases, and restore volume loss to give a more youthful appearance. “If you think of your face as a sculpture, adding filler is akin to creating contours in the face,” says Dr. Chaneve Jeanniton, M.D., a Brooklyn-based board-certified oculofacial plastic surgeon, founder of Brooklyn Face and Eye, and skin care line Epi.Logic.
Breaking The Stigma Surrounding Injectables
The ancient narrative that “Black don’t crack” has misinformed skin care practices (i.e. skipping sunscreen) and created a stigma surrounding cosmetic enhancements that deserves investigation. “Black might not crack, but it does sag, sink, dry, and dull,” says Dr. Michelle Henry, M.D., a New York City-based board-certified dermatologist, Mohs cosmetic surgeon, and founder of Skin & Aesthetic Surgery of Manhattan. “We know that with regards to photoaging, we age a decade later than those with white skin, and in different ways that are independent of the sun.” The overarching mentality is that since Black women are blessed with melanin, undergoing cosmetic procedures is unnecessary and fiscally irresponsible. It creates unrealistic expectations about maturing gracefully and ultimately, a culture of shame. Women already face enough pressure to look beautiful but compounding it with race makes it even more complex.
Historic distrust of Western medicine, financial barriers, and lack of representation in marketing campaigns add to why Black people have apprehension towards certain cosmetic work. However, the tides are turning. Now more than ever, Black women are seeking non-invasive treatments to enhance their natural beauty. A quick TikTok search reveals that the hashtag #blackgirlbotox yields 2.7 million views on the platform. Social media has had a major hand in the dissemination and democratization of beauty information, making treatments that once seemed reserved only for the white and wealthy, accessible to all.
Attribute it to the rise in screen time (hello, Zoom fatigue) or being forced to slow down and self-reflect, but the pandemic marked a palpable shift for many women of color — one that allowed them the agency to center joy and wellness and define beauty standards on their own terms. “It's beautiful to see Black women prioritizing self-care because we haven't for so long. We’ve had so many other obstacles and things that we've had to balance,” says Dr. Jeanniton. This new wave has ushered in unprecedented levels of transparency among Black celebrities and influencers (like SZA and Cardi B), who by candidly admitting their cosmetic surgeries, add to the newfound normalization. “Pre-pandemic my clients were more secretive… now friends are more open with one another about their work without shame,” she continues. Socio-economic status plays a role too. Black women are earning more and feel empowered to invest their coins in a luxe lifestyle that accentuates and preserves their beauty.
In a 2020 study published by The American Society of Plastic Surgeons, 1.7 million Black people had cosmetic procedures, in comparison to one million a decade prior. Black women spend $8 billion on beauty and cosmetics annually, so it’s no surprise that their spending habits are expanding past topical treatments into more advanced procedures. At its core, getting tweakments is a natural extension of a beauty regimen that already includes hair, facials, and nails.
How Black Women Are Getting Injectables
“Myth buster — Black people definitely get Botox…like lots of it all day long. There are so many things Botox can do separate from just lines and wrinkles, ” says Dr. Jeanniton. Lifting brows, carving a defined jawline, alleviating migraines and excessive sweating, Botox is your friend. “Once you know anatomy and what muscles do what, you truly have a palette with all the interventions out right now.”
While under-eye filler is the bread and butter at her practice, Dr. Jeanniton is increasingly administering Botox to relieve TMJ (temporomandibular joint) pain. “We're stressed to unprecedented levels and there’s a lot of tooth grinding happening right now. This treatment is done to reshape the face and kind of ease tension in the jawline.”
A common concern in patients with deeper skin tones is hyperpigmentation and loss of elasticity and volume starting in the midface region. “We start to lose that yummy baby fat that we have in our 20s. It goes down really fast and we start to see that out-pouching of the tear trough earlier,” says Dr. Henry.
She tells TZR that nasolabial fold and lip fillers, contrary to popular belief, are highly requested procedures among Black women. “I'm doing lip augmentation on women of color for structure, symmetry, and hydration more than volume, but there’s a demand for fullness too.” They’re seeking poutier lips and crave a defined shape a la Rihanna’s cupid bow.
Age plays a factor as well. In Dr. Parikh’s practice, Millennials and Gen X are the core clients but there’s a steady rise in Gen Z too. Patients in their 20s are seeking augmentation or preventative treatments, while those 30, 40, and 50+ are coming in for corrective treatments.
The Cost of Injectables
Botox ranges from $200-300 on the lower end to over $1000 depending on a number of factors, including location, experience of the injector, number of units needed (that’s how it’s measured), and placement. According to Dr. Parikh, fillers typically start at $850 and increase based on the procedure, volume, and number of vials used. “It can become an affordable luxury, but we would want people to see board-certified in their field and not skimping even if it’s cheaper. This is not a decision you want to make based on price alone because something is compromised,” he says.
In an era of fast food injectables, where you can snag Botox deals on Groupon, proceed with caution. Before diving in head first, do your research on providers who are skilled in working with Black skin for optimal results. “You want to go to someone who is a true expert in the dynamics of aging and what these treatments will do for you in the future. It’s about longevity,” says Dr. Henry. Quality over quantity should always be the benchmark of good work. Dr. Parikh advises patients to set realistic expectations and not let social media be the motivator for such an important decision. “We don’t want to tap into people’s insecurities. It’s beautiful to do modifications but approach it calmly with safety.”
What to Expect During Your Appointment
The Botox procedure is pretty simple. Your dermatologist, surgeon, or injector will assess your facial concerns and suggest a tailored treatment and dosage based on your aesthetic goals. A topical numbing cream is applied and goes into effect within 20 minutes to an hour. The needles are quite tiny and the insertion, which feels like a slight prick, lasts a few minutes. Getting filler is quite similar. “There’s some degree of discomfort, largely psychological as things are starting. For most people, it's the pressure of the filler going in and expanding the tissues that feels odd.” explains Dr. Jeanniton. “Luckily, the filler products that we inject have some anesthetic mixed into them. So really that discomfort is temporary.” What’s critical to note is that while filler results are noticeable immediately, the full effect of Botox can take up to two weeks to show.
Safety Precautions for Deeper Skin
In general, Botox and filler are incredibly safe and have no long-term health issues, but it’s not totally risk-free. There are precautions taken to protect Black skin from hyperpigmentation, keloids, and scarring. “You may want to use a cannula more than a needle. A needle is fine too, but you want to make fewer puncture sites to prevent bruising,” Dr. Henry suggests. It’s normal to notice tiny bruising or swelling where the product was administered but this typically subsides after a few days.
The Longevity & Maintenance of Injectables
On average, Botox typically lasts three to five months. Touch-ups are suggested every four months around the time when the effects have worn off. Fillers placed under the eyes, cheeks, jawline, and chin last for about a year, but there are some exceptions to that rule. “Lips are really dynamic and so those will typically last about six months,” says Jeanniton. Dermatologists recommend annual touch-ups for maintenance. Unlike Botox, fillers can be dissolved if you’re not happy with your results. On the celebrity front, Blac Chyna recently documented her journey to remove facial fillers in an effort to embrace her authentic self.
Ultimately, the decision to get minimally invasive cosmetic enhancements is up to you. Black women are honoring life on their own terms and building community around new wellness practices, and it’s inspiring to see. Who are we to judge?