When Ali Weiss, 30, shares a selfie on Instagram, she often adds a caveat: This is a face that hasn't had any work done.
“The most punk thing you can do in 2024 is not fuck up your face,” the New York City-based host and podcaster writes via email. Surrounded by peers who have gotten fillers early and often, she believes her choice puts her in “the minority,” especially among those who work in front of the camera. “The fact that people seem to be more shocked by a 30-year-old who hasn’t had surgery than a 30-year-old whose face is frozen is crazy,” she says.
Weiss speaks proudly of her filler-free face, but she still cares about her youthful appearance. She has several less-invasive treatments in her arsenal, including a red light therapy device, laser facials and facial massages. In a few years, she hopes to try more invasive laser treatments that cost thousands of dollars. Anything before considering injections.
Over the past few decades, the consumer base for neuromodulators like Botox and dermal fillers like Juvuderm has grown exponentially. In 2010, more than 5.3 million people received Botox and more than 1.7 million received fillers in the U.S. By 2022, 8.7 million received Botox and more than 6.2 million received fillers, according to the American Society of Plastic SurgeonsEspecially in recent years, these procedures have gone from being a luxury for the rich and famous to casual, frequent visits costing a few hundred dollars.
“They are incredibly effective, relatively inexpensive and have become part of a widely accepted lexicon for personal care,” said Dr. Steven Williams, president of the group of plastic surgeons.
But now, a number of beauty-conscious consumers are saying “no” to injectables and putting their money toward expensive natural treatments.
Marta Freedman, 33, is one of them.
“I grew up in the era of over-the-top injections and the Kardashian era, so it makes sense to me that the pendulum is swinging back as people look into alternatives,” the Los Angeles-based entrepreneur said.
Weiss and Freedman are part of a chorus of anti-injectable sentiments on social media and in beauty publications that has intensified in recent years.
“Art consists in making the work disappear and making it look like nothing happened.”
— Dr. Ava Shamban, founder of Skinfive Medical Spa in Pacific Palisades
TikTok and Instagram have thousands of videos From women (mostly) who recount the process of their filler dissolving. The sometimes painful process can take several sessions and is done by injecting an enzyme called hyalase that can cause facial features, such as the lips, to turn purple and swell before returning to their original shape.
Many Los Angeles professionals are noticing filler fatigue among their clientele. They have seen more patients not only asking to have their fillers dissolved, but also seeking alternative procedures to maintain an enhanced, yet technically more natural look.
“There’s a pendulum movement that brings us back to the best, most natural version of ourselves, similar to the ‘no makeup makeup look,’” said Dr. Ava Shamban, founder of Skinfive Medical Spa in Pacific Palisades. “The art is in making the work disappear and looking like nothing ever happened.”
So what do beauty-obsessed people who reject Botox do? Some pay top dollar for all-natural, ancient practices, while others opt for high-tech, sometimes painful treatments as long as they can claim they are toxin-free.
Julie Civiello Polier has amassed more than 120,000 followers on Instagram by promoting noninvasive anti-aging facial massage techniques. Before the pandemic, the Los Angeles-based aesthetician and Chinese medicine practitioner offered in-person facials to her celebrity clientele, including Goldie Hawn, Miranda Kerr and Christy Turlington, but has since moved her practice online, teaching clients massage techniques for facial lifting and sculpting.
Her Instagram videos, with titles like “Ovarian support and brow lift” and “It is not necessary to use botox to sculpt the forehead” — have built her a dedicated audience. The services she offers range from live-streamed classes on at-home facelifts (which cost $100 a ticket) to individual training packages, priced upwards of $2,000.
“I don’t identify with fillers or Botox, I prefer a more natural look.”
— Marta Freedman, Los Angeles-based entrepreneur
Angela Cravens, a 45-year-old copywriter living in San Diego who favors chemical-free beauty products and natural, Eastern-inspired practices, is one of her followers. Since finding Polier’s free tutorials on Instagram, she’s created a gua sha and facial routine that works for her. She says people often mistake her for someone younger than she is, which she says may be because she avoids injections, “not the other way around.”
Polier says her clients come for her treatments for the aesthetic benefits, but find an unexpected emotional release with her techniques. Inspired by traditional Chinese medicine, she believes that internal trauma can affect parts of the face.
“This client was constantly undergoing surgeries on one side of her face and it would droop or not match the other side, until we started looking at her relationship with her father,” Polier said. “That left side of her face is where our relationship with her father is. [our] “The father is guarded.”
In West Hollywood, a three-year-old cosmetic acupuncture clinic called Reset caters to people in their 20s and 40s who don’t want to try injections. Owner Toni Weinrit, a certified and licensed doctor of acupuncture and Chinese medicine, says that while some of her older clients still use injections, the younger generation is thinking twice.
Freedman, the Los Angeles-based entrepreneur, found Weinrit on Instagram and did weekly treatments at Reset for about 10 weeks last year. She plans to resume them there soon. (In the meantime, she's supplementing her treatment with at-home electrocurrent devices, Frown wrinkle-reducing patches and professional facial massages).
“I don't identify with fillers or Botox. I prefer a more natural look,” she said.
Weinrit charges $250 per visit for the service and recommends a regimen of 10 sessions over five to 10 weeks (after which she recommends once-a-month maintenance, combined with occasional $500 microneedling, which she says helps improve skin texture).
The American Institute of Alternative Medicine Cosmetic acupuncture is “based on the belief that the face reflects the body’s internal balance and health,” she says. While the practice has roots in more than 2,000 years of traditional Chinese medicine, limited studies have been conducted. scientific studies investigating its benefits on the elasticity of facial skin.
Although Weinrit's services are significantly more expensive and time-consuming than a Botox or filler treatment, her schedule is full. She believes that's because the results are gradual.
“If you get Botox, 24 to 48 hours later you have a different face,” Weinrit said. “This is not the case.”
“If you apply Botox, 24 to 48 hours later you have a different face. This is not the case.”
— Toni Weinrit, owner of The Reset acupuncture studio in West Hollywood
Some clinics have begun advising patients on the changes they want to make, even going so far as to reject requests that look unnatural.
Aesthetic nurse Vanessa Lee nearly left the industry after she was asked to give a teenager lip injections with her mother’s approval. In 2018, she opened The Things We Do, a medical spa in the downtown Arts District (now also with locations in Chino Hills and Venice) that focuses on a gentle approach. Lee, who has more than a decade of experience, says the medical spa gets so many requests to dissolve filler performed by other professionals that it has had to start charging for the service that was once free.
The things we do have a naturopathic doctora licensed healthcare provider on staff who is trained to address skin care through gut health. Lee says she has turned away patients who request excessive work and referred them to a therapist.
“If someone comes to you and says things like, ‘This guy just broke up with me,’ or ‘I’ve been through the hardest year,’ you might not be in a position to make an important decision about full facial balance while you’re in this emotional state that needs some support,” she said. “Let’s start somewhere else first.”
Still, Lee has a business. For patients seeking a youthful look, she and her nurses first suggest biostimulant treatments such as platelet-rich fibrin matrix.
The treatment, which Clinical studies have been shown to reduce wrinkles and hyperpigmentation, involves drawing blood from a patient, extracting the plasma from it and injecting it into the face for those with volume loss in a specific location or using it with microneedling devices for patients with thin or dull skin.
One session costs $1,100 and the results can last up to two years if done twice. Yes, needles are used, but no foreign bodies are injected into the face, a technical detail that is important for clients who want to avoid chemicals.
The procedure is proof that while the pendulum may be swinging toward a more natural approach and look, there is one thing that will never go out of style: the willingness to pay (and suffer) for the promise of beauty.
