It was a Tuesday when my lunch date asked if I’d like some: ‘Not for me,’ I said. ‘I don’t do that stuff anymore.’
But as my mouth said no, the word yes bounced around my brain. I tried to ignore it. I was done with the needles and syringes, that was behind me.
Come Friday, though, it was late afternoon and I’d had a glass of wine after work. Inhibitions slightly loosened, I sent him a text, ‘Actually, yes. But just a tiny bit.’
We arranged to meet the next day at his hotel. ‘Where are you off to?’ asked my boyfriend. ‘I’ve got to do a thing. For work,’ I said vaguely.
My erstwhile lunch companion had a good-sized room in one of those small, chic hotels that smell of discretion, money and fresh flowers. Business was obviously good.
Kate Spicer did not use Botox and filler for four years but has never been able to stop altogether
There, after brief niceties, he looked at my face in natural light and drew on it with a soft wax pencil. ‘I will treat your cheek, the mid-face, the nasolabial fold, the marionette zone, the chin and your jawline,’ he said.
Boom. Moments later the syringe hovered over my face and with one little prick of the needle, I fell off the wagon.
I have sworn off Botox and filler several times now. This time, I’d gone four years without either treatment. But I’ve never been able to stop altogether, and it’s been more than 15 years since my first fix.
It was in 2008, while making a Channel 4 documentary about cosmetic medicine, that I began to dabble. It was a more niche business then, estimated to be worth £900million in the UK. This year it’s a flourishing £3billion industry here, according to medical market researchers Rare. Globally its value runs to £45billion according to one estimate, and is assured of continued growth, thanks, partly, to ‘an increasingly diverse consumer base,’ according to managing consultants, McKinsey and Company.
Back then, my default position as I made that documentary was one of scepticism, but while acting as on-screen guinea pig for a number of these treatments, including Botox and filler, I became hooked.
Not that I ever went full tilt at it. I was always a little ashamed of my need for it, and always tried not to be the woman who does this stuff. While being the woman who does this stuff.
I’d just have ‘Baby Botox’ – a mini-dose that leaves the face less frozen – or a ‘light touch’ procedure to brighten up my tired eyes. I tried small amounts of Botox injected very shallowly under the skin, via an injecting device called Aquagold.
Sometimes there would be months and months, years even, when I didn’t have anything, but then would come a period of gloominess, or I’d see myself in a photo looking awful or on television looking crumpled and grey next to a polished gleaming anchor, and I’d think: ‘I can’t face my face. I need cheering up.’ And back I’d trot to the doc for just a little bit, again.
The beautiful actress Naomi Watts, who at 55 is one year older than me, once said: ‘Personally, I feel for me it’s tough to do Botox – but it’s also tough not to. Sometimes, I think I need the help.’
That perfectly sums up how I feel.
So what happened this time? As ever, it’s complicated.
The doctor I was interviewing over lunch on that fateful Tuesday was skilful at sculpting faces with soft tissue fillers. Over the years I’d heard of him often and the work he’d been doing quietly sorting out the faces of some of the world’s most famous actresses, pop stars and models (male and female).
Fascinated by the recent explosion of distorted, puffy, tragic, over-filled ‘pillow’ faces seen on celebrities from the most A-list of Hollywood to the dregs of reality TV, I was keen to discuss the phenomena with someone who used the same techniques with restraint and artistry. I wanted his take on the widespread abuse of soft tissue fillers by even reputable doctors. When he came to the UK, we met and talked for nearly two hours.
Kate first began to dabble with treatments in 2008, while she making a Channel 4 documentary about cosmetic medicine
‘There should be only one philosophy in this field of medicine, that of the natural human face. These people who overfill, they don’t know what they’re doing,’ he told me.
Then came the offer of dermal fillers – an offer I was too weak to refuse.
His list of areas needing to be treated sounded long. But he did it by injecting hyaluronic acid under my skin in just six places, three either side of my face. The acid was put in tactical spots on the bone to compensate for the reduction in bone density that happens as we age. Effectively, he built up my shrunken facial scaffolding, which gives the skin a bit more to sit on top of.
I walked out feeling odd. A little bit guilty for having succumbed, but also relieved that the struggle to resist was over. The result was exactly what I wanted – I looked better, less exhausted and more open. When a friend mentioned that I looked well, I was tempted to lie: ‘It’s the nice light.’ ‘I’ve been sleeping better.’ ‘I’ve started running again.’
But in the end I decided to come clean. ‘Maybe I went to see a cosmetic doctor.’
‘Hang on, you said you were going to live with your natural face!’ she replied, adding with a curt little laugh: ‘You’re addicted.’
Am I? Is it possible to be addicted to something you can give up freely for four years? Or did I never really give it up?
For the first year or so I can definitely say that, yes, I was serious and committed to quitting my Botox and filler habit. I set about my goal of cultivating inner confidence rather than outer allure with determination – and by not looking in mirrors too much. If I could happily let my hair go grey in an attempt to age with grace, why shouldn’t I be able to handle a bit of creasing and sagging?
Then a trend for apparently less invasive tweakments really got going. News came in of a machine developed in the Czech Republic called EmFace, which uses a technology originally designed to fix prolapse and a weak pelvic floor. When used on the face, it builds muscle, which lifts the face and then refines the overall appearance, by heating the skin’s lower layers via radio frequency, which causes the body to produce new cells and collagen.
‘I’ll try that’, I thought. ‘That’s not a tweakment, it’s ‘natural’. So, there I lay in a clinic one day, with electrical currents passing from the wall socket through my back and up onto my face. The cost, £2000.
Then came the EmFace ‘Submentum’, which was designed for the neck. Ooh, I’d been feeling bad about my neck after the dog rested its head on my shoulder in a cute way as I was working and I took a selfie at an unfortunate angle so that the skin under my jaw was quite repellently concertinaed.
Again, ‘natural’, right?
I made common cause with other women who had given up injections and embraced these electronic ‘medical’ devices. Davinia Taylor, a former actress turned best-selling author of It’s Not A Diet, said she’d given up fillers because ‘I could feel some residual filler and it was blocking one of my lymphs in my face so that one of my eyes looked smaller and hungover’.
She went to a well-known cosmetic doctor, but – almost worse – the medical process required to dissolve the filler also ‘took away a load of the natural collagen in my face’. According to Davinia, the doctor now said: ‘Don’t worry, we can just put some more filler in’.
Like me, Davinia was claiming to have given up while still – at some level – keeping up the hunt for a holy grail or a silver bullet, some other way not to look quite so knackered and old.
A doctor was giving her Smart Cell Plasma Filler – filler made from proteins in our blood. And ‘injections of salmon DNA’.
Like me, she wasn’t having Botox but she was having something. It felt like swapping cheap supermarket white sliced for a wholesome sourdough. Definitely better, but not a full stop.
The trouble is, once you go cold turkey on Botox and filler, it’s like looking in the mirror at a stranger. Suddenly you look so crumpled, so aged.
Even when you resolve to quit, they’re incredibly hard to give up. When we give up booze, fags or drugs, our appearance tends to improve. The cosmetic medical addict has to contend with the exact opposite.
Cosmetic medicine is a flourishing £3billion industry in the UK, medical market researcher Rare says. Globally its value runs to £45billion, according to one estimate
Still, I felt quite smug about my decision during those four years of Botox and filler refusal. When a glamorous celebrity facialist offered me a session of Opus Plasma – a treatment that causes controlled damage via radio frequency to kick start the skin’s collagen production – we talked about how sad it was when people went over the top with the injectables.
Not like me, I said to myself primly, while also wondering how much better my eyes would look after this rather painful treatment. In fact, it left me with a swollen scarred eye area for a week or more.
Ultimately, cosmetic ‘medicine’ is elective, a matter of consumer choice, not need. And it’s not really medicine, is it? When we have a tweakment, we don’t go somewhere that looks like a hospital but to a ‘clinic’ with the feel of a spa or boutique. There is a growing normalisation of cosmetic procedures. A 2019 survey of 51,000 Snapchat users by online news source Vice, found 59 per cent viewed such tweakments as comparable to getting a manicure.
The real trouble is that the UK has little regulation around fillers and energy-based devices. When it comes to injecting fillers into the soft tissues under the skin, a manicurist could be doing the work. Data from the British College of Aesthetic Medicine (BCAM) last year found that 69 per cent of the 3,523 incidences of complications and poor work, corrected by their members in 2023, had been performed by beauticians, therapists and podiatrists.
And yet it should be treated with the seriousness we require of a medical procedure. Dr Catherine Farris, President of BCAM said, ‘What you need is someone to treat it as a medical treatment, take proper notes, have a consistency of care. The amount of energy you put through someone’s skin [during some machine-based treatments] is really relevant.
Or with Botox, if you have it too frequently you are more likely to develop antibodies and it will simply stop working.’ She describes the problem of doctor shopping. When a reputable doctor will say no to too frequent Botox treatments, the patient simply goes elsewhere. I have interviewed surgeons who complain that lots of residual filler makes it much harder to do a facelift, and a longer procedure.
Farris says that the machines, too, are not harmless. And, if people are not having treatments under the supervision of one doctor, there’s a temptation to just shop around and end up having too many: ‘If you’ve had a lot of work that has caused a lot of tightening it may distort your anatomy. The layers of the skin can adhere together, what’s known as fibrosis.’
But growing old naturally takes grit. Over the past few years, more and more regularly, I’d have the shocking realisation that the editors commissioning me to write had yet to hit landmarks I’d long passed: 40, 35, in one case, 30. Instead of feeling like I was the wise older writer I just felt, well, that word again, crumpled.
At the back of my mind, I knew there was always the contents of a syringe waiting to smoothe it all out again.
Indeed, when I probed some of the women who claimed only to use machines, every one admitted they still had a ‘a tiny bit of Botox’ here or ‘a little filler on my chin because it’s gone a bit witchy’.
It’s also been fashionable for celebrities to say they’ve given up injectables. I struggle to believe it.
I don’t think it’s helpful to pathologise every aspect of our habits and personality – and the word addict rather diminishes people struggling with far bigger problems – but I have to admit the pious friend who called me an addict had a point.
Cosmetic medical facilities have long been recognised as magnets for people with body dysmorphia. Multiple studies show that mental health issues, like depression and anxiety, can go hand in hand with dissatisfaction about physical appearance.
One study found that patients of cosmetic dermatologists are twice as likely to have mental health issues as patients of general dermatologists. Studies of women who have sought breast augmentation have shown suicide rates two to three times higher than rates in the general population, for example.
Not everyone trots off for tweakments. Does Mary Beard reach for the filler every time the TV cameras catch a bad angle? No, she has more self-esteem than that.
I so wanted to be above it all too. There’s a nobility to natural, untouched faces.
I look down on tragic figures with puffy fish lips, perfect noses and glassy perfect faces from which work has erased all emotion. But I can’t help but wonder, am I really any better than them?
