The Injectable Age: Why New Yorkers are Pouting on their Lunch Breaks
Cosmetic injectable procedures are skyrocketing across the country. But the syringe isn’t always in a doctor’s hands.
By Annie Abramczyk
Hailey Chandler had a sushi roll and a quarter syringe for lunch. In less than 15 minutes, she plumped her lips for the price of $375 and minor bruising. Other customers were there too, ordering injectables á la carte. Chandler walked back to work with time to spare on her lunch break. Her new lips lasted a year. And she loved them.
Welcome to the world of botox boutiques. Botox bars and filler locations are sprouting up all over New York City. There are more aesthetic boutiques in a five-block radius of my Flatiron apartment than bodegas. Places like Plump, Ject, and Alchemy 43 offer express lip injections, dermal fillers, botox, micro-needling, and other cosmetic services. Some places offer memberships for regulars like Chandler, 23, whose name was changed in this article for medical privacy.
The process is made to be seamless: you can easily book appointments online, walk in, take a few Instagram photos, have a mocktail, and be on your way — like DryBar, but for Botox. Plump has a massive social media presence, with 15.4K followers on Instagram and over 63.1K views on one of their TikTok videos. In fact, Chandler found the company through her TikTok feed. Plump Cosmetics & Injectables has multiple influencer partnerships, giving influencers free and discounted filler to advertise their services on the app. Chander saw people having luscious lips and wrinkles erased on their lunch breaks and booked an appointment in 2 minutes on her phone.
Injectables are now a major trend in romanticizing New York City glam-girl culture — much to these companies’ benefit. And the franchises keep coming: Plump will open a Hoboken location in the next few months. This is no surprise considering Plump’s Co-Founder and CEO Eric Wisman specializes in “retail expansion” and has franchised DryBar, Blushington, and Sugared and Bronzed.
The expansion tracks nationally. Demand for cosmetic injectables is at an all-time high. Dermal fillers in the United States have had a massive 42% increase in procedure count since 2020, according to The Aesthetic Plastic Surgery National Databank. Women accounted for approximately 94% of all procedures. In 2021 there were 1,857,339 dermal filler procedures at 294 participating plastic surgery offices across the U.S.
The injection craze is booming. People are syringe-happy. Companies capitalize on social media trends to sell medical procedures with cutesy, boutique marketing. And that’s only part of it. The Aesthetic Society only accounts for cosmetic injections occurring at board-certified plastic surgery practices. Medical Spas and boutique injector companies are not included in those data pools. And here’s why: the injections at these places are done by “medical professionals” but not licensed doctors. And to experts, that’s a cause for concern. It begs the question who is responsible when these procedures go wrong?
Some companies require medical backgrounds in nursing. Plump trains employees for 350 hours (or two and a half weeks) according to their injector fellowship program guidelines before giving them the syringe. Compare that to the required medical school, internship, residency, exams, and 12,000 to 16,000 patient care hours doctors must log to become board-certified dermatologists.
“There’s no way these people are doctors. I don’t know what they are, but they are not doctors. And I’m pretty sure they’re probably just there for the free fillers for themselves,” Chandler laughed, describing her typical “medical professional” at Plump.
When I called Plump, I spoke with the receptionist and asked her who the injectors were. “You can make an appointment with anybody,” she said. “You can choose the person you’d like to see or do next available we have NPs, we have PAs. I believe Dr. Blinski is the only doctor.” She’s right. Out of the “thousands of procedures” boasted on the website, some are done by nurses, physician assistants do some, and there is only one doctor for the company’s six locations– one of which is in Miami.
So the injectors are, in fact, professionals. Both nurse practitioners and physician assistants have their own requirements in medical training and certification processes in the US. Furthermore, the company has a system for training, and the injectors are trained by at least nurse practitioners or Dr. Blinski– the founder of Plump. But it still doesn’t answer the question: why do doctors need to log thousands of hours to inject and medical professionals only need 350?
For this, the receptionist very deliberately kept referring me to the website, she was happy to answer any questions that were already vaguely explained on the site in the company’s very specific jargon. When I asked her about complications and liability, she said, “that’s on our website as well, but they’ll also go over the forms at the appointment.” They offer to “re-evaluate” after 14 days if your filler is botched, but the fine print is missing. It’s in the forms. Which I was told I couldn’t see until I got the treatment– in other words, until I paid a minimum of $375 for filler.
“Oh yeah, I pretty much signed my life away,” Chandler laughed. She then admitted that she didn’t even read the forms. “I figured if other people were doing it, how bad could it be? The influencers trusted them.” But where should you draw the line for expertise when it comes to medical procedures?
Dermatologists and plastic surgeons have spent years studying anatomy and technique for medical procedures and even the leading experts in cosmetic dermatology are still learning the latest techniques in injectable practices. It’s a rapidly growing and evolving field. “Even now, 20 years after my residency, I go three or four times a year to different medical conferences to learn and update my skills,” Doctor Geraise Gerstner, MD, told me.
Dr. Gerstner is a board-certified dermatologist and one of Manhattan’s leading experts in the industry. She has a private clinic on the Upper East Side. Her work has been featured in the Wall Street Journal, Vogue, and Vanity Fair. Dr. Gerstner advocates for knowing a patient’s medical history before injecting.“A patient could potentially have an autoimmune disease and react badly to the injections,” Gerstner explained. The needle could push bacteria into the vascular tissue if the procedure is done incorrectly. “Filler is definitely more dangerous because of the complications you can get, it can cause blindness or infection.”
Although chances of these adverse reactions are low — and certainly lower with doctors involved — smaller infections, edemas, lumps, bumps, and allergic reactions can occur, according to the FDA. 22-year-old cosmetic botox and filler patient, Katarina Adams, whose name was also changed in this article for medical privacy, has her own Plump horror story.
Adams went to Plump in SoHo four times from 2019 to 2021 for full facial filler and botox until she switched to a luxury medical dermatologist because of gravelly lumps forming in her lips. “The doctor was horrified,” Adams explained. “He was like, ‘I’m not injecting you today. We need to dissolve all of your filler immediately.’” In fact, the filler had been migrating, largely due to the inconsistencies of injection techniques in Adams’ face. The doctor dissolved the filler for free.
But Adams’ story is not unique. In 2021, dermal filler reversals were up 57%, according to The Aesthetic Society. The increase in people getting filler might correlate to the number of patients getting it dissolved. Although dermal filler chemicals– hyaluronic acid and poly-L-lactic acid (PLLA)– are designed to be metabolized by your body after one to two years, dissolving filler requires expertise. “When you’re using the solution to dissolve the filler, you want to make sure that you’re not dissolving too much of the actual like, good, like collagen,” Sim Uppal, a medical assistant to Dr. Gerstner, explained.
For Adams, the trade-off was worth the cost. Sure, booking a doctor’s appointment over the phone might be more of a hassle and cost around $200 more per syringe. “Once I started going to a real doctor, I never had bruising on my lips. I had way more minimal swelling, and like everything, the experience was like, honestly, a complete 180,” Adams said.
To Adams’ point, injectables are expensive wherever you get them. In fact, Plump has almost doubled their prices in the past year. “I swear I used to get my lips done for $200, and the last time I went, it was $400,” Chandler explained. For botox boutiques, the prices will continue to rise due to demand. “It took me three months to book an appointment at Plump last time,” Chandler said. “I really have zero loyalty,” the once self-proclaimed Plump enthusiast stated. “I’m just lazy when it comes to making appointments. But with the price increase, I might as well just see a real doctor.”
You can paint the spaces pink, offer elixirs, get influencers on your side, and come up with cute names for medical procedures, but buyers beware if botched: 15 minutes could cost you 15% or more on medical bills.
One of the many injectable boutiques on my block (Flatiron, NYC)
Screen grab from Plump’s TikTok account
