The millennial moment – tips for treating younger patients in an age of reality TV

Love Island was for many a summer obsession. Viewers across the country tuned in to follow the islanders over eight weeks as they paired up and put their new romances to the test whilst living in isolation from the outside world under the constant glare of video surveillance. But all good things come to an end. Whether you were a lover or a loather of the show, its influence cannot be denied. This year’s final attracted a record 3.6 million viewers and one record-breaking episode was watched by more than six million people.

Concerns about the impact of reality TV on young people’s mental health

 While viewers of all ages enjoyed Love Island, the influence of the show and other reality TV shows on young people has increasingly become a cause for concern. Research released ahead of this year’s series fuelled the controversy about the ‘perfect’ bodies featured in the show and the effect it has on young viewers. Almost one in four people aged 18 to 24 said that reality TV makes them worry about their body image, according to the survey data released by the Mental Health Foundation.

The Mental Health Foundation was not alone in expressing concern about the impact that TV shows like Love Island have on viewers, particularly younger audiences, who are most likely to be distressed about their bodies.

The Mental Health Minister also blamed reality shows such as Love Island, The Only Way Is Essex and Absolutely Ascot for fuelling a trend in cosmetic surgery – because they give young viewers unrealistic ideas about body image.

Jackie Doyle-Price pointed out that NHS hospitals are seeing a six-fold increase in corrective surgery on people who have sought out lip fillers and breast implants overseas.

Speaking to The Sun, Ms Doyle-Price pleaded with people to think twice before going overseas for cheap surgery and warned that the risk of procedures going wrong could cause long term damage to both physical and mental health.

What has changed?

Twenty years ago, the majority of people seeking aesthetic treatments were patients over the age of 40, who wished to look younger. Today, more and more younger people are opting for cosmetic surgery to look like reality TV stars and celebrities. In fact, a recent global report by Allergan revealed that, out of all age groups, those aged 21-35 are the most likely to consider aesthetic treatment as soon as they notice a concern. Another report by Mintel found that 28 per cent of 18- to 24-year-olds and 31 per cent of 25- to 34-year-olds have had some form of cosmetic treatment (compared with an average of 21 per cent for the whole UK population).

With this in mind, what are the main considerations for an aesthetic practitioner when treating millennials?

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Celebrity culture

Today, TV shows like Love Island and The Only Way is Essex shine the spotlight on reality TV stars with flawless skin and fuller lips. This, it is clear, fuels the desire of the younger generation to seek cosmetic treatment so that they can emulate the same ‘look’ – during an episode of Keeping Up with the Kardashians in May 2015, it was revealed that Kylie Jenner had lip fillers – this revelation generated a peak in Google searches for the treatment globally, with one London clinic reporting a 70 per cent rise in enquiries during the following 24 hours. This, for aesthetic practitioners, may be great news – a boost in searches means a boost in sales – but ensuring your patient is in the right frame of mind and is suitable for treatment is key. While you may not be able to prevent them going elsewhere or even seeking treatment overseas if they are determined to do so, it is important that you protect your own reputation and do what you feel is right for that patient. That may mean politely refusing to treat them.


Education is paramount when it comes to treating younger patients. With the rise in celebrities seeking cosmetic surgery, influencers posting about their treatments on social media, and selfie filters like ‘FaceTune’, patients may come into your clinic with a firm idea of what, or even who, they wish to look like. As an aesthetic practitioner, it is your job to merge the patient ‘wants’ with patient ‘needs’, to provide safe and subtle treatments, and meet patient expectations.

Patient selection

Prior to treatment, providing a consultation is the first step to ensure your patient is not only physically suitable for treatment, but psychologically too. According to The Journal of the American Medical Association (JAMA), filtered selfies and editing apps like FaceTune have led to a rise in Body Dysmorphic Disorder – especially in younger patients.  As a practitioner, it is your responsibility to identify if your patient has full capacity to give truly informed consent for cosmetic procedures. While no one wants to turn business away and reject a patient who does not listen to your guidance and advice, saying ‘no’ to unsuitable patients can often be the safest option – not only for your patient, but for you as a practitioner, as it could prevent a claim against you in the future. For more information on the importance of patient selection you can read our comprehensive guide here.

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Treatments for younger patients

According to the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), popular treatments amongst the younger generation include:

  • Preventative treatments such as facials, platelet rich plasma (PRP) and Botox
  • Lip fillers
  • Non-surgical rhinoplasty
  • Dermal filler
  • Microneedling

Natural enhancements are recommended for younger patients, so as not to result in drastic or unnatural-looking changes they may regret down the line. Dr Rupert Critchley has developed a standardised approach to dermal filler for those in the younger age category. As a practitioner, using a ‘less is more’ approach and giving treatments over multiple sessions is advisable, providing regular follow ups and ensuring the patient is aware of the contraindications and possible side effects that may occur.

When treating younger patients, it is just as important that you follow a robust consenting and consultation process as it would be with any other patient. Be sure to check their age and do not feel pressurised into treating a patient if you feel that they are unsuitable, either due to physical or psychological reasons. If appropriate, provide a gentle and supportive introduction to cosmetic procedures that are suited to the individual patient, whilst ensuring that you are managing their expectations appropriately. Be mindful of the ‘Love Island effect’ and if in any doubt, say no.

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