Cosmetic procedures used to be the preserve of middle-aged women and often involved surgery. Today they are increasingly sought by girls who want the faces of their favorite social-media influencer, and by a growing number of men wishing for fewer wrinkles, fuller lips and sharper jawlines. Globally, more than 14m nonsurgical procedures were conducted last year, up from fewer than 13m two years earlier.

Research and Markets, a firm of analysts, reckons that the global sales of noninvasive aesthetic treatments, currently around $60bn, could more than triple by 2030. A large part of that growth will come from injectables. These include Botox and other substances that freeze facial muscles, as well as dermal fillers which plump softer tissue. Demand has been fueled by the proliferation of selfies and high-resolution video-calls. Snapchat and Instagram filters give users a glimpse of what they could look like with a filler-generated “liquid facelift”. The contrast with what they see on unadorned Zoom can be stark.

In America 2.4m injectable procedures were carried out last year, roughly one for every 100 American adults. About 700,000 such treatments were performed on Germans, not renowned for an obsession with looks. Brazilians, who are famously beauty-obsessed but much poorer, subjected themselves to around 500,000. Demand for “prejuvenation” work is especially strong in Asia, where younger patients want to pre-empt a craggy face before any lines actually appear. Since injectables have to be topped up every few months, they guarantee producers of the substances and clinics that administer them a source of recurring revenue. The younger the customer starts, the better for business.

Some modern dermal fillers are formulated with ingredients such as hyaluronic acid that are typically found in mild skincare products. That is more attractive to potential customers than Botox, which is derived from a toxin that occurs naturally in spoilt sausages. Other new treatments are stopping using foreign substances entirely. Certain cosmetic clinics offer to inject stem cells from a patient’s own fat into their face, or platelets from their blood to rejuvenate the skin.

However, the injectables craze, especially among youngsters, worries regulators. Botox is a prescription drug in most places but many dermal fillers are not. “Treatments are often trivialised on social media and people don’t understand the full consequences of what can go wrong,” says Tijion Esho, a cosmetic surgeon in Britain. Misplaced injections can lead to abscesses or, in some cases, necrosis. An outcry from doctors and victims of the procedures forced the British government to require a licence for people administering nonsurgical treatments. England has already banned them for under-18s.

What is driving young girls to undergo cosmetic procedures?