Zac Foote, 20, had been thinking about getting anti-wrinkle injections for "ages" before he booked in for his first session in October.
While he was not unhappy with how he looked, Mr Foote said he had seen his father age "a lot" in the past five years and wanted to avoid a similar fate.
Enter the idea of "baby botox".
"I read an article and heard that if you start [botox] when you are younger, it is meant to be preventative of wrinkles," Mr Foote said.
"If in the resting face you can see wrinkles, then it is too late."
Mr Foote first came across the idea of "preventative botox" when he saw a video of Australian TikTok star Anna Paul, 22, talking up the treatment.
She has been getting cosmetic injections since she turned 18.
Several of Mr Foote's friends had already had treatments and one worked as a receptionist at a cosmetic clinic.
"She booked me in," he said.
"Knowing people who have had it, it feels more normal and not so taboo."
Zac Foote, 20, before and after getting anti-wrinkle injections.(Supplied)
Mr Foote initially had more than 50 units injected into his crow's feet, frown lines and forehead.
The procedure took about 15 minutes and cost $800.
"It's amazing, I am really happy with it," he said.
"I was worried it would be too much and I wouldn't be able to move my face, but there's still movement."
Mr Foote says the treatment has given him peace of mind and — as the effects of anti-wrinkle injections generally wear off after three to four months — he plans to have two or three treatments a year.
If he can afford to.
The scale of the 'baby botox' boom
There is no industry-wide data about who is using anti-wrinkle injections in Australia, but several practitioners have told the ABC they are busier than ever, with many clinicians closing their books to new clients.
SILK Laser Australia Limited claims to be one of the country's largest providers of non-surgical aesthetic procedures, with more than 50 clinics across the country.
In a market prospectus, SILK estimated its revenue from injectables, including botox and fillers, was $627 million for the 2020 calendar year, with expected annual growth of 25 per cent over the next four years — more than any other part of its business.
The company told potential investors it had seen "increasing female acceptance of cosmetic injectables as a means of providing anti-ageing solutions, as well as the growth of celebrities actively promoting anti-wrinkle and dermal filler treatments".
"This has expanded the key demographic beyond 40+ years to a younger age group," the prospectus said.
A woman has botox injected into her forehead.(Reuters: Mike Segar)
Some of the most detailed data about the use of botulinum toxin injections — of which Botox is one brand — is kept by the American Society of Plastic Surgeons (ASPS).
In 2000 only 786,911 Americans had botulinum toxin injections.
After being approved by the US Food and Drug Administration for cosmetic use in 2002, the number of botulinum toxin treatments soared into the millions.
The trend continued upwards until the pandemic struck.
Between 2010 and 2018 the number of people aged 20 to 29 getting botulinum toxin procedures increased dramatically, up 39.4 per cent.
However, this is only slightly more than the increase in total botox procedures (38.2 per cent).
If Australian trends are following the US, there has been a rise in 'baby botox' — but there has also been a rise in the use of botox across the board.
No scientific evidence it works
Despite the growing popularity of "baby botox", the immediate past president of the Australasian Society of Aesthetic Plastic Surgeons, Sydney-based Dr Naveen Somia, says there is no scientific evidence that it works to prevent wrinkles.
"It's an anecdotal opinion," he said.
"There is an age where botox is appropriate, but I'm not convinced that preventative botox is the way."
Some clinicians who spoke to the ABC said there did not need to be scientific evidence because anti-wrinkle injections stop muscles moving, so it must prevent wrinkles if a client continues treatments.
Dr Somia says there is no proof that early botox injections prevent wrinkles from forming.(Supplied: Australasian Society of Aesthetic Plastic Surgeons )
Dr Somia said it was "not seen as good practice" to promote a procedure in the absence of evidence.
"I think if you look at the medical argument, the answer is there's no evidence to support this," he said.
"But if you look at this from a pure business point of view, that's where you see the drive for preventative botox coming through."
GP and founder of Cityskin Cosmetic Clinics Dr Jonathan Brown says he always tells young clients the best thing to do to avoid wrinkles is wear SPF 50 sunscreen every day and don't smoke.
"I spend a lot of time telling people what they don't need," he said.
Still the average age of his clinics' patients is trending younger (from 37.5 years old in 2013 to 35.6 years old in 2020), and many people in their 20s are getting 'baby botox'.
"I've never been busier, really," he said.
After using sunscreen and not smoking, Dr Somia says the next thing to do to prevent wrinkles is to ensure you have a good diet and gut health.
"You want to look at your skin health as a pyramid where you start off with the basic skincare — good health, good exercise, good diet, good lifestyle [during your] 20s," he said.
"As you get older, you add on to the solid baseline that you have by introducing products which have got active ingredients like topical vitamins A, vitamin B, vitamin C, and then also increase the dietary intake of vitamins A, B and C.
"People forget that your diet actually provides a very high concentration of bioavailable active ingredients … so you have to feed your skin both ways."
Botox 'new normal'
Brisbane woman Laura Meadows, 29, was initially "very against" botox, but now sees it as a natural progression in preventative health care.
"I used to think that you should age gracefully and not want to alter your body at all, but it is becoming so much more common now," she said.
"You wear sunscreen to prevent skin damage, exercise to keep your heart healthy, eat well so you don't get sick and get botox so you don't get wrinkles."
Space to play or pause, M to mute, left and right arrows to seek, up and down arrows for volume.WatchDuration: 17 seconds17s Laura Meadows films her first Botox treatment(Suplied: TikTok: @meadows77_)
Miss Meadows had her first anti-wrinkle treatment earlier this year after she noticed faint lines developing on her face.
She posted about the whole procedure online and was pleased with the results.
"Quite a few people had done it before me and not people you would necessarily expect," she said.
"Now I think it's just for regular people."
What is behind the rise?
According to the doctors who spoke to the ABC for this article, cosmetic injectables are becoming more accessible, affordable and socially acceptable.
"With the rise of the laser chain clinics in shopping centres there is a low barrier to entry now," Dr Brown said.
"In every shopping centre there seems to be a clinic offering treatments and with a price point that is affordable."
Nearly two years into the pandemic and all the video calling it has necessitated, a recognised phenomenon has emerged from having to work and socialise via video chats.
A small survey Dr Brown conducted with more than 100 patients at his clinics found that, over time, his clients had become more open about getting cosmetic injectables.
Between 2013 and 2019 the number of people who told their families about getting injectables almost doubled, from 33 per cent to 62 per cent.
More people were telling their best friend as well — up from 54 per cent to 81 per cent.
Dr Somia believes an increasingly visual world and social media are driving more young people to seek out anti-wrinkle treatments — with children as young as 10, 11 and 12 being exposed to these types of procedures online.
"They don't have to go searching for it, it gets fed to them [on TikTok and Instagram]," he said.
"That is where we see that this becomes normalised … and it becomes almost a desire from a very young age."
The pandemic may also be driving a spike in demand, with researchers noting a so-called 'zoom boom' in demand for cosmetic procedures as people notice new appearance concerns after hours of looking at their face on screen.
Dr Jonathan Brown has seen an increase in demand for anti-wrinkle injections from younger patients.(Supplied)What are the risks?
According to ASPS, the potential side effects of anti-wrinkle injections include pain at the injection site, temporary facial weakness or drooping and, in rare cases, breathing problems, trouble swallowing, muscle weakness and slurred speech.
For dermal fillers, patients can get unwanted lumps, bruises or even become permanently blind.
The medical regulator announces a major review of patient safety in the cosmetic surgery sector, after Four Corners revealed details of serious hygiene and safety breaches in clinics operated by Dr Daniel Lanzer.
In terms of potential mental health side effects, psychologist Toni Pikoos said if clients had a good understanding of the procedure and its effects, most people would have a slight increase in self-esteem and body image.
However, for people who had unrealistic expectations it could have a negative impact on their mental health.
"Young people are more likely to have unrealistic expectations of what the treatment is going to do for them, thinking it might make them more popular or boost their social media following," she said.
"It could also create an unhealthy preoccupation with their appearance, which could lead to more serious issues."
Dr Somia and Dr Brown recommend consumers do their due diligence on a clinician before getting any cosmetic treatment.
To administer cosmetic injectables you need to be a registered medical professional, such as a nurse, doctor or dentist.
However, there are no specific training pathways for specialising in injectables.
In Australia, any doctor can call themselves a cosmetic surgeon.
So it is extremely important to do your research to check how experienced a clinician is — because experience can make a big difference to the final outcome.