here’s an aesthetic clinic on almost every major street now. They operate independent of a hospital or a physician’s office. There is soft lighting, a reception desk that looks like a hotel lobby and a menu that reads something like: thread lifts, lip fillers, Botox, PRP, chemical peels, laser everything.

In Lahore alone, they have multiplied so fast that keeping count feels pointless. They are in DHA, in Gulberg, tucked between pharmacies in Johar Town, and so on. The industry has exploded before our very eyes and nobody’s really talking about how strange that is.

Ten years ago, cosmetic procedures were a secret. Women got the work done and denied it in the same breath. Now it’s a talking point over coffee. Younger women, older women, women who are online and women who aren’t; are all moving through these clinics like they’re running errands. The normalisation happened so quietly and so completely that to even call it remarkable now feels slightly embarrassing.

First off, the influencer economy did a lot of the heavy lifting here. Look at any Instagram influencer’s page and you’ll find one of these eventually: a before-and-after, a referral code, a clinic tag, a glowing caption about confidence. What’s being sold is almost never the procedure but the transformation narrative. The idea that you were already fine but you could be better. The clinic gets the client. The influencer gets the commission. Everyone is happy, apparently.

Men are in it now, too. PRP for hair loss, jawline fillers, laser hair removal and the works. The interesting shift isn’t that they are doing it, it’s that they have stopped being coy about it. No more “I just started exercising.” The pressure that women have quietly suffocated under for decades has simply found new real estate. Progress, some would argue. Maybe just more people inside the same anxious loop.

The loop, once you are in, is hard to exit from. Cosmetic procedures have a well-documented psychological dimension that the industry has absolutely no incentive to talk about. Body dysmorphic disorder, the condition where a person becomes preoccupied with a perceived flaw to the point of dysfunction, was first described in 19th Century Italy as dysmorpho-phobia. It has been around for as long as mirrors have. What’s new is that aesthetic clinics are, by design, places where the answer to “I don’t like this about myself” is always yes, and always fixable by some machines or needles.

Studies consistently show that people who seek cosmetic procedures are not made happier by them, they move on to the next thing. It starts with the lips, then the nose, then the under-eyes. The goal keeps shifting because the goal was never really the lips.

Look at any influencer’s page and you’ll find a before-and-after, a referral code, a clinic tag, a glowing caption about confidence. What’s being sold is hardly the procedure but the transformation narrative — the idea that you were already fine but you can be better. 

The other thing that changed is money, or rather the illusion of not needing much of it. Getting fillers used to mean knowing someone, or flying somewhere. Now it’s an Instagram DM and a few swipes on a payment plan. Clinics have figured out that if you make it look and feel affordable, people will find a way. So they introduced tools like package deals, introductory offers, split payments on procedures that probably shouldn’t be impulse purchases. The less it costs to walk in, the less people think before they do.

On the supply side, keeping prices low means cutting costs somewhere. In this industry, what gets cut is usually training, product quality or both.

Which brings us to the part that makes the whole thing uncomfortable. ‘Aesthetic medicine’ in Pakistan is operating in a regulatory grey zone that borders on a free-for-all. The procedures being performed — lasers, injectables, chemical peels etc — require medical training. The people performing them don’t always have it. Beauticians are injecting fillers, aestheticians are operating laser machines, and so on. There have been burns, disfigurements, botched procedures. There are patients who went in for a small fix and came out with something they are still dealing with years later.

The Pakistan Medical and Dental Council has tried to weigh in. But it’s one thing for the rules to exist, another to enforce them. A clinic with a professional-looking Instagram and a well-designed interior doesn’t need to prove anything to walk-in clients who, most of the time, don’t know the questions to ask. That’s the trap. The whole industry is built on aesthetics, including its own. It looks clean, clinical and credible. It is slick enough that the due diligence question doesn’t always come up until something goes wrong.

There is nothing inherently wrong with wanting to change something about yourself. That’s not the argument here. The argument is that an industry growing this fast, this profitable, with so little oversight, is an industry that will keep producing disasters alongside its success stories. The disasters tend to be quieter but grave.

The question is who is responsible? Is anyone going to be asked to answer for it? Possibly not anytime soon. Industries this profitable tend to regulate themselves only after enough (important) people get hurt, and even then, slowly.

Meanwhile, the city’s face is changing; literally.

Kiva Malick is an academician and a writer who focuses on education, philosophy, music and culture