AESTHETIC TRENDS: THEN, NOW AND BEYOND

Nurse prescriber Julie Scott looks back on the trends that have accompanied her 20 years in aesthetic medicine and gives her insight into what she believes 2025 holds

Trends in medical aesthetic treatments come and go, just as they do in fashion. I have witnessed this first hand in the 22 years I have spent in the industry – the way its growth has ebbed and flowed, the rapid advancement of the technology available to us, and the vast array of changes that have emerged because of it. All of this has impacted the evolution of our patients, resulting in an industry diversified through the pursuit and application of knowledge.

While the history of aesthetic medicine can be traced back to the cosmetic surgery boom in the nineteenth century, my interest lies in reflecting on the industry’s developments since the turn of the millennium which have made treatments increasingly accessible to patients, allowing trends to unfold. This era was still a moment of emergence; medical aesthetics was not yet a recognised speciality.

Even so, our practice has always been shaped by our understanding of the ageing process, but at this point the knowledge we held was not as nuanced or in-depth as it has grown to be. Training was not available from educators, so we received it instead from the pharmaceutical companies themselves. This seemingly subtle difference in the origin of our knowledge manifested in our practice, with early patient journeys often chasing a line.

Beyond our own knowledge, the technology accessible to us was similarly taken at a base level. In 1989, Allergan’s Botox became the first toxin treatment to receive FDA approval; for an extended period this was reflected in the classic shiny foreheads and raised brow looks we are all familiar with and have now turned our back on. This trend, no longer in vogue, was a direct result of the lack of sophistication our practitioners could execute with the treatments in their contemporary form.

This cause and effect asks the key question – were trends in aesthetic medicine motivated by appetite or availability? Where these trends were observed at the time because of a multitude of patients presenting with the same result, upon reflection this popularity may have been a result of patients simply having the few procedures available to them. My clinical practice has always been focused on achieving natural results through holistic and subtle approaches. However, the rise of the overfilled syndrome in the industry more broadly during the 2010s not only represented the increased interest in dermal fillers but was also indicative of a patient demographic which was keen to receive multiple treatments.

MORE SOPHISTICATED DELIVERY

The demand for a more sophisticated delivery of aesthetic procedures has been mirrored by a heightened understanding among medical professionals of the necessity for control over access to the procedures themselves. This population who sought out aesthetic procedures became, and to a great extent still is, viewed by some underqualified aestheticians less as a patient group and more as a market. The Keogh Review, published in 2013, made pioneering demands for the urgent need to provide substantial regulation to prevent unlicensed treatments and ensure standard practice sees medical professionals put patient safety front and centre. When I consider the future of aesthetics, I see an environment where this call for safety is not a restriction for patient accessibility, but where it goes hand in hand with their wants.

As more holistic and sustainable approaches to aesthetics gain popularity, it seems that our industry will begin to increasingly align with the wellness domain. Looking good and feeling good go hand in hand; it is vital that patients not only feel good because of the appearance of their results, but because of a fulfilling patient journey from start to finish.

Underlining this journey is the elevation of patient autonomy. As technological advancements diversify the treatments possible for us to offer them, our patients have more choices to make. It is becoming increasingly rare for a patient to present with just one concern and for practitioners to respond with just one treatment modality. The development of regenerative medicine and its application to aesthetics not only provides another treatment modality to offer in our clinics but also allows us as practitioners to begin preservative work with younger patients not yet presenting with significant signs of ageing. Working with our biology, not against it, regenerative medicine is in my opinion, an increasingly key ingredient in the patient journeys that we craft.

I believe that the direction of our industry’s future trends will be shaped equally by the decisions of our patients as it is by those who advise on and administer their treatments, or by the companies developing the products that end up in their practitioners’ hands. This ability for patients to select from a wide-ranging menu of treatments will only drive competition between developers of aesthetic treatments, inevitably vying to produce the most desirable results. While the threat of unregulated products will continue to exist until real government action is taken to intervene, I hope that as technological advancements continue this competition will drive the production of even higher quality medical aesthetic products with the motivation of becoming the next genuine trend in the industry.

DEVELOPING TRUST

The incentive for practitioners and products to develop trust with their patients and deliver high-quality results every time has only increased as a result of the shifting social attitudes towards medical aesthetic treatments. When I was starting in aesthetics 20 years ago, there were no interpersonal referrals; now this is a frequent experience at my clinic and a crucial component in developing my patient base. The population’s collective interest in new treatments is being magnified and accelerated by the reduced taboo around the topic. Consequently, the discussions our patients are having with each other, independent of industry input, are shaping the market for medical aesthetics through the creation of a reciprocal relationship between the development of technology and the wants of our patients.

With the future now held half in our hands and half in the hands of our patients, it will be fascinating to watch what aesthetic trends emerge over the next decade or two. ‘As they say, history does not repeat itself but it rhymes’ noted Margaret Atwood, known for her piercingly insightful dystopias and ability to project the events of our past into our future. Now that we can offer our patients a diverse portfolio of medical aesthetic treatments from which they may select themselves, only time will tell what trends of the past may return.

The industry is positioned for an era of unparalleled technological advancement and I am so thrilled by the promise of seeing its potential realised. Whether this is via the introduction of new treatments in my clinic, or through witnessing breakthroughs in research from afar, the prospect of involvement in and observation of the future of aesthetic medicine is an incomparably exciting one. What I most look forward to gaining from this progress, however, is a regulated industry that harnesses its advancements to solidify the safety of its patients. A future in which technology and safety advance side by side, enhancing one another for the benefit of practitioner and patient, is undoubtedly a future to be excited about.

JULIE SCOTT

Julie Scott is an NMC registered Independent Nurse Prescriber, Level 7 qualif ied aesthetic injector and trainer with over 30 years of experience in the field of plastics and skin rejuvenation. As an aesthetic mentor and international speaker, Scott has won ‘Aesthetic Nurse Practitioner of the Year’ at the Aesthetic Medicine Awards in 2024, and at the Aesthetic Awards in 2024 and 2022. Her clinic also received the ‘Best Clinic South of England’ award at the 2023 Aesthetics Awards. She also sits on the Aesthetics Reviewing Panel for Aesthetics Journal, is a Board member for Dermatology Aesthetic Nurses Association Ireland (DANAI) and is a KOL for the JCCP and several leading aesthetic brands.