In the past decade there have been some major changes to the way cosmetic procedures are done. You will find a preponderance of non-surgical options, technology that is a cut above what was available before, and for most treatments a much abbreviated recovery. There is also a concerted effort to deliver natural results that do not shout from the room. The patient pool has widened in terms of age and background; they tend to be more safety and value conscious, better versed on what is on offer and, one might say, guided by social media.
Cassian Holt would tell you that having been in service industries long enough he has seen how trends are as much about what people are afraid or too put out to ask of the front desk as they are the treatment per se. Beauty and aesthetics is no different. The last ten years have redefined what constitutes good work and altered expectations when it comes to a consultation or the aftermath of a procedure.
The Big Shift First
Make no mistake, the market has gone hard after any treatment that can show you a difference without the ordeal of the downtime associated with the surgical routes of yesteryear. Surgery is not off the table, but the middle ground has been quickly occupied.
Ten years ago it was a blunt choice: surgery or forgo it. Today the lane in between is well populated thanks to a host of minimally invasive procedures, from skin tightening and laser work to injectables.
Why Patients Are Different
These days a modern patient is after maintenance and prevention, perhaps a tweak, rather than something to make a spectacle of. Hence the vogue for pre-rejuvenation. One does not see younger adults so much as wanting to be younger as they want to put off the effects of age or weather them more uniformly.
Do not be fooled into thinking this is all a sudden outbreak of vanity. It is down to practicality. If you have to be at work Monday or put in an appearance at 3 pm for school pick-up, you are not going to put up with weeks of bruising and swelling indoors.
Non-Surgical Has Gotten Away With It
In commercial and cultural terms this is the change of the decade. Non-surgical work is the front door for a lot of patients who find it more affordable and not as final or daunting. Be it radiofrequency, laser resurfacing or injectables, some of these device-based treatments live up to their billing and some do not. That is the rub.
Injectables Go Mainstream
If you follow the Botox and dermal filler trends the story is plain to see. What was once fodder for the celebrity pages is now part and parcel of suburban talk. ISAPS and others like The Aesthetic Society or PlasticSurgery.org have reported on the volume of such treatments worldwide.
There is an obvious draw to it. It is a quick process and the results come in faster than with surgery. Call it a lunchtime procedure if you like, though that is somewhat disingenuous. Some will be lumpy or bruised for a few days and those who claim otherwise are putting a brochure in your hand.
Devices To Bridge The Gap
You will also see an expansion in resurfacing and laser systems, sitting as they do between skincare and the operating theatre. With more training for operators and refined settings the options are more bespoke. But then there is the matter of reality. No laser is a wand that will put right years of redness or sun damage in a single session. Expect to put in a series and pay for it, and the gains will be incremental.
A More Natural Look
Taste has changed. Many clinics have moved away from the “I have had work done” aesthetic in favour of something fresher and less fatiguing but still you. As Cassian Holt puts it, they want the sandwich but not one so overdone it makes a mess of itself in public. Subtlety is the order of the day now.
Prevention Over Correction
With pre-rejuvenation on the rise, younger patients are not waiting for laxity or loss of volume to become apparent before they put in a low-intensity intervention. One should not read this as a call for all to begin at an early age. Rather it is indicative of the language itself making way for maintenance in place of repair, a change that lies at the heart of what is fashionable in cosmetic surgery and its non-surgical counterparts today.
The Overfilled Look is no longer in vogue
Trends have a way of engendering regret as well as demand and that is where people are taken aback. Clinicians have been more forthcoming in the past ten years on the subject of fillers and the long-term toll of going after volume time and again: the puffiness, the migration, the facial imbalance.
So you will find a good deal of restraint in the approach of many reputable clinics these days, along with careful facial assessment and staged plans. In the mid-face or around the lips and tear troughs there is truth to less being more.
Surgery has not been idle
Non-surgical may have had the spotlight but surgery was not in the corner with the cards. There has been marked improvement in anaesthesia, scar management, post-operative planning and technique. A number of procedures are put together with an eye to precision and to limit recovery.
Be it body contouring, breast work or a facelift, one sees the same thing: greater customisation, proportion and a willingness to talk about how things stand in the long run as opposed to some instant fix.
A more refined facelift
The deep plane is the name on everyone’s lips when it comes to facelifts since it is about repositioning the deeper structures of the face and not just tautening the skin. Experience is not to be found in every clinic that claims to do them and they are not for all, yet the trend is towards results that are structural and enduring and not so windswept.
Do not be misled into thinking the new facelift is any one procedure. It is an assemblage of finer tissue handling, neck work and volume management to arrive at something less artificial.
Body contouring has become more practical
Techniques for abdominoplasty have evolved and patient marketing will make much of the no-drain tummy tuck. Provided the patient is suited to it, the advantage is plain: a recovery that is not quite so trying and fewer drains to see to.
But to think a deft technique takes the sting out of surgery is a mistake. There is still the pain and swelling, the limitations on movement and the need for time from work and attention to scars. “Minimally invasive” is not synonymous with easy.
Then there is technology
Workflow and outcomes have been put through their paces by technological advances. A consultation can be expected to have better imaging, standardised photography and precise planning, with teleconsultations making follow-up a formality. The process is smoother for the patient from enquiry to review; for the clinic it is a matter of having your options and documentation in order to avoid surprises.
Shorter recovery times
Some treatments have more lenient recovery than their predecessors thanks to updated aftercare, better suturing, less aggressive energy and so on. But in practice many come unstuck over recovery. They have put aside the money for the procedure but overlook the soft costs of it: the pharmacy bills, compression garments, transport, childcare and the irritation of not feeling entirely human for some time.
Consultations are not what they were
Teleconsultations are de rigueur now for an initial screen or to get access across state lines. They are convenient and a time saver but they have their boundaries. When it is a question of anatomy or surgical planning, as in revision cases or with facial and body work, a video call for triage and education is no substitute for an examination.
The patient is a different proposition
Forget the old stereotypes. The mix of patients is far broader, from younger adults and men to older ones wanting to maintain their looks, and skin tones and cultural proclivities that were not always accommodated. Diversity is a factor in aesthetic medicine, not an afterthought; it has bearing on everything from device settings and risk to the definition of “good”.
Men in particular have made their presence felt in the market. Anti-wrinkle, hair restoration, eyelid and body work are sought after more by men of late. The stigma has gone. They may be quieter about it and later to the party than women but they are not uncommon in the clinic. As Cassian Holt would know from his time in hospitality, get one bloke to own up to having given it a go and lived to tell the tale and the next three will want to hear about it.
A good grasp of pigmentation risk and scarring, an appreciation for the way facial proportions and beauty ideals can vary from one culture to the next, are all part of what diversity in aesthetic medicine entails. One must recognise that a treatment which is right for one patient will not be for another; this is especially true with the use of laser resurfacing or more powerful energy devices on darker skin.
In such cases it is provider skill you will want to rely on, not marketing. You do not see a competent clinic treating every face as if it were some flat template and invite trouble by doing so.
The Demand Altered By Social Media
Plastic surgery and social media have become inextricably linked. The platforms have done much to make discussion of treatments de rigueur, put before-and-after pictures in front of people at every turn and in the process have made the distinction between salesmanship and education rather hazy.
There is merit in the wider public discourse and ready access to information that results. But then there are the pitfalls: expectations that have been run through a filter, a propensity to follow trends and the mistaken notion that any given treatment is without risk and easy to come by.
What Patients Misjudge
It is not uncommon for a patient to come in under the impression they require a certain procedure after seeing it on screen. When you get down to it, the problem could be laxity where one sees wrinkles, or skin quality, or even lifestyle, not just anatomy.
So the better consultations take time to put things in perspective. What is your goal? What is it you notice in daylight as opposed to under a ring light? And what would be a sensible outcome five years hence?
Safety Takes Precedence
Demand has grown and with it a necessary conversation on the training, regulation and safety of procedures. A market of this size will have its share of opportunists as well as fine clinicians.
Those in Australia would do well to look at credentials and regulation before looking for a deal. For information on safety one can turn to the Therapeutic Goods Administration, the regulator for therapeutic goods in this country and some of the products used in aesthetic practice.
Hype is no Match for Training
One can go to PubMed or PlasticSurgery.org, or the American Board of Cosmetic Surgery, ISAPS and The Aesthetic Society for trend analysis and general edification but that does not tell you about an individual practitioner’s scope. Nor does the fact that a name like Harley Street Skin Clinic or La Belle Vie Cosmetic comes up in a search mean standards are on a par.
Most put their emphasis on the product when they should be on the person administering it. Put a top of the range injectable in the wrong hands and the medicine is no better.
A More Complex Cost Structure
Accessibility and cost have evolved in a manner of speaking. There is more to be had at the entry level and marketing has got better at making regular maintenance seem unremarkable. Yet the outlay for upkeep over the long term is considerable; repeat a supposedly cheaper alternative to surgery enough times and it will run you to more.
Some will look at an invoice and think they have found the best option. Surgery tends to be steeper and the recovery more of an ordeal. Non-surgical may appear a simpler proposition but it is an open ended tab. Neither is superior. The question is whether it makes sense for your budget and tolerance for downtime in the long run.
| Area | About A Decade Ago | Current Pattern | For the Patient |
| Injectables | Niche affair, not much talk of it | Now mainstream with high demand, calls for subtlety | Skill and restraint of the injector is what you will see in the results |
| Facial Surgery | The tighter look was de rigueur | Structural refinements of a natural order are in vogue | Experience of the surgeon trumps the technique |
| Lasers/Devices | Broad claims, limited settings | Treatment pathways are more of a custom job | More than likely a series is called for |
| Recovery | Less room for manoeuvre in the follow-up, longer to recover | Telehealth and shorter recovery in some instances | Do not let them underplay the downtime |
| Patient Demographics | A narrow view of the typical patient | You will find a mix of age, gender and culture | Assessment is not one-size-fits-all |
Data Points
As for the statistics on plastic surgery, they are only as good as the source and will vary depending on the country and if surgical and non-surgical are being tallied together or apart. There is a consistency in the broad thrust of what one reads from industry and academia: non-surgical cosmetic work has seen robust expansion, injectables are still the volume leader, while surgery goes on with more discerning patient expectations and indications.
The ISAPS puts it in numbers, their annual surveys putting millions of aesthetic procedures on the world stage of late, injectable and facial ones in particular. One will find the same strong showing for minimally invasive treatments and a steady appetite for surgery in the trend summaries put out by PlasticSurgery.org and the Aesthetic Society. Then there is the matter of the PubMed literature; for ten years now it has been documenting an upturn in research on everything from safety and technology to demographic shifts and patient satisfaction.
Quick Practical Checklist
- Do not measure what is realistic for your face or body against some Instagram profile.
- When budgeting, think beyond the day of the treatment to the aftercare, reviews and any maintenance that may be called for.
- Have a look at credentials, how they handle complications and their training before you do the waiting room décor.
- And be cautious of those who would have you believe there is no risk or downtime, or that you might not need to be treated in the first place.
Who This Shift Suits
Patients in the last decade have had more scope for choice and personalised planning, as well as options that are more gradual. It is for those who prefer subtlety and staged improvements to making one dramatic move.
Not so much for the individual who is after a filtered fantasy or is driven solely by price and thinks a quick syringe and a good quote will see off structural issues or laxity.
One Takeaway
Should you retain only a practical point from this article, make it this: decision-making is all the more important given the size of today’s treatment menus. The most talked about trend is not necessarily the safest, nor is the latest option invariably the right one; natural results tend to be the product of a careful assessment, not an aggressive one. That is what has changed with cosmetic procedures over the past ten years, more than any technique or device.
Frequently Asked Questions
As a rule people are “just curious” when they ask these questions, but they are sensible enough to warrant an answer.
Why Does Dr. Phil’s Wife Look Different?
It is irresponsible to put a name to a procedure from a photograph. Public figures can look different due to ageing, weight, styling, make-up, lighting, image editing or treatment. Better not to take a celebrity as your guide.
What Is The Most Regretted Cosmetic Surgery?
You will not find one procedure that is universally regretted. It is a very personal thing, usually born of poor expectations or an unnatural outcome, or having made a hasty call. In conversation patients will speak of revision rhinoplasty, overfilled faces or body work with troublesome scars, but then again there can be complications or the wrong treatment for the problem.
Why Does Tom Brady Look Different?
Unless he says so himself, no one should be claiming otherwise. A change in expression or skin quality can be down to stress, age, grooming, photography or body fat. Speculation on social media and plastic surgery has a way of outrunning the evidence.
What Is The New Facelift Everyone Is Getting?
They will tell you it is the deep plane facelift, though the term is used liberally in marketing. What is in vogue is a better technique based on anatomy for neck definition and support that will last, with less reliance on a label.
Are Non-Surgical Treatments Safer Than Surgery?
For the most part there is less disruption and downtime. But non-surgical is not without its risks. An ill-advised treatment is a waste of time and money, lasers can cause burns or alter pigment, injectables are not immune to vascular problems. Proper aftercare, the skill of the clinician and the quality of the product are what makes it safe.
