Aesthetic medicine: what works, what is marketing

Sat, 25 Apr 2026 00:00:00 +0000

Abstract. Aesthetic medicine is one of the medical fields where the gap between scientific evidence and advertising narrative is widest. Some treatments have thirty years of solid literature behind them; others were born yesterday and live on sponsored trials and photographic promises. Here I draw the line, one by one, between what has real clinical foundations (botulinum toxin, hyaluronic acid fillers, some lasers, peels), what has an interesting biological rationale but evidence still being built (Profhilo, polynucleotides such as Plinest, new-generation biostimulators like Ellansé and Juvelook), and what travels almost entirely on marketing (HIFU as a “lift”, injectable vitamin cocktails, mesotherapy, carboxytherapy). First of a three-part series, written for those who want to understand before they choose; the second part is Skincare: actives, concentrations and medical grade.

When you walk into an aesthetic-medicine clinic, you are usually handed a menu. Toxin, fillers, biostimulators, skinboosters, polynucleotides, injectable vitamins, next-generation lasers, scalpel-free lifts, peels, microneedling, PRP. Prices change, names change every year, the promises do not: “natural rejuvenation”, “skin quality”, “collagen stimulation”, “lifting effect”. But behind this menu — almost always presented in identical language — lies an enormous gap in scientific evidence. Some treatments have thirty years of independent literature, randomised trials, well-documented safety profiles. Others have a handful of studies, often manufacturer-sponsored, and a mechanistic rationale that sounds convincing — but is not yet clinical evidence. Others still are pure narrative, propped up by before-and-after photos and the perceived authority of whoever is offering them.

There are two mirror-image mistakes when discussing aesthetic medicine. The first is wholesale rejection — “it’s all vanity, it’s all marketing, it’s all dangerous”. This is wrong because many treatments really do work, have medical as well as aesthetic indications, and improve the quality of life of those who choose them with awareness. The second is blind enthusiasm — “if it’s new it’s better, if it costs more it’s better, if everyone is doing it, it must mean something”. This is wrong because aesthetic medicine is one of the fields where marketing innovation systematically precedes clinical innovation, and where many technologies we now consider obsolete are still on sale.

Fillers on noema

Aesthetic medicine: what works, what is marketing