As the use of medical aesthetics treatments expands, the field is moving away from excessive volume correction toward a focus on natural balance and improved skin quality.

As the proportion of surgical procedures decreases, minimally invasive procedures are expanding, and a strategy focused on maintaining long-term safety and efficacy is becoming more critical.

DailyPharm met with Dr. Jonathan Kadouch, a dermatologist in the Netherlands, to discuss trends in global medical aesthetics and strategies for safety management in injectable procedures.

"From overcorrection to balance...natural aesthetics is trending"

Dr. Kadouch explained that the most significant recent change in the field of medical aesthetics is the 'transition from overcorrection to natural harmony.'

"Over the past 20 years, surgical procedures have decreased, and minimally invasive injectable procedures have become the mainstream," he said. "The focus is shifting from simply adding volume to restoring balance, considering the face's structure and tissue changes."

Notably, strategies to enhance the skin's inherent quality and its regeneration process are currently gaining attention.

Dr. Kadouch said, "Regenerative aesthetics is not just about creating volume, but about creating an environment where tissues can heal themselves," and added, "As interest in regenerative medicine, such as quality improvement, is growing, the medical aesthetics trend is evolving toward prioritizing procedure safety."

Dr. Kadouch also emphasized, "In the past, artificially correcting many areas of the face was popular, but now, both patients and medical professionals prioritize natural and long-term sustainable results."

"HA and CaHA differ in mechanism and complication management"

The major injectable agents are Hyaluronic Acid (HA) fillers and Calcium Hydroxylapatite (CaHA). Although they appear similar, the two agents differ in their mechanisms of action and approaches to managing complications.

First, HA fillers are characterized by their degradability with hyaluronidase. This allows for immediate management should side effects occur or if aesthetic adjustments are needed during the procedure.

In contrast, CaHA is a microparticle that induces collagen and elastin production as it gradually degrades in the body.

Dr. Kadouch distinguished them, explaining, "HA is a natural component of the human body found in joints, eyes, and skin, and has established itself in the medical aesthetics market for improving volume and wrinkles." He added, "CaHA is a biostimulator that promotes tissue regeneration, where anatomical understanding and the precision of the injection layer determine the treatment outcome."

Given the high interest in minimally invasive procedures and safety, the approach to managing complications differs between HA and CaHA.

Dr. Kadouch explained, "The biggest advantage of HA filler is its reversibility, meaning most issues can be managed by dissolving the filler using hyaluronidase." He noted, "CaHA lacks a dissolving enzyme, requiring an algorithm-based approach to reduce particle concentration or induce tissue diffusion."

Dr. Kadouch also mentioned, "The lack of a specific dissolving agent can be a burden for practitioners with limited clinical experience with CaHA. However, as CaHA is increasingly used for regenerative purposes rather than volume correction, the risks of complications and side effects have significantly reduced compared to the past."

"Evidence-based product selection and patient expectation management are key"

Notably, Dr. Kadouch emphasized that while complications and adverse reactions from filler procedures are often multifactorial, selecting products based on scientific evidence is crucial for ensuring procedure safety.

"The more clinical papers and research results a product has accumulated to prove its safety and efficacy, the higher the confidence a practitioner can have in selecting that product," Dr. Kadouch said. "Therefore, rationale decision-making based on objective data and literature is the starting point for safe procedures."

Dr. Kadouch said, "Some biostimulator agents have long-proven safety and efficacy," and added, "In contrast, some rapidly expanding new products lack sufficient data accumulation, necessitating a cautious approach."

He also explained that with the increase in patients requesting specific procedures seen on social media, the consultation process is important for managing patient expectations.

Dr. Kadouch stated, "As information dissemination through social media accelerates, the speed at which specific procedures or products become trends has also become very fast. Combined with new products and marketing, physicians in the medical aesthetics field face greater challenges than before."

However, Dr. Kadouch believes that medical professionals must uphold their medical convictions and ethical standards while still meeting patient expectations amid this changing trend.

Dr. Kadouch emphasized, "If medical professionals present scientific evidence and logical reasons, many patients understand and prioritize safety in their decisions," and stressed, "Adequately guiding patients on the limitations of expectations and the criteria for safe product selection is essential not only for medical ethics but also for providing trust-based treatment."

Finally, Dr. Kadouch projected that the future of the medical aesthetics field will center on improving skin quality, long-term maintenance treatment, and combined-procedure strategies.

Dr. Kadouch said, "Across the industry, invasive procedures are being minimized, and the shift toward minimally invasive or non-invasive procedures is clear and expected to continue," and added, "Combining the advantages of different procedures to improve overall skin quality is expected to become the core trend in the aesthetics field."