Since 2006, the International Association for Physicians in Aesthetic Medicine (IAPAM) has provided training, guidance, industry blogs and reports on the latest aesthetic trends to help aesthetic professionals excel in their roles as industry experts. Aesthetic physicians and other licensed providers greatly depend on critical information provided to them by reputable sources such as the IAPAM. The need to focus on the most popular procedures, as well as knowing what new procedures have come to market is paramount for this type of practice to be competitive and successful to meet patient demand.
2019 Aesthetic Trends
As 2018 comes to a close, we like to reflect back on the highlights of the year and set goals for the next one. Physical appearance is always on the top of that list. As technology and medical research continues to advance, non-invasive procedures are on the rise. Impressive results can be achieved so that a person’s physical appearance can be dramatically improved without having to go under the knife.
According to a study performed on the American cosmetic industry, the number of non-surgical procedures performed has increased by 461% since 1997. The use of Botox has gone up by 600%, a 205% increase was observed in soft tissue filler use and laser skin resurfacing is now 198% more popular. Surprisingly not all these numbers come from women as 10% of patients were men, leading to a 106% increase in the number of men that opt for aesthetic procedures in the last 20 years.
Cosmetic treatments have a major impact on the confidence and self-image of a patient. This is the reason nose jobs and breast enhancements will always remain popular. But many of the aesthetic trends we saw in 2018 were non-surgical. Also, the average age at which patients begin getting aesthetic treatments has gotten lower because people do not wait for the wrinkles to form and are taking pre-emptive measures to maintain their natural youthful appearance for as long as they can.
New technologies continue to develop to tighten, shape, lift and rejuvenate the skin. Patients prefer low-risk and pain-free non-invasive procedures over surgery and will continue to do so in the future because they have those options.
It is now more important to introduce subtle yet necessary changes to the face that slow down the aging process and make a patient look like the best version of themselves. There is no need to get a full face-lift when there are non-invasive and effective alternative procedures available.
One of the popular aesthetic trends for 2018 was a non-invasive procedure called Facial Contouring, where the face is restructured and sags are lifted. The procedure involves the use of gel filler injections that can lift the skin, reduce folds and wrinkles to create a brighter and younger looking face. Also adding volume and definition to the face to create a more youthful appearance was another trend for 2018. Patients went for filling up their cheeks to restore the lost fat and make the face look fuller. These two popular trends will continue in 2019, along with these top 5 non-invasive aesthetic trends.
#1 Defined Abs
Emsculpt® is a new technology by the manufacturer BTL that uses high-intensity electromagnetic waves to add definition to muscle, eliminate excess fat and produce a more sculpted body. Studies have shown improvement in the shape of the body for up to three months after the treatment.
The treatment consists of a 30-minute procedure with at least 4 sessions required with a 3-day rest period in between. There is no down-time involved and it is a painless non-surgical procedure that can make the abs more defined and lift the buttocks. The positive results are reported within two to four weeks after the last session has concluded and the appearance continues to improve for many weeks after the treatment.
The selling point of Emsculpt® is that it offers dual benefits. Not only does it destroy the fat cells by 19 percent after the procedure, but it also builds up the muscle fibers at the same time. This results in more defined abs and a rounder back-side. The technology causes the muscles to contract 20,000 times in 30 minutes and constricts them beyond their physical limit. It also targets the fat in the area which is something exercise cannot accomplish on its own.
Emsculpt® has also created a buzz in the celebrity world as more public figures are sharing their reviews. One of them is Dolores Catania, from a Real Housewives show and Lady Gaga was also seen at an Emsculpt® event held in New Jersey. Look out for this hot new trend!
#2 Platelet Rich Plasma (PRP)
The PRP or ‘vampire facial’ is a technique many celebrities like British actor Rupert Everett and model Bar Refaeli have had performed. However, it was Kim Kardashian who popularized the treatment by posting pictures from her procedure on social media.
The demand for PRP-related procedures has increased tremendously in the last few years. It is not only popular in the United States but is so all over the world. There is nothing more powerful than using your body’s natural healing powers to improve your appearance. PRP procedures had the largest share in aesthetic procedures for the last year and accounted for 58.1% of the total number of treatments.
Platelet-Rich Plasma as the name suggests requires harnessing the healing mechanism in a person’s blood to trigger the natural process in the skin. This is a quick and easy way to get the body to repair the damage and restore it back to its original state. A sample of the patient’s blood is taken and then spun at high speeds in a centrifuge to isolate the plasma rich with platelets. This is then injected back into the body to promote healing. The plasma can also be used in its gel-state to apply on chronic wounds.
The complete effect is only visible after a month and lasts up to 12 weeks. However, the cellular rejuvenation experienced after the PRP facial is unparalleled as collagen production is stimulated.
PRP has also shown promising results for hair rejuvenation and regrowth. It sends signals to the body which promotes the hair growth cycle. Injecting the platelet-rich plasma in the head can increase the number of individual hair strands and enhance their thickness as well. The results can be achieved safely and without having expensive procedures performed either.
#3 Non-surgical Nose Job
Non-surgical rhinoplasty also known as the ‘nose filler’ treatment is becoming popular amongst women as well as men. According to recent studies, the number of non-surgical nose job procedures performed has gone up by 29% in the last year. With this evident rise, the aesthetic treatment is going to be a top trend for 2019.
The treatment has been popularized by social media influence, the quick and easy treatments with little downtime involved. It can be used to lift the tip of the nose, smooth out any small bumps or curves on the bridge of the nose and make the nose smaller and more symmetrical. The dermal filler is carefully injected above and below the nose bump to make a hooked nose appear straighter. The tip of the nose can also be lifted by injecting Botox® in the nose muscle to continuously pull it down.
Many actors and singers have had their appearance tweaked by fillers and it is evident in most cases. Jennifer Anniston for example, is known for having procedures performed and she has experienced zero downtime because she has always been busy with one media project or another. In the fast-paced world of today, with social media on the rise and celebrities influencing our actions, people want quick results at an affordable price. Non-surgical nose jobs are giving more people the freedom to look the way they want.
#4 Laser Resurfacing Facial Treatment
Laser resurfacing is a facial treatment used to solve skin problems such as acne scars and facial wrinkles. With the help of a laser beam the skin is removed one layer at a time. There are two types of laser used i.e. ablative and non-ablative. CO2 or erbium lasers are the most commonly used ablative lasers for resurfacing treatments. Non-ablative laser resurfacing is done by fractional lasers, infrared lasers and high impact light sources.
The rise in skin problems such as wrinkles, acne, and pigmentation have led to a growing demand for aesthetic procedures. Most patients now want minimally invasive treatments which has contributed to the market growth in laser resurfacing facial treatments. Predictions show that laser resurfacing is expected to grow by 7.1% in the upcoming year because of their effectiveness at solving a host of skin problems without having surgery performed.
Different lasers vary in the problems they address. For example the CO2 laser is used as an ablative laser treatment for warts, scars, wrinkles and flaws that are embedded deep into the skin. The erbium lasers on the other hand promote the production and remodeling of collagen which is why it is suitable for patients with fine lines, wrinkles, age spots and sagging skin.
Pulsed-dye lasers are usually non-ablative and they heat up the skin to absorb pigments and reduce redness, broken capillaries, rosacea and hyperpigmentation. Then there are fractional lasers that distribute the laser energy into a thousand tiny beams of light to treat a very small section of the skin. This technique reduces down-time and can treat a number of age-related skin problems. Intense pulsed light is also a resurfacing treatment but the source used is not technically a laser. They can treat sun damage, rosacea, acne and hyperpigmentation.
The ablative technologies offer much better results however, longer recovery times are associated with these treatments. The non-ablative technologies can provide moderate results, no side-effects and very little downtime. Fractional laser is a new type of machine that can combine the best of both worlds i.e. impressive results with a short recovery time. There is a wide range of technologies that are being used by aesthetic clinics to help patients recover their lost confidence.
#5 Lip Injections/Fillers
In the forthcoming year the focus will shift towards creating a facial balance which means the lips will occupy a proportionate part of the face. Patients and physicians alike are moving towards the “less is more” philosophy. Over-filling the lips and making them grotesquely huge is no longer the order of the day and now people just want to enhance the shape of their mouth.
Even in Hollywood, oversized lip augmentation is not in vogue anymore and according to predictions this trend will not make a comeback any time soon. The shaping of lips will be more refined and it will mostly be for rejuvenation or asymmetry corrective purposes.
There are different types of dermal fillers that can be injected in the lips. The most common types are ones that contain hyaluronic acid. This is a natural substance that is found in the body and it helps increase the volume of your lips. Hyaluronic acid improves the appearance of the mouth by adding shape, volume and structure to it. The results from hyaluronic acid fillers last for up to six months after which patients need to get a follow-up procedure performed.
There are many types of dermal fillers that can be injected in your lips and around your mouth. But the most common fillers today are products that contain substances similar to hyaluronic acid. Only 0.5 to 1 ml of the filler is injected into the lips to create a natural fuller look however to create a heavy, enhanced appearance up to 2ml might be required for each session. A local anesthetic is applied before the procedure and then the administrator injects the filler using a couple of small injections. They will inject along the lip lines and the entire session will last only 15 to 30 minutes.
Another type of procedure is the ‘Botox® Lip Flip’ which involves the injection of Botox® in the muscles around the lips to produce a much more prominent pout. The hyaluronic acid fillers are injected inside the lip while the lip flips uses a different approach to attain lips much fuller than the ones you naturally have.
It is important that aesthetic practices and the physicians associated with them are conscious about the needs of their patients. Practices have to keep an eye out for the medical aesthetic trends as it is an evolving market. It is useful for them to understand all that is happening and then modify their marketing strategy accordingly to keep up with the times. Nobody wants their practice to lag behind and not grow as the market is growing.
Another market shift that has been observed recently is that the percentage of male clients consulting with dermatologists and aesthetic clinics is increasing. For 2019 the number is expected to increase even further. Men will be requesting facial fillers, lifting treatments and skin rejuvenation. Businesses should respond to the change in clientele and alter their facilities to accommodate the growing number of male customers too.
For the past 12 years the IAPAM has been providing hands-on CME training and has seen a strong continuous increase in these top 5 non-invasive procedures. Jeff Russell, IAPAM executive-director, says “Consumer demand will drive non-invasive procedures to the top of all aesthetic procedures once again in 2019.” It’s also important to note that these are all medical procedures, and they should only be performed by trained physicians or licensed healthcare providers.
IAPAM Top Aesthetic Trends for 2019 Infographic
Past 2018 Aesthetic Trends According to The IAPAM
Since 2006, the International Association for Physicians in Aesthetic Medicine (IAPAM) has been providing a platform for licensed practitioners of aesthetic treatments to learn about the aesthetic medicine industry. It has provided guidance and training, along with industry blogs and reports on the latest aesthetic trends, to help aesthetic professionals excel in their jobs. These aesthetic practitioners greatly depend on critical information provided to them and it helps them focus on getting well-trained in the procedures that are likely to experience rising trends.
As people age, their needs and requirements change. Hence, many older procedures are being replaced by newer ones. For example, there has been a continuous rise in the popularity of non-invasive procedures. There are new treatments in the market, such as Kybella®, Platelet Rich Plasma (PRP), radio-frequency and laser-assisted technology. These are slowly replacing longer and riskier surgical procedures.
Non-invasive procedures have been rapidly gaining popularity over time (Parker B. J., 2014). These are procedures that require little to no direct incisions or grafts on the body. There are several reasons behind their rising popularity. The first one is that they are less painful than invasive procedures. Secondly, they are less likely to cause immediate damage or risky side effects after the procedure. Invasive procedures are often considered to have a higher chance of not meeting patient expectations. Third, invasive procedures take a relatively long time to carry out. Lastly, patients need a longer period of rest and it takes them longer to recover from surgical procedures.
Non-invasive procedures are the opposite. One can undergo non-invasive procedures and experience little to no downtime. Also, they have proven themselves to be more reliable in terms of safety and results and success rates. Therefore, patients now prefer procedures that are more convenient for them. Physicians also benefit from non-invasive procedures as it puts them under far less pressure than their invasive counterparts. So far, both physicians and patients have given positive reviews for non-invasive techniques for aesthetics.
There is also a rise in the popularity of dermal fillers, Botox® injections and laser treatments. Reality TV stars, including the Kardashian family have very much contributed to setting trends in aesthetic treatments. According to a small-scale survey, 82% physicians revealed that celebrity influence was a major reason why younger people – “millennials” – opted for aesthetic procedures in the first place (Hilton, 2016). Another study showed that the main factor behind this was that younger people identify with celebrities and are thus prone to follow in their footsteps (Wen, 2017).
The overall theme of non-invasive procedures is leaning towards fat removal and vaginal rejuvenation.
Top Trends in Aesthetic Medicine in 2018
This is a treatment that has been growing exponentially in terms of popularity. In the past, even talking about such a thing was taboo. It was also not marketed much either. Now, however, vaginal rejuvenation is expected to continue to trend as it has become a more convenient procedure and prominent in media. The procedure was promoted by TV shows such as The Doctors. Many physicians have already added it to the list of services they provide.
Dr. Stevens, a plastic surgeon from California, claimed that modern non-invasive laser enhancements in vaginal rejuvenation is “the female Viagra” (Mann, 2017). He went on to say that non-invasive treatment options, which essentially tighten the vaginal muscles and improve lubrication through laser treatments, “involves only one short treatment with no downtime.” This makes it clear why it is going to continue to trend.
In the past, vaginoplasty was the main and only option for vaginal rejuvenation, which is a very painful, lengthy, and complicated procedure and requires a long recovery period. With the new non-invasive techniques, women can now go through the process without pain or lengthy downtime. One popular non-invasive procedure is the Femme 360™ procedure by BTL Aesthetics (8 Minutes That Can Change Your (Intimate) Life, n.d.). It takes only 8 minutes to perform, making it the shortest non-invasive vaginal rejuvenation procedure to date. It uses radio frequency waves and 360-degree volumetric heating, making the procedure very comfortable and convenient for females.
Sometimes, body fat may be too stubborn to get rid of through the traditional methods of rigorous workout routines or excessive dieting. This is where non-invasive fat removal techniques come in. Non-invasive fat removal techniques have eliminated risks otherwise associated with invasive processes, such as embolism, infections, and above all, the pain and long recovery caused by undergoing surgery. Non-invasive fat removal leads to a greatly improved body shape with minimal pain and lower risk. The results are permanent, given that one focuses on healthy life choices in future. There has been an increase of 18.7% in the popularity of non-invasive fat reduction during 2016 and continues to rise each year according to the statistics released by the ASAPS (American Society for Aesthetic Plastic Surgery). Hence, these easier non-invasive techniques will continue to grow. The most popular non-invasive fat removal procedures will continue to use freezing or heating of fat cells to naturally eliminate and dispose of them through the body. Fat removal of less common body areas are becoming more targeted through these procedures such as the removal of fat along the bra-line on the back, fat pockets above the knees, and the double chin.
One of the biggest procedures for fat removal in the chin area is Kybella®. It was made commercially available in 2016, after the FDA approved it in 2015. The double-chin-reducing procedure involves injecting a substance known as deoxycholic acid into fat deposits in the neck and chin which dissolves fat around the points of injection. Unlike some fat-reducing cosmetic procedures, such as liposuction, where the fat cells can repopulate post-surgery, the fat cells destroyed by the Kybella® treatment can no longer store or gather fat, meaning the double chin is permanently removed.
Another rising trend, even though surgical, is the replacement of fat to other areas of the body. One such procedure is the “Brazilian Butt Lift”. Even though it is a type of plastic surgery, it is considered minimally invasive due to lesser pain and shorter downtime experienced by patients as opposed to undergoing the Butt Augmentation surgery (Brazilian Butt Lift vs Butt Augmentation, n.d.). It involves the transfer of fat from one part of the body to another. This retains the patient’s fat in the body however, removing it from the “wrong places” and adjusting it into where it could be of more use for aesthetic treatment, that is, the buttocks (Slater MD, n.d.).
With the growing awareness of the importance of natural and healthy living, many are turning away from synthetic aesthetic options for rejuvenation. A growing trend for facial rejuvenation using treatments from the body’s own regenerative resources. One such advanced solution is stem cell therapy for facial rejuvenation. Even though it is in its infancy, this is a trend that is expected to grow. Here stem cells are extracted from the patient’s own fat, and then used in wrinkle treatments and correcting facial volume. (Stem Cell Therapy for the Face, Skin, and Hair, n.d.). Another facial rejuvenation procedure that involves using a patient’s body resources is the Platelet Rich Plasma (PRP) therapy, often referred to as the “Vampire Facelift”. PRP treatments involve the separation of plasma and platelets from a small sample of the patient’s blood. It is then inserted into the patient’s skin through a series of injections or through microdermabrasion. It supports the growth of collagen which makes the skin appear softer and smoother.
Another trend that has been trending and will continue to grow is Microneedling. This is also known as collagen induction therapy because it stimulates the skin into producing collagen by piercing or puncturing the surface of the skin with very thin needles.
Pharmaceutical companies are also working on launching a wider variety of face creams which slow down the aging process. The more recently developed anti-aging creams are more aggressive in fighting against the physical effects of aging by using aggressive anti-aging ingredients such as Retinol and Hyaluronic Acid. (Parker E., 2017).
Most people do not wait to reach an older age for eye rejuvenation and these treatments are sought for by the younger demographic. Common problems that people of all ages wish to eliminate is the look of tired eyes caused by crow’s feet, eye bags and dark circles from under the eyes. There are many dermal fillers, such as Restylane®, which add volume to the skin. Non-invasive procedures here are also more preferred. Volume augmentation around the eye area is a major trend in eye rejuvenation and can be achieved with both synthetic fillers such as injectable hyaluronic acid gel (Juvederm®; [Allergan] and Restylane® [Galderma]) and autologous facial fat grafting. Restoration of lack of volume around the eye specifically upper lid sulcus, the lower lid-cheek junction, the brows, the midface, and the temples can dramatically restore freshness and younger look in the eye area. In addition, injectable fillers are an excellent option for the patient who desires nonsurgical rejuvenation.
Another rising non-invasive procedure using radiofrequency waves and heating technology, is Exilis™ by BTL Aesthetics. This eye rejuvenation treatment serves as a solution to reducing fine lines and simultaneously tightening the skin around the eyes for a more youthful appearance.
Crow’s feet are commonly treated by Botox® injections too and they are expected to continue their rising trend. Chemical peels are also a popular choice, recommended by many professionals. They are good for treating hyperpigmentation (dark circles) under the eyes.
Usage for dermal fillers is expected to expand as we have seen many new procedures arise. Some of the procedures expected to trend are the non-surgical nose job, chin augmentation and liquid face lifts. Considering surgical procedures are on the downfall, dermal fillers were able to replace nose job and face lift procedures with much quicker and safer treatments. There is a rising demand for longer lasting and bulkier facial fillers. This has resulted in newer hyaluronic acid fillers that last longer, like Juvederm Voluma®. Voluma generally lasts for up to two years, much longer than other types of fillers. Another filler that is longer lasting is Radiesse®, a facial filler that has an average lasting period of 18 months. Radiesse® is made from calcium hydroxyapatite, substances found in teeth and bones. This facial filler is longer lasting because it helps the skin create additional collagen, resulting in rejuvenation. Sculptra, another longer lasting facial filler works similarly and can last up to 2 years as well.
Defined jawlines will continue to gain in popularity as more and more men and women desire a more defined chin and jawline. Non-surgical options for this are Allergan’s Voluma, along with Galderma’s Restylane® Lyft and Sculptra® dermal filler products.
The growth of non-invasive procedures continues to be strong with more and more procedures added to this segment. Once invasive facelifts and liposuction procedures were the only options, but now we are seeing effective, non-surgical alternatives. The IAPAM has been providing hands-on CME training for over 10 years, and has seen a strong increase in these non-invasive procedures. IAPAM executive-director, Jeff Russell, says “2017 was certainly the year of non-invasive fat removal and skin tightening, now we are seeing a strong demand for non-invasive vaginal rejuvenation. Consumer demand is going to drive non-invasive procedures to the top of all aesthetic procedures once again in 2018.” It’s also important to note that these are all medical procedures, and they should only be performed by trained physicians or licensed healthcare providers.
About the IAPAM: The International Association for Physicians in Aesthetic Medicine
The International Association for Physicians in Aesthetic Medicine is a voluntary association of physicians and supporters, which sets standards for the aesthetic medical profession. The goal of the association is to offer education, ethical standards, credentialing, and member benefits. IAPAM membership is open to all licensed medical doctors (MDs), dentists (DDSs/DMDs) doctors of osteopathic medicine (DOs), physician assistants (PAs) and nurse practitioners (NPs). The IAPAM offers aesthetic medicine and medical weight management programs, including: Botox training, medical aesthetic training, laser training, physician medical weight loss training, and aesthetic practice business training. Additional information about the association can be accessed through the IAPAM’s website (https://iapam.com).
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