The Evolution of Aesthetics: Insights from the FACE Conference

The decline of the “Instagram face”

For years, aesthetic medicine was dominated by a single, recognisable look — the “Instagram face”: overfilled lips, over-sharp jawlines, frozen expressions. The clear direction of recent industry conferences and clinical practice is a move away from that, toward results that look like a well-rested version of you rather than a different person. This is a trend observation from practice and conference discussion rather than a formal statistic — but it’s a consistent one, and it’s changing how thoughtful clinicians treat.

The dermal filler reality check

The most clinically important shift is a more cautious attitude to filler volume, driven by mounting evidence that dermal fillers can persist, encapsulate and migrate far longer than once assumed — sometimes years after injection. According to PubMed, this is not theoretical. A 2026 case report describes hyaluronic acid filler causing delayed upper-eyelid oedema appearing more than two years after a temporal injection, in tissue distant from the original site; orbital MRI was unremarkable and the diagnosis was only confirmed on histopathology after surgery, when the patient finally recalled the earlier treatment (El Feghaly & Tawa, 2026, Plastic and Reconstructive Surgery Global Open, DOI). A separate 2025 case report describes surgical removal being required for filler that had persisted and migrated years after treatment (Zhang & Pan, 2025, International Journal of Surgery Case Reports, DOI).

Individually these cases are rare. Collectively they explain why many practitioners have abandoned high-volume “liquid facelift” approaches for something more conservative and strategic — and why product choice matters more than headline longevity. A material that lasts a long time is not automatically a good thing if it can’t be reversed when something goes wrong.

Why “reversible” beats “permanent”: the material spectrum

A widely referenced way to think about injectable safety sorts products by risk profile rather than by brand:

• Lower-risk — hyaluronic acid (HA) fillers. Predictable and, crucially, reversible: the enzyme hyaluronidase can dissolve them if there’s a problem such as a vascular event or unwanted migration.
• Intermediate — collagen-stimulating biostimulators (poly-L-lactic acid, calcium hydroxylapatite, polycaprolactone). These work by prompting your own collagen rather than adding inert volume, but they are not reversible in the same way and carry a real, if modest, rate of nodules and, rarely, vascular complications (see below).
• Higher-risk — permanent or semi-permanent materials (silicone, PMMA). Higher risk of infection, granuloma and migration, with no easy exit route — the class most often implicated in the delayed-complication case reports above.

The rise of regenerative medicine

The centre of gravity in aesthetics is shifting from filling to regenerating — supporting the skin’s own collagen and elastin rather than simply adding volume. Several approaches now have a growing (if still imperfect) evidence base:

Biostimulators. According to PubMed, a 2024 systematic review of poly-L-lactic acid, calcium hydroxylapatite and polycaprolactone found genuine improvements in skin texture, elasticity and contour through collagen induction — while candidly reporting adverse events (erythema, bruising, nodules) in 15–30% of cases and rare severe complications such as granulomas and vascular occlusion, plus a lack of molecular understanding of how the agents work (Tam et al., 2024, Aesthetic Plastic Surgery, DOI). Regenerative does not mean risk-free.

Polynucleotides. A 2024 systematic review found polynucleotide injections showed promising, statistically significant improvements in wrinkles, texture and elasticity with mostly mild, transient side-effects — but rated the underlying studies as low-to-moderate quality and called for rigorous trials before firm conclusions (Lampridou et al., 2024, Journal of Cosmetic Dermatology, DOI). Genuinely promising, not yet definitively proven.

Better-tolerated topicals. On the skincare side, bakuchiol — a plant-derived retinol alternative — is the standout. According to PubMed, a randomised, double-blind trial found bakuchiol produced improvements in photoageing and hyperpigmentation comparable to retinol, but with significantly less scaling and stinging (Dhaliwal et al., 2018, British Journal of Dermatology, DOI).

A note on healthy scepticism

Not every “regenerative” ingredient earns the label. Some actives promoted in this space — certain amino-acid blends, or botanical extracts marketed for “collagen reorganisation” — have far thinner published evidence than bakuchiol or the biostimulators above, and a few have no peer-reviewed clinical support we could locate at all. The honest position is to treat those as emerging and manufacturer-championed until a primary study exists, rather than adopting the marketing language as fact. A clinic that tells you what isn’t well-proven is usually more trustworthy than one that claims everything works.

Where regulation is heading

Worth knowing as context: in the UK, non-surgical injectables have historically been far more lightly regulated than the public assumes — most dermal fillers are not prescription medicines, and who can inject them has been loosely controlled. The direction of travel (and of stated government intent) is toward a licensing scheme for non-surgical cosmetic procedures, precisely because of the complication and reversibility issues described above. Until that lands, the burden of asking good questions sits with the patient — which is exactly what the conservative, evidence-led approach is designed to support.

Final thoughts

The direction of aesthetic medicine is toward ingredients and techniques with real biological support — better-tolerated actives, more conservative filler volumes, regenerative approaches that work with the skin — and a growing respect for a simple truth: “reversible” and “temporary” are not the same thing in practice. The best outcome is rarely the most product; it’s the right, safest amount, chosen in consultation.

References

According to PubMed, the sources cited above are:

• El Feghaly C, Tawa P. Late-Onset Upper Eyelid Edema Following Temporal Hollow Correction With Hyaluronic Acid. Plast Reconstr Surg Glob Open. 2026;14(4):e7612. DOI
• Zhang W, Pan Y. Iatrogenic migration from multiple filler injections for tear trough: A case report. Int J Surg Case Rep. 2025;136:111941. DOI
• Tam E, et al. A Systematic Review on the Effectiveness and Safety of Combining Biostimulators with Botulinum Toxin, Dermal Fillers, and Energy-Based Devices. Aesthetic Plast Surg. 2024;49(10):2809–2833. DOI
• Lampridou S, Bassett S, Cavallini M, Christopoulos G. The Effectiveness of Polynucleotides in Esthetic Medicine: A Systematic Review. J Cosmet Dermatol. 2024;24(2):e16721. DOI
• Dhaliwal S, Rybak I, Ellis SR, et al. Prospective, randomized, double-blind assessment of topical bakuchiol and retinol for facial photoageing. Br J Dermatol. 2018;180(2):289–296. DOI

General educational content only; not medical advice. Product categories are discussed generically for education and are not endorsements of any brand. Any treatment decision should be made in consultation with a qualified practitioner.