Cosmetic medicine has revolutionised how we approach ageing, making treatments accessible to women from all walks of life. Options range from Botox (botulinum toxin) to Dysport, or Xeomin, that smooths frown lines, and various fillers that restore lost facial volume like Juvéderm, Restylane, and Belotero. Today, a treatment can enhance and rejuvenate the skin at any age. It's no surprise, demand for these procedures is increasing, and treatment options are expanding. The global cosmetic medicine market is projected to reach $35.32 billion by 2030, coinciding with the prediction that one in six people worldwide (approximately 1.4 billion) will be 60 or over in that same year.
With technological advancements, the array of treatments now available is extensive. These options aim to reverse the signs of ageing and prevent wrinkles, encouraging the skin to function more youthful and maintain its natural moisture and suppleness for a glowing appearance. Trends are also evolving; today, consumers seek natural results delivered by skilled practitioners who can sculpt and enhance features judiciously.
Despite the wealth of options and increasing knowledge, misconceptions about cosmetic procedures and their safety persist. Editor Trudi Brewer speaks with Dr. Ellen Selkon, a skilled physician at Clinic 42, to address the myths surrounding cosmetic medicine, discuss which treatments are likely to endure over time, and why there are still lingering misconceptions around practices and safety.
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“Everybody wants to look radiant and healthy, and glowing skin is the best way to do that. Therefore, anyone can have biostimulators or regenerative skin treatments.”
Dr Ellen Selkon knows her way around the cosmetic medicine industry. She has 18 years of experience, is an industry trainer and a key opinion leader among her peers. Still, most importantly, she understands what women seek, the hesitations, and expectations, while driving change. “We are entering the age of regenerative medicine. Even though Botox is still the most popular treatment, we are seeing a decline in filler usage. This does not mean that fillers are unnecessary anymore; they are, but judicious usage and using small amounts of filler in the correct anatomical place are all important. We now use regenerative treatments, such as Profhilo, to enhance collagen and elastin formation and biostimulators (which communicate with the cells to stimulate the body's natural collagen production) to build tissue.” Below, Dr Selkon shares her advice on navigating the myths and truths and answering some of the most commonly asked questions on what’s available in the appearance medicine market.
How has Botox evolved since its launch as a cosmetic medicine 23 years ago?
Initially, we used much higher doses of Botox and only the frown lines were treated; we have subsequently learnt the art of Botox and dosage for individuals. We also successfully treat the entire face and some medical conditions like hyperhidrosis (excessive sweating) and bruxism (grinding teeth).
Could you explain the difference between Botox and fillers?
Botox is a medication injected in micro amounts into the muscles to stop their movement temporarily (it works by blocking the muscle action, causing a temporary paralysis of the injected muscle) so that facial lines and creases improve or stop occurring. It can lift features such as the eyes or corners of the mouth along with relaxing lines. Fillers are mostly made from hyaluronic acid, a natural substance injected into various layers of the face to volumise, create structure, and lift various features of the face.
What is baby Botox?
It is Botox but used in tiny amounts, so it looks very natural.
Does Botox last longer in different areas of the face?
Yes, it does, but that is only because we can’t use high doses in certain areas. Botox should last anywhere from three to six months, but in certain areas, like around the mouth and the forehead, you can only use small doses; otherwise, you would drop the forehead, creating a heavy brow look. Therefore, how long it lasts is often dose-dependent. If you put less in, it lasts a shorter time.
What can you expect with neck Botox?
Neck Botox is a very simple procedure that tightens the skin and gives you a bit of a lift. We inject it into the neck bands and along the jaw line into the platysma muscle (spanning from the chest to the lower jaw), which pulls the mouth down to stop this from happening.
What are the potential side effects of Botox?
Luckily, Botox is a very safe procedure with minimal side effects. It can inadvertently be injected into the incorrect muscle, causing adverse effects; in rare circumstances, you can get some flu-like symptoms.
What is the future of fillers? What's new in 2025?
We will always need fillers to redefine facial structure and lifting, but the trend of using them superficially continues. We are now using biostimulators, regenerative products, and products that work on a cellular level so our bodies can do the work over time to regenerate healthy, youthful tissue.
The latest filler trend of 'glowifier' rather than 'volumiser' has taken off. Who is the best candidate for this treatment?
Who doesn’t want glowing skin? Everybody wants to look radiant and healthy, and glowing skin is the best way to do that. Therefore, anyone can have biostimulators or regenerative skin treatments.
How should you prepare for a filler treatment?
We don’t want you to have filler treatments within two weeks of any dental treatment, including hygiene appointments, as there are circulating bacteria after these treatments. No COVID or vaccinations, as these can react with the filler in the acute phase. We would like you to be well and not travel overseas within two weeks to ensure you don’t get any complications.
How do you use fillers today vs. ten years ago?
Gosh, this has changed over the years. We know the anatomy of the face intimately, all the potential pitfalls, and where to put filler to give us the best lift and effect. We no longer just treat lines on the face. Also, the products have changed, and we now have various fillers for different areas and depths.
What are the potential side effects of fillers?
Unfortunately, most people don’t realise that fillers can potentially have very serious side effects. Luckily, these are extremely rare. From blindness when treating the area between the eyes (labella) and the nose to even a stroke if the former occurs. Other serious ones are when the filler is injected into an artery and needs to be dissolved (that’s why it’s important to use dissolvable fillers), which can lead to tissue breakdown and scarring. Immune responses can also occur, creating granulomas, which form hard lumps, which are also very rare. The most common side effects are bruising, bleeding, pain with injection and overfilling.