Why We Don't Follow Social Media Trends
and why that Is good news for your face
The Problem with Trends in Cosmetic Treatments
Every few months a new treatment becomes the aesthetic industry's obsession. Here is why we approach those moments with scepticism and why you should too.
The trend cycle in aesthetic medicine
It starts on Instagram. A celebrity mentions a treatment, an influencer documents their experience, a hashtag accumulates momentum. Within weeks, clinics are adding it to their menus, training academies are offering weekend courses, and patients are arriving at consultations asking for it by name.
A new treatment may be entirely legitimate or it may be under-tested, over-hyped.
Social media cannot tell the difference.
Sometimes the treatment in question is genuinely useful and the enthusiasm is warranted. More often, the excitement has considerably outrun the evidence and by the time the cycle moves on to the next thing, a significant number of patients have had a treatment they did not need, delivered by a practitioner who learned it last month.
This is the trend cycle in aesthetic medicine. At the Cosmetic Doctors Company in Surrey have watched it operate for over twenty-five years. And we do not follow it.
Why trends are not the same as advances
There is an important distinction between a genuine clinical advance and a trend. A genuine advance — the development of hyaluronic acid fillers with better rheological properties, the growing evidence base for biostimulators like Profhilo, the deepening understanding of how Botox works at a neurological level — represents a real improvement in what we can offer patients, supported by credible science and clinical experience. We embrace those developments and incorporate them into our practice when the evidence warrants it.
A trend is something different. It is a treatment that has become popular not because the evidence supports it but because the right people have talked about it in the right places at the right time.
The treatment may be entirely legitimate or it may be undertested, overhyped, and delivered by practitioners whose training consists of a weekend course and a box of product. Social media cannot tell the difference between these two things. A well-lit before-and-after photograph looks the same whether it represents a genuine clinical achievement or a carefully selected result from a treatment that failed most of the patients who received it.
The followers problem
We have written about this before in our piece on celebrity culture and the aesthetics industry, and in our piece on why followers are not qualifications. The point is worth revisiting here because it is directly relevant to how trends propagate.
An influencer with a million followers who documents their Botox is not providing clinical evidence.
An influencer with a million followers who documents their Botox, their dermal fillers, or their latest biostimulator treatment is not providing clinical evidence. They are providing a single anecdote, selected because it produced a result worth sharing, delivered in a context, that is good lighting, professional photography, a motivated subject, designed to present the best possible outcome.
The treatment that produced a bruise, or a disappointing result, or a complication, does not make it to the feed. The selection bias is absolute and entirely invisible to the audience consuming the content. Let us not forget that Influences are ‘influencing’ for the financial rewards that come from having thousands of followers.
This matters because the patients who arrive at our clinic asking for a treatment by name, having seen it on social media, have often formed their expectations based on exactly this kind of curated, unrepresentative evidence. They deserve an honest conversation about what the treatment can actually achieve for their specific face, which may or may not resemble what they saw on a screen.
What we do instead
Our treatment decisions are guided by peer-reviewed evidence, many years of clinical experience, and individual patient assessment; not by what is currently generating engagement on Instagram.
When a new treatment arrives, we ask the questions we outlined in our Evidence Problem piece:
who funded the research ?
what did the methodology actually show ?
has the result been independently replicated ?
does the claimed mechanism correspond to a plausible biological reality ?
That process takes longer than adding a new treatment to a menu. It means we are occasionally slower to adopt something genuinely useful than clinics that move faster. We consider that an acceptable trade-off, because it also means we are considerably less likely to offer something that does not work, or that works less well than the established alternatives we already use.
When a new treatment arrives that clears our initial evidence threshold, our approach is deliberately gradual. We may try it with a small number of patients, all of whom are fully informed that the treatment is under our own clinical evaluation and that the results may or may not live up to its promise. If those early outcomes are encouraging, we extend cautiously to a few more.
Only when the results consistently justify our confidence does a treatment become part of our regular practice. It is a slower process than simply adding something to a menu because it is trending. It is also, we believe, the only responsible way to introduce anything new into a clinical setting.
The treatments we offer — Botox for dynamic lines, hyaluronic acid dermal fillers for volume restoration, Profhilo and other biostimulators for skin quality, medical-grade skincare for the daily foundation are not the newest things available. They are the things with the strongest evidence base, delivered by medical doctors with the deepest clinical understanding of how and why they work. That combination is not exciting in the way that a trending treatment is exciting. It is, however, considerably more likely to produce a result you will still be happy with in five years.
The patient this piece is written for
If you have arrived here having seen a treatment on social media and wondering whether it is right for you, that is an entirely reasonable starting point. Social media is where most people begin their aesthetic research, and there is nothing wrong with that. The question worth asking, before booking anything, is whether the enthusiasm you have encountered reflects genuine clinical evidence or simply successful content.
A practitioner who can answer that question honestly, who can tell you what the evidence for a treatment actually shows, what its limitations are, and whether it is genuinely the right choice for your specific concern, is one worth trusting. That conversation, rather than the trend that prompted it, is where good aesthetic decisions are made.
Further reading:
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