Picture this: It’s fall in Chicago and the country’s top cosmetic dermatologists are all in one place, comparing notes on what’s working, what’s fading out and what’s about to define the next year of aesthetic medicine. The American Society for Dermatologic Surgery meeting made one thing clear: beauty is shifting toward safer treatments, regenerative technology and hyper-personalized plans powered by the newest devices and injectable science.
So what does that mean for us? Expect smarter fillers, energy treatments that fight gravity and rising conversations about lasers and procedures designed with more skin tones in mind. Above all, one of the biggest shifts we’re seeing isn’t a trend at all, but a renewed focus on improved skin quality instead of quick fixes. NewBeauty was there—and here’s where aesthetics is headed next.
Injectable Updates From the Show
Two of the biggest names in injectables—Galderma and Allergan Aesthetics—came to ASDS with updates that point to where treatments are headed next: better skin quality, softer contouring and more options for areas beyond the face.
On the skin-quality front, both brands hinted at what’s coming for the chest and neckline. Galderma shared investigational data on Restylane Skinboosters for the décolletage, signaling that smoother, more hydrated chest skin is becoming a real focus. Allergan is moving in the same direction, revealing new clinical data supporting its request to expand SKINVIVE to horizontal neck lines, a notoriously hard-to-treat area.
On the toxin front, both companies also signaled a new chapter. Galderma presented new phase III data on investigational Relfydess, a next-generation neurotoxin, while Allergan shared new clinical results on TrenibotE, their own fast-acting, short-term toxin.
Allergan also hosted a panel tied to its recent report on hyaluronic acid injectable fillers, “The Aesthetic Evolution: Redefining HA Fillers Through Education.” Led by Melanie Rud with experts Dr. Terrence Keaney, Dr. Sabrina Fabi, Dr. Patricia Ogilvie and Dr. Kavita Mariwalla, the conversation zeroed in on what consumers want most: safety, transparency and believable results.
Recent FDA Headlines That Resonated at ASDS
Two major FDA updates shaped conversations at ASDS and signaled that aesthetic dermatology is entering a more transparent, safety-driven era. The FDA’s warning about certain radio-frequency microneedling devices and the risk of burns, fat loss and nerve damage came up repeatedly among dermatologists. Houston dermatologist Kemunto Mokaya, MD, reflected the concern clearly. “There are a lot more people doing microneedling now, especially with radio frequency and many people are not trained as well. Some of them just went too deep. They don’t understand the energy and they’re using too much, so patients are having more complications,” she said. Her takeaway was simple: training and credentials matter more than ever.
The second update made waves for a very different reason. The FDA removed the long-standing black box warning for many menopausal hormone therapies, shifting dermatologists’ thinking about aging and skin health. Germantown, TN dermatologist Purvisha Patel, MD, put it bluntly. “Yes, estrogen cream, testosterone cream and topicals matter. Face, neck, thighs, vagina. In our office, we have been compounding estradiol with hyaluronic acid for years. I always told people your biological age is not your chronological age,” she said. “If you are in perimenopause or getting close, start the topical. The black box warning has been removed. It is safe.”
Exosomes Are the New Anti-Aging Signalers
If there was one regenerative ingredient dermatologists couldn’t stop talking about at ASDS, it was exosomes. These cell-derived “messenger bubbles” act like traffic directors for the skin, delivering signals that tell fibroblasts to produce more collagen and elastin. Shreveport, LA dermatologist Skylar Souyoul, MD explained why they’re showing up in everything from post-laser serums to microneedling add-ons. “They are sending the signals to help tell your body to make more collagen and elastin and do those anti-aging activities,” she said. Souyoul noted that exosome-infused microneedling has become her most requested in-office treatment thanks to its ability to brighten, strengthen and calm inflammation across skin tones.
Peels Are Making a Comeback
Even with new lasers everywhere, dermatologists say chemical peels are having a moment again. West Palm Beach dermatologist Mark Cappel, MD said patients love how straightforward the results are. “Chemical peels have been around a long time. They do things other treatments can’t do. People like seeing that dead skin come off and the baby skin underneath,” he said.
He advised sticking to trained providers. “All skin tones can do superficial chemical peels. If used correctly, pretty much any skin tone can get a superficial peel. The deeper ones are where you have to know what you’re doing.”
Treating Skin of Color Takes Precision
Hyperpigmentation remains one of the biggest concerns for patients with deeper skin tones. Montclair, NJ dermatologist Jeanine Downie, MD said the basics still matter. “Skin of color needs more education, more consistency and more sun protection. Pigment will always find a way to show up if we do not control inflammation,” she said.
Fresno, CA dermatologist Regine Mathieu, MD added that the wrong approach can make discoloration worse. “The right laser in the wrong hands is the wrong laser. You have to protect melanocytes before you do anything,” she said. “Complications happen when people don’t understand the device they’re using—the depth, the heat, the energy. Training matters.”
Addressing Bias in Dermatology Care
One of the most important sessions of the entire meeting was a multi-expert presentation on bias in aesthetic medicine, where Dr. Downie addressed how racial and gender bias continue to influence everything from documentation to counseling to outcomes. She explained that inequity often shows up in subtle language, noting, “A white patient ‘reports’ symptoms, but a Black patient ‘claims’ them. Those are two different things, and bias shows up in ways patients never realize.” She also spoke about misogyny and misogynoir and how these patterns shape the experiences of Black women in medical settings.
Downie emphasized that change begins with uncomfortable but necessary dialogue. “The only way forward is to see each other as humans, have tough discussions and take responsibility so we can do better.” The session also incorporated perspectives on anti-Asian bias, antisemitism and LGBTQ+ patient experiences, making it one of the most urgent and wide-reaching conversations at ASDS on safety, equity and the future of inclusive care.
Skin-Quality Devices Are Taking Over
Skin quality dominated conversations at ASDS, especially devices designed to firm, smooth and thicken the skin without altering facial shape. New York dermatologist Doris Day, MD said one device repeatedly stood out. “Sofwave is number one because it helps skin quality, and people consistently come back and say the same three words: ‘This really works.’”
Phoenix-based physicist Shimon Eckhouse, MD cofounder of Sofwave and inventor of IPL, explained the science behind that shift. “What we have done is create a controlled thermal injury inside the dermis without needles, bleeding or downtime,” he said. The device targets the dermis at about 1.5 millimeters. “The dermis is the collagen factory. If you go deeper, you risk melting fat or hitting nerves and blood vessels, and you do not even have the fibroblasts you need to get a result.”
Weight-Loss Skin Changes Are a Full-Body Issue
Dermatologists said GLP-1–related weight loss is changing not just the face but the body as well. New York dermatologist Anthony Rossi, MD said the fat-skin connection runs deeper than most people realize. “We think the fat in the face and body is very sensitive to weight change. You are not only losing the cushion but the cross-talk between fat and skin. There is a lot of biochemical interplay,” he said. “People are coming in with texture changes on the arms, the abdomen and the inner thighs. It is not just facial hollowing.”
Seattle dermatologist Heather D. Rogers, MD said that is why body-focused devices are having a moment. “Everybody is losing weight, which is good, but the skin does not always come back,” she said. “That is why we got Sofwave and why the new body clearance for Ellacor is so important. It is meeting the number one concern people have after GLP-1 weight loss.”
Longevity Is Driving New Treatment Choices
The longevity mindset shaped dozens of conversations at ASDS. New York dermatologist Marina Peredo, MD said patients now want treatments that help them age well, not just look good in the moment. “Everything is longevity and biohacking right now,” she said. “People want to optimize their health. They want to feel good.”
She said interest in peptides and NAD+-based options is rising, but warned that not all providers are qualified. “A lot of people are doing peptides who are not qualified, and that’s one thing. But there are also dermatologists using them in practice. I have mixed views on it. Is this our new obsession, or is there something to it?”
If there was one takeaway from ASDS 2025, it’s this: the future of aesthetics is about working with your biology, not fighting it. Dermatologists are prioritizing treatments that strengthen, protect and keep skin performing well over time. With safety conversations front and center and longevity gaining momentum, the next wave of cosmetic treatments is shaping up to be smarter, gentler and far more strategic.
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