Medical aesthetics covers non-surgical treatments for the skin and soft tissues of the face and neck: injections, chemical peels, lasers and energy-based devices. Here the cause-before-treatment question is mechanical: is a line or fold made by muscle movement, by lost volume, by surface damage or by loose skin? Each injectable or device acts on only one of these.
In short
Skin changes with age, sun exposure, smoking, repeated facial expressions and inherited traits, and each treatment reaches only some of these causes.1 Muscle-relaxing injections act on expression lines, fillers add volume, resurfacing treats the surface, and none of them lifts significantly loose skin.2 Most non-surgical results are temporary and need repeating. The first assessment is a look at your face at rest and in movement by a medically qualified prescriber, with a dermatologist first if a new or changing mark is part of the concern.
What this field covers
- Muscle-relaxing injections (botulinum toxin): relax targeted muscles to soften frown lines, forehead lines and crow’s feet.2
- Dermal fillers: gels such as hyaluronic acid, calcium hydroxylapatite or poly-L-lactic acid that add volume to lines, folds, lips, cheeks and chin.23
- Skin resurfacing: chemical peels and ablative or non-ablative lasers that work on texture, fine lines and uneven colour.2
- Energy-based tightening devices: focused ultrasound, radiofrequency and laser-fibre treatments marketed for mild laxity. Evidence differs from device to device and is covered in each guide.
- Fat-reducing injections: deoxycholic acid for fat under the chin, which does not treat wrinkles.2
Start with the cause
| Concern or symptom | Possible causes | Usual first step / type of specialist |
|---|---|---|
| Fine lines and wrinkles | Natural ageing with drier, less elastic skin; ultraviolet (UV) damage; smoking and pollution; repeated expressions; family traits1 | Dermatologist or medically qualified aesthetic practitioner; sun protection and skin care come before any procedure |
| Lines that appear only when you move your face | Muscle activity from frowning, squinting or smiling1 | Clinician assessment of whether muscle action, rather than volume loss, is the main driver |
| Loose skin, jowls or a softer jawline | Loss of collagen, elastin and fat with age; sun damage1; weight change | In-person assessment of how much laxity is present; a facial surgeon if laxity is significant |
| Rough texture, sun spots or uneven colour | UV exposure; ageing; skin conditions that need diagnosis before treatment | Dermatologist, especially if a mark is changing, bleeding or new |
| Fullness under the chin | Fat deposits2; loose skin; weight change | Clinician assessment of fat versus skin before choosing any approach |
| Persistent worry about a feature others barely notice | Possible body dysmorphic disorder (BDD), a mental health condition centred on perceived flaws6 | GP or mental health professional; cognitive behavioural therapy (CBT) is the main treatment, sometimes with medication6 |
Main types of option
| Option | What it can do | What it cannot do |
|---|---|---|
| No treatment, sun protection and skin care | Avoids procedure risks; limiting UV exposure and not smoking address two causes of skin ageing1 | Reverse established lines or laxity |
| Prescription creams (retinoids) | Reduce fine wrinkles and blotchiness over weeks to months2 | Treat deep folds or loose skin; not for use in pregnancy2 |
| Botulinum toxin | Soften expression lines; effect seen within about a week2 | Last beyond a few months without repeat injections2; replace lost volume |
| Dermal fillers | Plump lines and folds and restore volume in specific areas2 | Lift heavy, loose skin; most need repeating after about six months2 |
| Peels and laser resurfacing | Improve texture, fine lines and some colour irregularities2 | Fix sagging skin2; carry a risk of colour change that is higher in darker skin2 |
| Surgery (facelift, neck lift) | Tighten the lower face, jawline and neck2 | Correct fine wrinkles, sun damage or uneven colour; results are not permanent2 |
What cannot be decided online
Photographs flatten the face. Whether a fold comes from volume loss, muscle action or loose skin, how thick and elastic the skin is, and how it behaves when you speak and smile can only be judged in person. A clinician also needs your medical history, current medicines and any previous injections or implants before advising.
In the UK, botulinum toxin is a prescription-only medicine that can only be prescribed after a healthcare professional has assessed you, while fillers do not always need a prescription.5 Meeting the person who will inject you, checking their professional registration and asking how they would handle a complication, such as filler blocking a blood vessel, are worth settling before the first injection.5 Any new, changing or bleeding skin mark needs a medical diagnosis before cosmetic treatment.
When to seek urgent medical help
- After filler: unusual pain, any change in vision, or skin near the injection site turning white, grey or blue. These can signal a blocked blood vessel and need immediate attention.3
- After filler: sudden difficulty speaking or drooping of the face, which can be signs of stroke and need emergency care.3
- After botulinum toxin: difficulty swallowing, slurred speech or difficulty breathing, which can be symptoms of botulism.4
Guides in this section
Related guides elsewhere: if laxity is the main concern, see facelift and when surgery may be the better option. Before choosing a practitioner, read how to verify medical credentials.
Common questions
- How Long Does Botox Last?
- How Can You Tell Whether Botox Is Genuine?
- What Are the Warning Signs of a Filler Blocking a Blood Vessel?
- Can Dermal Fillers Be Dissolved?
- Can Jowls Be Treated Without Surgery?
- What Are the Options for a Double Chin?
- Ultherapy vs Thermage: How Do They Differ?
- What Is Morpheus8 (Radiofrequency Microneedling)?
- What Are Skin Boosters?
- How Do Chemical Peels Work, and Which Depth Is Which?
- What Are the Treatment Options for Melasma?
- Which Treatments Can Improve Acne Scars?
- What Is Recovery Like After Endolift?
Sources
- Mayo Clinic Staff. Wrinkles: symptoms and causes. Mayo Clinic; 2023. https://www.mayoclinic.org/diseases-conditions/wrinkles/symptoms-causes/syc-20354927. Accessed 5 November 2026.
- Mayo Clinic Staff. Wrinkles: diagnosis and treatment. Mayo Clinic; 2023. https://www.mayoclinic.org/diseases-conditions/wrinkles/diagnosis-treatment/drc-20354931. Accessed 5 November 2026.
- US Food and Drug Administration. Dermal fillers (soft tissue fillers). FDA; 2023. https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/dermal-fillers-soft-tissue-fillers. Accessed 5 November 2026.
- UK Health Security Agency. HPR volume 19 issue 8: news (7 August 2025) — iatrogenic botulism associated with cosmetic botulinum toxin injections. Health Protection Report, GOV.UK; 2025. https://www.gov.uk/government/publications/health-protection-report-volume-19-2025/hpr-volume-19-issue-8-news-7-august-2025. Accessed 5 November 2026.
- NHS. Choosing who will do your cosmetic procedure. NHS website; 2023. https://www.nhs.uk/conditions/cosmetic-procedures/choosing-who-will-do-your-procedure/. Accessed 5 November 2026.
- NHS. Body dysmorphic disorder (BDD). NHS website; n.d. https://www.nhs.uk/mental-health/conditions/body-dysmorphia/. Accessed 5 November 2026.