INTEGRATED PROTOCOLS, A PREVENTIVE APPROACH, AND NEW PATIENTS: AESTHETIC MEDICINE ENTERS A NEW PHASE OF EXPANSION

Introduction

CEPTON is a strategy consulting firm dedicated exclusively to the healthcare sector. We advise executives, industry players, and investors on strategic development, transformation, and transactions. Our teams cover the entire ecosystem: pharmaceuticals, biotechnology, consumer health, medical technology, diagnostics, healthcare services, and digital health.

In aesthetic medicine, CEPTON has established recognized expertise. With more than 30 projects completed for industry players and investors, we cover all segments, including injectables (hyaluronic acid, biostimulators, and polynucleotides) and topical treatments. Our engagements range from market opportunity assessments and launch strategies to commercial due diligence.

This sector expertise is supported by an international presence: more than 100 consultants operating across Europe, the United States, and Asia through our offices and a longstanding network of partners. Senior teams, in-depth sector expertise, tailored solutions, and an international footprint are the strengths CEPTON brings to its clients’ high-impact strategic decisions.

After two decades centered on volume restoration and wrinkle correction, aesthetic medicine and surgery are broadening their scope of innovation toward a complementary objective: regenerating the skin, in addition to reshaping it, through new treatment categories. This represents an expansion rather than a disruption: an enrichment of the therapeutic armamentarium that broadens a market whose fundamentals remain strong.

For nearly 20 years, innovation in aesthetic medicine focused on a relatively narrow set of objectives: filling and smoothing wrinkles and restoring lost volume. Botulinum toxin and hyaluronic acid remained its two pillars, still accounting for the majority of nonsurgical procedure volumes worldwide. Yet the market’s growth dynamics are changing profoundly.

The global nonsurgical aesthetics market has grown steadily at approximately 9% to 10% annually since 2018. However, this aggregate growth masks widening differences between categories. Hyaluronic acid and botulinum toxin, which accounted for nearly 80% of total aesthetic spending in 2018, are expected to represent only approximately 60% by 2030. Their projected annual growth of around 5% between 2025 and 2030 is approximately half that of the overall market.

Skin boosters and polynucleotides, injectable biostimulators, energy-based rejuvenation procedures, and next-generation topical treatments are capturing most of the incremental growth, with annual growth rates of 15% to 30%. Rejuvenation treatments, broadly defined, have become the market’s principal growth drivers.

Rejuvenation: the new epicenter of innovation, extending beyond injectables

The clearest indication of this shift lies in both the repositioning of existing products and the emergence of categories developed entirely around rejuvenation. On the one hand, several products introduced years ago as conventional fillers were repositioned as “biostimulators” around 2020. The term was virtually absent from practitioners’ vocabulary before COVID-19, and messaging around these products was entirely refocused on claims of collagen regeneration and improved skin texture.

This repositioning has been accompanied by strong commercial performance. Products such as Sculptra (Galderma) and Radiesse (Merz) have recorded double-digit growth in recent years, supported by the momentum of biostimulators within their respective portfolios.

On the other hand, entire categories have been built around the rejuvenation narrative from the outset. Polynucleotides (PN) and polydeoxyribonucleotides (PDRN) provide the most direct illustration: their mechanisms of action, positioning, and claims explicitly center on collagen biostimulation and fibroblast activation.

Although skin boosters share this focus on skin quality, they act primarily through hydration and improved radiance using minimally cross-linked forms of hyaluronic acid, rather than through direct collagen stimulation. In topical treatments, several modalities now claim the same positioning: biostimulatory peels with “no downtime,” microneedling, and topical PN formulations applied after procedures.

This trend also extends to an emerging category whose regulatory status remains uncertain: injectable peptides. These share the same cellular signaling rationale and are attracting growing interest among practitioners, although their regulatory status has yet to be clearly established in most European markets.

This momentum extends beyond injectables. Certain peels that have been available for years have been redesigned to offer protocols with no downtime and positioned as topical biostimulators. Energy-based technologies, including lasers, radiofrequency, and focused ultrasound, are being repositioned around promises of skin regeneration rather than remodeling alone.

Surgery itself is following this trend. Autologous facial fat grafting is gradually gaining traction, perceived as more natural and regenerative, while rhinoplasty, a quintessential structural procedure, is losing momentum. Rejuvenation has become the dominant lens through which aesthetic medicine is reinventing itself.

Polynucleotides illustrate the speed of this transformation. The market’s longstanding leaders have reported annual growth rates exceeding 40% to 50% over the past three years. Market maturity remains highly uneven across regions. South Korea, where polynucleotides have been used for more than 20 years, is by far the most advanced market, with established players such as PharmaResearch and its blockbuster product Rejuran, as well as BR Pharm and Koru.

The United Kingdom and Italy are at the forefront of European adoption, partly because of Mastelli’s development in these markets. France, Germany, and Spain remain at an early stage, with substantial potential for further market penetration. Almost everything remains to be built in these markets. Exosomes, whose mechanisms of action, including collagen stimulation, dermal matrix repair, and cellular regeneration, follow the same rationale, could follow a similar trajectory over the longer term.

This activity is also reflected in investment and transaction activity throughout the value chain. Upstream, among raw material suppliers, longstanding hyaluronic acid manufacturers are diversifying into new active ingredients for rejuvenation. In 2024, France-based HTL Biotechnology acquired the human recombinant collagen platform of U.S.-based Modern Meadow. Meanwhile, Bloomage Biotech, the Chinese global leader in hyaluronic acid, entered the collagen market through Yierkang and developed its own PN and PDRN product lines.

Partnerships and transactions are also multiplying in finished products. France-based Vivacy signed a European distribution agreement for the polynucleotide product Rejuran (PharmaResearch), valued at approximately €55 million over five years. Private equity firms are actively investing in the segment, including Archimed in the topical biostimulator WiQo and Charterhouse in Skintech, while L’Oréal has acquired an equity stake in Galderma.

These parallel developments, diversification by established players and the entry of financial investors, confirm that the entire value chain is being reconfigured around rejuvenation.

Combination rather than replacement: a clinical and economic choice

It would nevertheless be mistaken to interpret this shift as the emergence of a new “gold standard” that will displace botulinum toxins and hyaluronic acid. Established treatments are, on the contrary, demonstrating clear resilience. Nearly 100% of aesthetic physicians currently inject these products, and the vast majority still anticipate growth in this activity, supported by the continued increase in patient numbers and the products’ demonstrated efficacy.

Although filler activity among longstanding market leaders is stabilizing, or even softening, this slowdown concerns specific products rather than the injectable category as a whole.

What is changing is the treatment rationale. Three treatment families now coexist without materially cannibalizing one another: the immediate “glow” effect of light peels and skin boosters; the structural volumization achieved with hyaluronic acid and certain calcium hydroxylapatite (CaHA)-based biostimulators; and the progressive regeneration of skin quality supported by polynucleotides, poly-L-lactic acid (PLLA)-based biostimulators, and energy-based technologies.

Polynucleotides exemplify this trend. Most practitioners who use them report combining them with laser treatments, botulinum toxin, or microneedling within their protocols. For next-generation topical treatments, such as no-downtime peels, more than 80% of practitioners use them in combination with other treatment options rather than as standalone procedures.

This preference for combination treatments also follows an economic rationale for practitioners. Integrating immediate and delayed effects within a single protocol increases the patient’s perceived value, supports a higher level of spending, and promotes long-term patient retention.

Market projections illustrate this reconfiguration rather than substitution. Between 2018 and 2030, the share of total aesthetic spending attributable to botulinum toxin and hyaluronic acid is expected to decline gradually from 80% to approximately 60% to 65%, while remaining the majority. Rejuvenation products are gaining share within an overall aesthetic spending market that continues to grow at approximately 9% to 10% annually.

France, Italy, the United Kingdom, and Germany: a shared trend unfolding at different speeds

France is participating in this European trend while maintaining a distinctive profile. Ranked among the four largest European markets, particularly for hyaluronic acid fillers, it is characterized by an increasingly stringent regulatory framework. The interuniversity diploma in morphological and anti-aging medicine is tending to become a de facto prerequisite for practice.The sector is also undergoing ownership consolidation, with the emergence of franchised clinic networks and growing participation by financial investors in a previously highly fragmented landscape. In the calcium hydroxylapatite segment, France is now a mature market, a level of maturity that Italy, somewhat paradoxically, reached only later.

Italy offers an instructive contrast. With approximately 6,000 practitioners and a regulatory framework that allows any qualified physician to perform aesthetic treatments without a dedicated specialty qualification, the Italian market shows particularly strong supply-side momentum, with double-digit growth in nonsurgical procedures.However, the historical dominance of hyaluronic acid among local market leaders long constrained the development of biostimulators, including CaHA-based products, which have only recently begun to catch up.

The United Kingdom presents a particularly instructive trajectory for polynucleotides, having now reached a level of maturity comparable to Italy despite their much more recent introduction. This rapid adoption can be explained partly by the profile of British practitioners. Unlike France or Germany, the British market is dominated by nurses and dentists who have transitioned into aesthetics, a practitioner profile that is structurally more price-sensitive and less attached to established European brands.

This has facilitated the penetration of certain Korean brands with often competitive pricing, which have found the United Kingdom to be one of their principal entry points into the European market.Germany, by contrast, remains structurally more cautious. Adoption of biostimulators and polynucleotides has occurred later, but German practitioners’ strong preference for quality and established brands has, in turn, limited price erosion.

Ultimately, these four markets reflect the same underlying development: the rise of rejuvenation as a growth driver. However, they differ in timing and sources of friction. These include regulation acting as an accelerator or constraint depending on the country, the strength of local market leaders’ established positions, and widely varying price sensitivity in response to new entrants, particularly from Asia.

A decade of reconfiguration rather than disruption

Aesthetic medicine is entering a decade in which value creation will no longer depend solely on growth in the major established treatment categories. It will also depend on the ability of established and emerging players to position themselves in the regeneration of skin quality, develop coherent combination protocols, and gain a foothold in markets where these new modalities remain underdeveloped.

For investors and industry executives, the challenge is therefore not to choose between yesterday’s standards and tomorrow’s innovations, but to orchestrate their coexistence in a market where rejuvenation is becoming the principal basis for differentiation.

9–10% / YEAR : GROWTH OF THE GLOBAL NONSURGICAL AESTHETICS MARKET SINCE 2018.

The aesthetic medicine treatment landscape has expanded considerably, with rejuvenation-focused modalities growing rapidly and combination protocols becoming increasingly common, reducing the extent to which established injectable products alone capture market growth.

Expansion of the treatment landscape over time, particularly in rejuvenation treatments

Procedure volume growth rates by aesthetic treatment category, 2018–2030