Minimally Invasive Facial Cosmetic Procedures for the Millennial Aesthetic Patient

January 2020 | Volume 19 | Issue 1 | Features | 100 | Copyright © January 2020

Published online December 13, 2019

Nisreen Mobayed , Julie K. Nguyen , Jared Jagdeo

aDepartment of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY bDermatology Service, VA New York Harbor Healthcare System – Brooklyn Campus, Brooklyn, NY

the leading products utilized to achieve subtle, yet notable improvement in facial aesthetics.3 Neuromodulating agents have been used cosmetically to reduce the appearance of dynamic rhytids and fine lines.32-34 By inhibiting muscles from contracting, neuromodulating agents decrease facial movement and in theory may be used preventatively to suspend the development of wrinkles.32,33

While neuromodulator injections have been widely used by older generations to achieve a more youthful appearance by treating fine lines and wrinkles, their popularity has been steadily growing in the millennial generation. According to the American Academy of Facial Plastic and Reconstructive Surgery, botulinum toxin injections have increased by 22% among millennials in the past five years; members of this organization have attributed this in part to the prejuvenation trend.2 Allergan, the maker of Botox® Cosmetic, has targeted millennials in its latest advertising campaign; this campaign seeks to emphasize the ability of Botox to produce natural and subtle results in this demographic, promising consumers to “look like you with fewer lines.”35

Dermal Fillers
Dermal fillers comprise the second most popular minimally invasive procedure in facial aesthetics in the millennial population. 3 Within the dermal fillers category, hyaluronic acid fillers remain the most popular, followed by calcium hydroxylapatite (e.g. Radiesse), and facial fat-fillers.3 Per the ASAPS’s 2018 Procedure Report, hyaluronic acid injections are up 58% since 2014.31 Of all injectable procedures performed in 2018, 30% consisted of hyaluronic acid injections.29 Given their lasting effects and lower potential to induce allergic reactions relative to other classes of fillers,36,37 hyaluronic acid fillers have become the preferred filler by cosmetic providers.

Dermal fillers have been utilized to improve volume distribution and ultimately achieve balanced facial contouring.34 Similar to neuromodulator injections, the subtle, yet notable results coupled with little to no down-time has made this procedure popular in millennials. The Global Aesthetics Consensus Group has devised consensus recommendations, advocating for an integrative approach to injectables by endorsing combination treatment of neuromodulators and hyaluronic acid fillers.30 Allergan has also tailored advertisement of Juvéderm, the company’s family of hyaluronic acid fillers, to millennial women in the advertisement montage titled “Juvéderm It”; in this montage, a diverse group of women pose as a backdrop to bolded pink messages directed at younger consumers: “Live it, work it, pose it, boss it.”38

Microdermabrasion, a popular method of superficial skin resurfacing, utilizes microcrystals or diamond tips, as exfoliants to remove the outermost layer of skin.39 Microdermabrasion has been studied for its effects on acne, pigmentation disorders, and scarring disorders.40 This rejuvenating cosmetic treatment has risen in popularity amongst millennials, coming in as the third most popular minimally invasive procedure in facial aesthetics. 3 Like fillers and neuromodulators, microdermabrasion provides subtle, natural, and rejuvenating results that are appealing to the millennial population. By smoothing and buffing the skin’s surface, microdermabrasion brightens the face,41 producing a natural glow that many patients are seeking. Furthermore, given that it is believed to stimulate dermal collagen and elastic fiber production, microdermabrasion serves as an additional tool utilized in the prejuvenation trend targeting millennials.40


The ASAPS reports that Americans spent more than 15 billion dollars on surgical and nonsurgical aesthetic procedures in 2016, with nonsurgical procedures accounting for 44% of this total.42 Given that millennials command a significant spending influence in the aesthetics sector and represent the leading age-group most likely to consider preventative treatments,1 it is important to explore and document their motivations and perspectives. While some research studies have elicited the opinions of millennials on social issues, education, and technology, there is a paucity of literature on millennials’ impressions, opinions, and perceptions of aesthetic procedures. With millennials serving as a target of several advertising campaigns in the cosmetic dermatology and aesthetic medicine markets, it is worthwhile to produce reliable studies of their experiences with cosmetic procedures. As a generation that has been reshaping the culture of healthcare delivery and encouraging the innovation of products and procedures with their unique values and perspectives, accounting for their beliefs and fostering a better understanding of their experiences will promote an elevation in the quality of their care.


NM and JKN have no conflicts of interest to disclose. JJ is a scientific consultant for Allergan and Galderma and received a Merz product grant for educational training purposes.


1. Allergan plc. Allergan 360°: Aesthetics Report. Available at: Published April 8, 2018. Accessed July 22, 2019.

2. American Academy of Facial Plastic and Reconstructive Surgery: AAFPRS 2018 Annual Survey. Available at: polls/m_stats.html. Published January 23, 2019. Accessed July 22, 2019.

3. American Society of Plastic Surgeons: 2018 National Plastic Surgery Statistics. Available at: 2018/plastic-surgery-statistics-full-report-2018.pdf. Accessed August 11, 2019.

4. Fry R. Millennials projected to overtake baby boomers as America’s largest generation. Pew Research Center. Published March 1, 2018. Accessed August 6, 2019. 5. Sherber NS. The millennial mindset. J Drugs Dermatol. 2018; 17 (12):1340-1342.