An open letter to the industry, as told by Dr Rodrigo Teixeira and James Vivian
Aesthetic medicine is at a crossroads.
Recent public commentary about the impact of evolving beauty standards and treatment approaches continues to spark fresh debate. As the industry rapidly evolves, are we offering a greater opportunity for cosmetic personalisation, or are we simply replacing one form of pressure with another? At a time when beauty trends, consumer perception, and medical ethics intersect in increasingly complex ways, the conversation is overdue.
As professionals from different branches of the aesthetics world: one surgical, one dermal, we’ve come together with a shared purpose: not to defend our field in its entirety, but to reframe it with humanity, honesty, and patient care at the centre.
We’re aware of the negative reputation our industry has in some circles. Whether it’s a scathing editorial, an anti- “anti-ageing” Instagram post, or another public callout, the underlying message often paints our work as exploitative or superficial. That doesn’t reflect the world we, or many of our colleagues, work in each day.
Many of us are working to strengthen our industry’s presence as a safe, non-judgmental and esteem-affirming necessity. But even with the best intentions there are times we can fall short.
People come to us for many reasons: illness, trauma, life transitions, or long-held insecurities. For some, it’s about confidence; for others, control or self-connection. These choices are rarely just about looks. When delivered with care and respect, aesthetic treatments can be deeply restorative and affirming.
But this requires industry-wide self-awareness. We must examine how our language, branding, and normalised standards might perpetuate insecurities, however unintentionally. We must question whether we are always operating from empathy and inclusivity, or sometimes from legacy mindsets and outdated ideals.
There is a possibility that we are, unknowingly, perpetuating centuries-old language, traditions, and philosophies that we don’t even realise could be causing harm.
This privilege of caring for people demands more than technical skill; it calls for accountability. In a space where regulation can be inconsistent, it is up to us to uphold high standards through rigorous education, honest communication, and a commitment to truly listening to our patients. Their outcomes should be more than aesthetic; they should feel informed, supported, and in control of their choices.
We must offset our industry’s lack of regulation with rigorous, ongoing training. We must ensure the information we share is truthful, inclusive, and free from fearmongering or moralising.
Integrity in this work means knowing when to pause, to guide gently, or to say no. There are limits to what aesthetic treatments can offer, and sometimes the most ethical advice is to do less – or nothing at all. Trust isn’t built through promises of transformation, but through honest, considered care.
At the heart of this work is a commitment to informed choice and genuine respect for patient autonomy. Ethical practitioners support those who choose to age naturally just as fully as those who explore cosmetic options. Our role is to educate, listen, and guide; free from bias, fear, or trend-driven influence, so that every decision is made with clarity, confidence, and care.
Aesthetic care is not just about outcomes. It is about impact; emotional, psychological, and relational. As an industry, we have the privilege of being part of people’s journeys. That comes with the responsibility to constantly reflect on our motives, our methods, and our messaging.
If anything we’ve said here sparks a feeling in you, then we hope you’ll reach out to share it with us. Our industry didn’t develop its bad reputation overnight but if we don’t act to improve its character, we become responsible for its future.
Let this be a turning point. Not one of polarisation or deflection, but one of constructive leadership. We can choose to do more than respond to criticism; we can evolve through it. With empathy. With ethics. With the person, not the procedure, at the centre.
About the Authors
Dr Rodrigo Teixeira, FRACS, is a Melbourne-based Specialist Plastic Surgeon and ANZBCPS Board Certified Cosmetic Plastic Surgeon. He is the Medical Director of Unveil Aesthetics and an advocate for ethical, evidence-based facial and aesthetic surgery. Contact Rodrigo rodrigot@unveil.com.au
James Vivian is a nationally recognised dermal therapist and the founder of the James Vivian clinic. He is known for his honest, compassionate approach to skin health and his commitment to improving aesthetic industry standards through transparency, education, and reflection. Contact James james@jamesvivian.co
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