Plastic surgery vs skincare: When does skincare turn into a cosmetic procedure?

Scrolling through your feed or reading your favorite fashion magazine, you will surely see ads and articles featuring gorgeous, fresh-faced models and celebrities. Search a little more, and what is their answer to their youthful glow? "Oh, I just have an excellent skincare routine."

Is that the whole story, though? Is "skincare" turning into code for cosmetic procedures? When does skincare, the practice of regularly using products to maintain and improve the appearance of the skin, turn into cosmetic procedures like neuromodulators and fillers? When do minimally invasive procedures like neuromodulators and fillers turn into cosmetic surgery?

The line between skincare and cosmetic procedures is blurred, proving confusing. Is this trend in the beauty industry sleight of hand or just the next logical step in skincare and maintenance?

What is skincare?

First, it is time to define "skincare." To most people, skincare is a routine that involves products that help maintain and improve the appearance of the skin, particularly on the face. The routine and products can be as basic or extravagant as an individual wants. Most basic skincare routines include cleansing, treating and moisturizing.

More intense skincare routines, like the "10-step Korean skincare routine," can become complex, involving numerous steps and products such as makeup removers, water-based cleansing, exfoliators, toners, essences, treatments, sheet masks, eye creams, moisturizers and sunscreen.

A skincare routine can be as basic or elaborate as a person wants. It is customizable and helps people address their concerns.

When does skincare turn into a cosmetic procedure?

There is an increasing trend of using skincare to mean more. Is the definition evolving thanks to new trends, technology and more accessibility to cosmetic procedures? It is a bit of a slippery slope.

"I think that celebrities are purposely using 'skincare' when they sometimes mean 'injectables, fillers, medical devices, lasers, skin boosters and minimally invasive treatments,'" said Roy Kim, MD. "It may not be meant to deceive, but rather, getting skin treatments is technically not surgery, has pretty rapid recovery, is easy to hide from the public, yet still has good results."

The difference between skincare and a cosmetic procedure should seem obvious, but it is becoming more difficult to distinguish.

"I would say the lines certainly get blurred since the skin overlies our entire body; it is the surface that people look at and is the coverage of our structure," said Sara Dickie, MD. "We can make structural changes like a facelift, add filler or fat to create contours or Botox the muscles that move beneath it, but the surface of the skin with fine lines, pigmentation, pores, hair and all the skin elements that make up the skin itself are the targets of what I would traditionally call skincare."

Dr. Dickie explained that when she talks to patients about skincare, she focuses on topics like reversing sun damage, protecting against environmental toxins and creating a balanced skin tone. Medical-grade topicals like retinol or niacinamide, products that penetrate the upper layers of the skin and create significant changes, are also skincare products.

Skincare vs skin treatments

What else does she put under the skincare umbrella?

"Treatments such as facials, pore extractions, superficial or medium depth chemical peels I would also classify as skincare because these do require some amount of repeat usage for consistent results – like going to a trainer once a week," said Dr. Dickie. "But the daily routine is the key to skincare for me."

So, where does skincare start to transform into cosmetic procedures? The definition may shift depending on who you ask.

"There are devices such as lasers, microneedling, radiofrequency energy, deep laser peels, which I would not classify as skincare," said Dr. Dickie. "They are skin treatments, for sure, but they cannot, for the most part, be done at home on a daily basis, a weekly basis or a monthly basis, forever. These may be sold in packages, so they need to be performed in a series for optimal results, but the goal is to treat to an endpoint. A patient or client may not need these treatments again for a long time, if ever, or in the same capacity to maintain healthy skin."

Botox and fillers also fall into the cosmetic procedure category because, although these treatments should be utilized on an ongoing basis for best results, their main purpose is not to impact the overall health of the skin, like a daily skincare regime would. She adds that plastic surgery can be part of the whole picture but cannot stand alone as skincare.

The difference

What's the distinction?

"Someone who has a skincare routine at home using the first methods mentioned and uses the treatments listed and uses Botox and fillers is practicing skincare," said Dr. Dickie. "But if that same person removes the first aspect and only does the lasers and the Botox, I would argue it is not practicing skincare."

Dr. Kim believes that the changing face of skincare may be part of a larger trend.

"I also think this goes into the trend of 'traceless rejuvenation' – where no one can figure out what you have had because you constantly get small treatments forever to avoid a really big surgery," said Dr. Kim.

Skincare vs surgery

Ultimately, a good skincare routine will most likely keep you looking younger longer, but it can't prevent aging on its own, and that's where cosmetic procedures come in, as they can prevent or even reverse aging. Together, cosmetic procedures and great skincare complement each other for superb results.

"Someone with an excellent skincare routine can still have wrinkles and look their age, but their skin is free of sun damage, dyspigmentation, wide dilated pores and dry skin," said Dr. Dickie. "This is why I tell all my patients who are undergoing surgery like a facelift or getting fillers and Botox that the key to maintaining their results and getting the best outcomes with these treatments is to start and maintain a skincare routine."

Find out what skincare and skin treatment options are the best fit for your face by consulting a board-certified plastic surgeon who is an ASPS member.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.