HA filler spending fell 15.6% in two years. Neurotoxins and biostimulators grew.

Who this is for

This is for physicians, PA-Cs, nurses, and other clinicians who may own a plastic surgery practice, dermatology practice or med spa that offers fillers, neurotoxins or body contouring. It is also for the operations lead who sets the marketing budget and broader operations strategy.

What we found

Guidepoint Qsight, a market data company, tracks what US patients pay at aesthetic practices. In its data, spending on hyaluronic acid (HA) fillers fell from 2023 to 2025. Two categories grew. Spending on neurotoxins rose over the same years, and so did spending on collagen-stimulating fillers.^1,2

The med spa trade group cited an annual report that counted a 40% drop in noninvasive fat reduction procedures (e.g., CoolSculpting, SculpSure, EmSculpt) in 2024.³ Separately, Qsight reports that 54% of the med spas it tracks offered GLP-1 weight-loss drugs by August 2025. These are the ever-popular glucagon-like peptide-1 drugs that include semaglutide and tirzepatide.²

Worldwide, a survey of plastic surgeons counted 17,883,610 (17.9M) surgical procedures in 2025, with 14.4% of procedures performed on men.⁴

How many aesthetic procedures did surgeons count worldwide in 2025, and what did US patients spend?

The International Society of Aesthetic Plastic Surgery (ISAPS) is a global society of plastic surgeons. Its 2025 survey counted 17,883,610 (17.9M) surgical and 17,320,420 (17.3M) nonsurgical procedures worldwide, as member surgeons reported them, and put the overall increase over the last four years at 9.2%. The 2025 count drew on data from 2,900 plastic surgeons, compared to 2,975 for 2024.⁴

The society's 2024 survey counted 7.8 million botulinum toxin procedures worldwide, the most common nonsurgical procedure for both men and women. Hyaluronic acid (HA) fillers came second, at 6.3 million procedures. Botulinum toxin is the neurotoxin class that includes Botox.⁵

In the US, Guidepoint Qsight tracks point-of-sale transactions at aesthetic practices, so its spending numbers are what patients paid at the practice at checkout. It put that spending at $17.5 billion in 2024, across nonsurgical categories it tracks.⁶

Pew Research Center, a nonpartisan research organization, surveyed 8,750 US adults in September 2025 about steps to look younger. Of those adults, 5% reported nonsurgical cosmetic treatments, and 3% reported cosmetic plastic surgery. Interest ran higher. A larger share, 23%, had gotten or would consider nonsurgical treatments, and 18% said the same of cosmetic surgery.⁷

In the American Society for Dermatologic Surgery (ASDS) 2025 consumer survey, 70% of respondents said they were considering a cosmetic procedure. Cost, at 24%, and pain, at 14%, were the top reasons respondents gave for waiting.⁸

Which injectables grew in US patient spending from 2023 to 2025?

Neurotoxins and collagen-stimulating fillers grew. Guidepoint Qsight reports that US patient spending on hyaluronic acid (HA) fillers fell 15.6% from 2023 to 2025, from $3.2 billion to $2.7 billion. Over the same years, spending on biostimulatory injectables grew 9.2%, from $760 million to $830 million. Biostimulatory fillers prompt the body to build collagen.¹

Neurotoxins gained share overall. In Qsight's split of US nonsurgical patient spending, they took 30% in 2023, 31% in 2024 and 32% in 2025 year to date. Dermal fillers took 20% of that spending in 2023, then 19%, then 17% in 2024 and 2025 respectively. Energy-based devices dropped from 20% to 17% over the same period. That category covers lasers and other machines that treat skin and fat with light, heat or sound. The rest of 2025's spending went to professional-grade skincare (11%), weight loss and dietary treatments (11%), skin rejuvenation and resurfacing without a device (7%), and other products and procedures (5%).² We looked at how new patients divide their spending in laser and injectable spending in a recent review.

In Qsight's earlier data, US patient spending on neurotoxins reached $5.6 billion in 2024, up 4% on 2023.⁶ We covered what patients pay per treatment in what patients pay for Botox.

Younger patients are part of the broader neurotoxin shift. In Qsight's sales data, Gen Z, patients born from 1997 on, made up 4% of US aesthetics patients in 2017. By 2024 they made up 10%. Neurotoxins took 12% of Gen Z's nonsurgical aesthetic spending in 2021 and 20% in 2025.^1,6

In the summer 2025 patient survey from NewBeauty, a beauty magazine, 42.2% of patients planned to book a neurotoxin treatment within a year. Nearly 70% said they are "more likely to book filler treatments if the conversation is framed around facial balancing."⁹

How did GLP-1 programs and noninvasive fat reduction change in 2024 and 2025?

AmSpa, the American Med Spa Association, cited an annual report that counted 439,032 US noninvasive fat reduction procedures in 2024, down 40% from 745,957 in 2023. Its examples are CoolSculpting, Liposonix, Emsculpt, Vanquish, Zerona and Kybella. Allure asked industry experts. They named GLP-1 medical weight-loss programs as one of many factors behind the drop.³

Separately, Guidepoint Qsight tracked GLP-1 offerings through August 2025. It found 54% of med spas and 32% of plastic surgery clinics offered these therapies. Spending on GLP-1 therapies passed $100 million that month across the practices it tracks. Weight loss and dietary lifestyle treatments grew from 7% of the US nonsurgical spending Qsight tracks in 2023 to 11% in 2024. They held at 11% in 2025 at the time of publishing.²

In Qsight's data, 61% of people who started GLP-1 treatment at an aesthetic practice in 2025 were new to that practice, suggesting GLP-1 treatment is a strong entry point for new patients into a practice. Within 12 months, a portion of them bought injectables, device-based treatments or skincare. Qsight sees two roles: it describes GLP-1 as both a competitor for patient spending and a way to bring new patients to the practice.²

A 2025 study in the Aesthetic Surgery Journal, a peer-reviewed journal published by Oxford University Press, compared two groups. Aesthetic procedures grew faster among GLP-1 users than among patients who had bariatric (weight-loss) surgery. Its abstract reports a mean annual growth rate of 36.1% for GLP-1 users from 2016 to 2021, compared to 27.1% for patients who had weight-loss surgery. After 2021, the rate rose to 53.8% for GLP-1 users. For patients who had weight-loss surgery it dropped to -4% a year.¹⁰

In the magazine's survey, more than two-thirds of GLP-1 users had lost over 20 pounds. Nearly 70% of GLP-1 users were interested in muscle-defining treatments. Half reported noticing hair thinning.⁹ We covered body lifts and fat grafting after weight loss in our GLP‑1 menu review.

Where do men's aesthetic choices differ from women's?

Men make up a small but growing share of procedures worldwide. In the 2025 global survey, men accounted for 14.4% of surgical and 15.2% of nonsurgical procedures. Women accounted for 85.6% of surgical and 84.8% of nonsurgical procedures. For the first time, eyelid surgery was the most common surgical procedure for both women and men. The next two most popular procedures for women were breast augmentation and liposuction. Men's next two differed: gynecomastia (male breast reduction) and rhinoplasty (nose surgery).⁴

In the dermatology society's consumer survey, 43% of men were interested in reducing facial redness and improving skin tone, compared to 35% of women. Women's interest led in almost all the other top procedures.⁸

In the UK, YouGov, a polling company, found in November 2025 that 26% of women and 11% of men had had a cosmetic treatment. Weight-loss drugs had been taken by 10% of women and 4% of men.¹¹

In the US, women were more likely than men to have taken, or to consider, the steps Pew asked about to look younger.⁷ We covered how a practice markets and prices for men in male aesthetic patients.

Where does the filler-to-neurotoxin shift show up in a practice's records?

Two years of revenue by service line would be one way to investigate. A practice can look at its mix of filler, neurotoxin, device and weight-loss revenue across the patients it serves. In particular, you might be interested in reviewing a breakdown of treatments in your higher-spending categories. Comparing across the same months in 2023 and 2025 removes seasonal swings from the comparison.

Our suggestions draw on the research above. First, compare HA filler, biostimulator and neurotoxin revenue for 2023 and 2025. Qsight's US data shows HA filler spending falling while the other two grew - do the trends at your own practice align or differ? Second, follow each new GLP-1 patient for 12 months, the window Qsight reports on, and note what else they book. Do you see GLP-1 patients differ from patients at large and non-GLP-1 patients? Third, set the chair time given to fat reduction against that line's bookings, given the 40% drop AmSpa reported for 2024. You might consider a change to maximize resourcing into the future.

About this review

We read 11 sources in October 2026: two ISAPS global survey reports, three Guidepoint Qsight publications, one peer-reviewed study, four consumer or patient surveys (Pew Research Center, YouGov, ASDS and NewBeauty) and one AmSpa news summary. For the Aesthetic Surgery Journal study we had the abstract only. Numbers from different publishers sit side by side, credited to whoever reported them, and none is added to, subtracted from or divided by another source's.

The two global surveys rest on plastic surgeons' own reports from 2024 and 2025. The Qsight data covers patient spending at US aesthetic practices from 2023 to August 2025, with patient age data from 2017. The peer-reviewed study on GLP-1 users covers procedures from 2016 onward. The AmSpa summary reports US fat reduction counts for 2023 and 2024. Pew, ASDS and NewBeauty surveyed US adults and patients in 2025. YouGov surveyed British adults.

Fractional Aesthetics is a growth strategy practice for aesthetic medical businesses.