Neo-Romanticism in Aesthetic Medicine

We are entering a new era in aesthetics: what I call the Neo-Romanticism Age. On a recent visit to Frankfurt, Germany, I had the opportunity to walk through the home and museum of Johann Wolfgang von Goethe, one of the seminal figures of 19th-century Romanticism. Goethe, along with other cultural leaders of his time, initiated a transformative period in art, society, and aesthetics. Parallels with our current moment are striking. Once again, we are experiencing a cultural shift that is bringing forth a new Romanticism, especially in the world of beauty and aesthetic medicine.

THE ENLIGHTENMENT ERA AND THE AGE OF BOTOX®

As the 17th and 18th centuries were defined by Enlightenment ideals (fueled by Newtonian physics, Voltairean philosophy, and the Industrial Revolution), the late 20th and early 21st centuries have been marked by a similar scientific rationalism, especially in aesthetics. For much of the 20th century, cosmetic medicine remained in its own “Dark Ages,” with minimal innovations and inconsistent standards. Scientific rigor was largely absent. Placebo-controlled trials were deemed inapplicable to surgical interventions, and progress was often based on anecdotal experiences from reputed surgeons or promotional narratives from corporations. Outcomes were subjective and poorly measured.

Then came botulinum toxin type A (Botox®), which democratized aesthetic medicine.1 It was affordable, minimally invasive, and reversible, and it required less invasive training to administer compared with surgery. More importantly, it could be evaluated using placebo-controlled trials (saline vs botulinum toxin), bringing unprecedented scientific rigor to the field.² This paved the way for subsequent innovations: fillers, cosmeceuticals, and large-scale studies backed by corporate research funding. Objective tools were developed to measure everything from wrinkle depth to chin projection. Techniques became standardized. Aesthetic medicine became quantifiable.

Yet, in this pursuit of perfection, much was lost. The focus shifted to creating mathematically “ideal” faces, stripped of cultural nuance, emotional expression, and individuality. Overinjection and hypercategorization became common. The field took on a mechanistic tone as clinicians were trained in rigid protocols of injection and instructed on predefined ideals of beauty. The result was uniformity: the same face, everywhere.

Simultaneously, the skincare industry became preoccupied with biomarkers (eg, cytokines, peptides, growth factors) without fully understanding their correlation with real-world beauty or emotional outcomes. The histological and molecular became paramount, while the patient’s subjective experience was marginalized.

COVID-19 AND THE GREAT REASSESSMENT

The COVID-19 pandemic marked a breaking point. Physical isolation, masking, and a pivot to virtual interaction promised safety and efficiency. Scientific authority was emphasized, with widespread calls to “trust the experts” and “follow the data.” However, as the pandemic progressed, emotional fatigue grew. Loneliness, depression, and substance use surged.³ People longed for touch, nature, and authentic connection.

By 2022, disillusionment with pure data-driven approaches had set in. Individuals began turning inward, seeking meaning beyond statistics. The cultural moment was ripe for a new Romantic movement, one emphasizing emotion, authenticity, and human connection.

ROMANCE IN CRISIS

Romance itself had been devalued by digital efficiency. Dating apps commodified intimacy, reducing partners to profiles and interactions to swipes.⁴ Although hookups became easier to obtain, genuine connection became more elusive.⁵ Paradoxically, sexual activity declined among younger generations.⁶

Many young women, empowered yet fatigued, began to reclaim femininity. Men expressed a desire for renewed purpose. Both genders sought deeper connection. Raised on screens, the younger generation yearned for eye contact, scent, and human warmth.⁷ The pendulum began to swing, ushering in the Neo-Romantic era.

NEO-ROMANTICISM IN AESTHETICS

Neo-Romanticism does not reject science; it rejects its overreach. It strives for equilibrium between reason and emotion, between biology and expression. In this new aesthetic paradigm, success is not solely determined by collagen levels or histological slides but also by outcomes like mood, confidence, relational satisfaction, and self-perception.⁸

Success is defined not just by numerical metrics but by a person’s affective response when seeing themselves in the mirror, their posture, and their interpersonal dynamics. The focus returns to the whole person, not just skin but psyche and soul.⁸

MOODCEUTICALS: A MOVEMENT

This cultural renaissance gave birth to new ideas. Personally, along with Sabrina Fabi, MD, I sought to cultivate a movement: to champion a new Romanticism in aesthetics.

Skincare must be personal as well as clinical. It should address emotional, social, and romantic dimensions. We developed a skincare line, XOMD, that is scientifically validated (clinically shown to improve skin texture, radiance, smoothness, and evenness)but that goes further. It represents one solution to a new category we term “moodceuticals,” designed to enhance mood, build confidence, and even contribute to sexual satisfaction.

These qualities are increasingly essential in a post-pandemic, Neo-Romantic world, where depth, connection, and authenticity are prized.

THE FUTURE OF AESTHETICS

To remain culturally relevant, aesthetic practices and skincare brands must listen. The Neo-Romantic generation rejects homogenization. They seek products and services that regard them not as variables or flawed features but as complex individuals with stories and dreams.

Aesthetic medicine must look beyond metrics, algorithms, and standardization. It must prioritize treatments that help individuals feel more human, not less. In this emerging age, aesthetic success will be measured not by conformity but by confidence. Not by symmetry but by sincerity. Not by perfection but by personal expression. 

1. Rashied R, Gold MH. Innovation in botulinum toxins. Dermatol Clin. 2025;43(1):55-66. https://doi.org/10.1016/j.det.2024.08.004

2. Hexsel D, Dal’Forno T, Hexsel C. A retrospective analysis of the use of hyaluronidase in aesthetic medicine. Dermatol Surg. 2008;34(6):764-771. https://doi.org/10.1111/j.1524-4725.2008.34158.x

3. Roberts A, Rogers J, Mason R, et al. Alcohol and other substance use during the COVID-19 pandemic: a systematic review. Drug Alcohol Depend. 2021;229(Pt A):109150. doi: 10.1016/j.drugalcdep.2021.109150

4. Ha A, Scott M, Zhang CA, et al. Factors associated with dating app use for sexual “hookups” in the United States: insights from the National Survey of Family Growth.J Sex Med. 2024;21(9):762-769. https://doi.org/10.1093/jsxmed/qdae083

5. Diesen PS, Pettersen L, Karlsen F. The overlooked and the overstudded: a scoping review of qualitative research on pursuing sexual, romantic, and loving relationships through online dating. Behav Sci (Basel). 2025;15(3):247. doi: 10.3390/bs15030247

6. Masoudi M, Maasoumi R, Bragazzi NL. Effects of the COVID-19 pandemic on sexual functioning and activity: a systematic review and meta-analysis. BMC Public Health. 2022;22(1):189. doi: 10.1186/s12889-021-12390-4

7. Impact 360 Institute. Gen Z values in-person relationships. Impact 360 Institute. Published March 11, 2024. Accessed August 19, 2025. https://www.impact360institute.org/articles/gen-z-values-in-person-relationships/

8. Merz Aesthetics. Pillars of confidence. Accessed August 19, 2025. https://merzaesthetics.com/confidence/