Medical Aesthetics Truth Bureau, Episode 1: Can Injected Substances Safely Disappear? — A Century of Medical Aesthetics Accidents

• Bovine collagen: The world’s first approved injectable filler, approved by the U.S. FDA in 1981 [5][22]—it established the precedent that fillers, too, require pre-market approval. Its critical flaws—being animal-derived and carrying a high risk of allergic reactions—directly spurred the development of hyaluronic acid (HA). • Hyaluronic acid (HA): The world’s first non-animal, stabilized, cross-linked HA filler launched in Europe in 1996 [6][7], entered the U.S. market in 2003 [6][7], and arrived in China around 2008 [9]. • PMMA (polymethyl methacrylate): Pursues a long-lasting strategy based on 'physical space occupation + collagen encapsulation stimulation'. Developed by Lemperle in the 1980s, it received CE certification from the European Union in 1994 [19]—the world’s earliest permanent filler. Its product Artecoll entered China as early as 2002, six years before Restylane [10]; its counterpart ArteFill gained U.S. FDA approval in October 2006 [11]. • PLLA (poly-L-lactic acid): The true pioneer of the 'regenerative' approach—no longer simply injecting a foreign substance, but instead stimulating the body’s own collagen regeneration. 'Baby-face needle' is merely its colloquial name. Its prototype, Sculptra, was approved in Europe in 1999 and subsequently received U.S. FDA approval in August 2004 [12]. • CaHA (calcium hydroxylapatite): Evolved from Coaptite (for urinary incontinence, 1990s) → Radiance FN (as an imaging marker, 2001) [21] → facial fillers in the U.S. (2003–2004) [14] → formal FDA approval for Radiesse at the end of 2006 [13]. • PCL (polycaprolactone): Belonging to the same ester family, its product Ellansé received CE certification in Europe in 2009 and entered markets in the UK, Germany, and Spain [15][20]. Here, two distinct regulatory 'household registrations' must be distinguished: PLLA, CaHA, and PCL are mostly strictly defined as 'regenerative materials'—biodegradable, with degradation products naturally present in the human body; the body itself 'builds the factory'. This represents a superior solution to the question, 'Can injected substances safely disappear' [4]. In contrast, PMMA is non-biodegradable and space-occupying, relying on collagen encapsulation rather than self-elimination—a concept rooted in earlier thinking. Yet for a long time, regenerative materials remained largely conceptual or limited to scarce imported products in China. The real turning point came in 2021: Within one year, China’s NMPA granted approvals for Evolus (PLLA), RuBai Angel (PLLA + HA), and Ellansé (PCL), marking the first large-scale, accessible rollout of regenerative fillers in China [16][17]. Meanwhile, 'drugs' began crossing over into this arena: • In weight management: In 2024, semaglutide (Wegovy®) was approved in China for long-term weight management—the first marketed weekly GLP-1 receptor agonist for weight loss [18]. • In wrinkle reduction: Botulinum toxin is regulated as a pharmaceutical—yet the 'most beautiful injection' sits squarely within the regulatory category of toxic drugs. (Botulinum toxin is listed under China’s 'Administrative Measures for Toxic Drugs Used in Medical Treatment'; the official list follows the current version of these measures—see Episodes 4 and 19 for details.)

Tech-Enabled Weight Loss: Can the Middle Class Rejuvenate with Just One Injection?

Is the 'lie-down-and-lose-weight' injection method truly miraculous? Is the weight-loss injection business yet another precisely targeted campaign aimed at China’s middle class? Cheat Codes for Weight Loss "In Week One, appetite decreased and I lost 4 jin (≈2 kg); my condition remained stable." Liang Jing, newly introduced to the 'black magic' of weight-loss injections by a friend, shared her progress log on a popular Chinese social platform. Her post drew a flood of enthusiastic praise in the comments. The weight-loss injection Liang Jing purchased—semaglutide—is a GLP-1 receptor agonist, short for glucagon-like peptide-1. It mimics intestinal hormones in the human body, signaling the brain that 'I’m full,' thereby suppressing appetite and delaying gastric emptying; some multi-target agents can further boost energy expenditure. GLP-1 receptor agonists were originally developed as anti-diabetic drugs for type 2 diabetes. Since reduced caloric intake and increased energy expenditure align perfectly with weight-loss goals, they were quickly repurposed by the medical community for obesity treatment. In 2022, Elon Musk publicly praised its weight-loss effects: "Fasting + sema (Wegovy) helped me shed 20 pounds." Starting in 2023, GLP-1-related drugs—including semaglutide, benralutide, and liraglutide (single-target agents), as well as more potent multi-target agents like tirzepatide—gained approval in China for obesity treatment. Clinical data show that semaglutide achieves an average weight loss of ~15%, tirzepatide ~20%, and mazdutide exceeds 20% in certain populations—each generation outperforming the last. Once the gate to this weight-loss shortcut swung open, people in Europe and North America were the first to celebrate. Hollywood celebrities mysteriously slimmed down en masse; tennis legend Serena Williams even demonstrated GLP-1 injection publicly in a Super Bowl commercial—despite controversy. Among young Americans, discussion of GLP-1 rivals that of ChatGPT. In reality, most international celebrities have not openly admitted using GLP-1 drugs—but whenever someone suddenly appears slimmer, the public’s immediate assumption is, "They’ve been injected." An internet-wide 'Semaglutide Witch Hunt' ensued, labeling sunken cheeks as the 'Semaglutide Face.' According to Morgan Stanley estimates, by the end of 2025, over 50 million people worldwide will have used semaglutide—with nearly 20 million doing so specifically for weight loss. Over the past two years, this trend has swept into China: from celebrities to everyday citizens, all joining the 'injection craze,' while observers vacillate between 'technology' and 'self-discipline.' Don’t blame people for succumbing to the 'allure of the needle.' For modern white-collar workers who never part with bubble tea or coffee, and who habitually snack late and burn the midnight oil, weight loss is virtually a lifelong endeavor. The World Health Organization classifies obesity as a chronic, relapsing disease affecting over one billion people globally. At this year’s China Obesity Prevention and Control Science Conference, data revealed that approximately 34.3% of Chinese adults are overweight, and 16.4% are obese. Professor Wang Fang of Peking Union Medical College Hospital stated that without effective interventions, by 2050, half of all adults—and one-third of children and adolescents—worldwide will face overweight or obesity. Moreover, according to the 2025 'White Paper on Healthy Weight Management for Chinese Adults' and TianYanCha data, roughly 70% of Chinese adults express a desire to lose weight. With proven products and a vast market, combined with humanity’s innate pursuit of beauty and viral social dynamics, the explosive popularity—and profitability—of weight-loss injections was inevitable.

Beauty giants target 'Ozempic face' as boom in obesity drugs opens new market

14 hours ago

Major beauty firms like Galderma and L'Oreal are developing treatments for facial volume loss linked to obesity drugs like Ozempic, with the market projected to reach $2 billion within five years.

reuters

2026-10-20

Beauty giants target 'Ozempic face' as boom in obesity drugs opens new market

Beauty giants target 'Ozempic face' as boom in obesity drugs opens new market

FAQ