Clinical Standards

What 23MD won't do, and why

Name: What 23MD won't do, and why
Creator: Dr Suha Kersh

Dr Suha Kersh

Co-Founder & Lead Aesthetic Doctor

11 May 2026·5 min·Vol. VII · 03

A woman applying face cream beside a mirror illustrating the subject of aesthetic care at 23MD

Quick answer: 23MD does not pay for awards, adopt every new device or trend, prescribe GLP-1 weight-loss medication without medical supervision, use energy-based treatments to reduce fat in the face, publish health claims it cannot support, or post before-and-after photographs of patients' faces in public. Each is a deliberate decision about protecting patients' trust and their results.

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Why we publish this

A practice is defined as much by what it declines as by what it delivers. Patients choosing a clinic often rely on signals that are easy to buy or easy to exaggerate: awards, headlines and promises of quick results. These are the lines we hold, and the reasons for each.

Why doesn't 23MD pay for awards?

Awards and "best clinic" listings are a common way to signal quality, but some can be won or bought through entry fees, sponsorship or paid placements. A title that can be bought tells a patient little about the care they will receive. 23MD does not pay to win awards or to buy rankings. We would rather patients judge us on what they can check for themselves: who treats them, what those doctors are qualified to do, and how openly we explain the evidence. You can read about our doctors on The Doctors page.

Why doesn't 23MD offer every new device or trending treatment?

New devices and treatments reach aesthetic clinics quickly, often with persuasive marketing and very little independent evidence. A review of 31 studies of radiofrequency skin treatments in Anais Brasileiros de Dermatologia is a useful example: almost all reported a benefit, but nearly all lacked a control group and none were blinded [6]. Early results like these are a reason to watch a technology, not to sell it.

Before we add anything, we ask what problem it solves that our existing treatments do not, what independent evidence supports it, who funded that evidence, and how it fits a plan for the whole face over years. Many trends do not pass, and some that do are added only once the evidence matures. A shorter menu of treatments we understand well serves patients better than a long one built around what is new.

Why doesn't 23MD prescribe GLP-1 medication without supervision?

GLP-1 medicines for weight loss are prescription-only. The UK medicines regulator, the MHRA, has called them "not cosmetic treatments but powerful medicines" and warned against buying them without a prescription, including from beauty salons and social media [1].

Prescribing them responsibly involves more than a dose. Before starting, we want to understand the metabolic picture through blood tests and a full history. During treatment, the weight lost includes some muscle as well as fat, so we track body composition, not just the scales. And there needs to be a plan for stopping: in the STEP 1 trial extension, people who stopped treatment regained about two-thirds of the weight they had lost within a year, and most cardiometabolic improvements moved back towards where they started [2]. Prescribing without that work-up, monitoring and exit plan is dispensing, not medicine. Our approach is set out in GLP-1 medication after the prescription and on our metabolic and weight optimisation page.

Why doesn't 23MD use energy-based treatments to reduce fat in the face?

Some radiofrequency and ultrasound devices heat the deeper layers of the skin, and some are marketed to reduce fat. On the body, fat reduction can be the aim. In the face it rarely is: facial fat supports the cheeks, the temples and the area around the eyes, and losing it is one of the things that makes a face look older. Once lost, it does not reliably come back.

High-energy treatments can remove facial fat that was never meant to go. In October 2025 the US Food and Drug Administration issued a safety communication on radiofrequency microneedling that lists burns, scarring, fat loss, disfigurement and nerve damage among reported serious complications, some needing surgical repair [3]. Reports describe fat loss particularly around the eyes and cheeks, and clinicians have been advised to take care with depth and energy and to avoid stacking repeated passes [4].

We do use radiofrequency to tighten and improve skin, including RF microneedling in Dubai and HydraFirm, with depth and energy chosen to protect facial fat rather than reduce it. We do not use energy-based devices, or settings, intended to reduce fat in the face. Our options are compared in What skin tightening treatments are available?

Why doesn't 23MD publish misleading health claims?

Health information spreads quickly online, and not all of it is accurate. Every 23MD Journal article follows a written editorial standard: each clinical claim links to a source that was opened and checked, the evidence is described honestly, including when it is small, early or funded by a manufacturer, and a named 23MD doctor reviews the article before it is published. We do not publish prices or guarantees. Our social media follows the same rule. When the evidence changes, we update the article and its review date.

Why doesn't 23MD post before-and-after photos of patients' faces?

Before-and-after photographs are among the most persuasive images in aesthetic marketing, and among the easiest to mislead with. Lighting, camera angle, expression, make-up and the timing of the second photograph can all change how large a result appears. The Advertising Standards Authority says such images must show the effect patients could typically expect, and that before-and-after images of a prescription-only treatment are very likely to be seen as an advert for a prescription medicine, which is not allowed [5]. There is also the patient's privacy: a face is the most identifiable thing about a person.

We do not post before-and-after photographs of patients' faces in public. If you would like to understand what a treatment might realistically do for you, your doctor will talk it through at your consultation.

What does 23MD do instead?

Every plan starts with a consultation that looks at skin, structure, movement and personality before anything is suggested; see Reading a face: the four dimensions before any intervention and The consultation: what 23MD asks before it offers. Treatments are chosen to work together over time. Declining a request, or referring a patient elsewhere, is part of that standard of care, not a failure of it.

Who this is for, and who it isn't for

Useful for: patients comparing clinics who want to know how treatment decisions are made, and anyone who has been offered one of these treatments and would like a second opinion.
Not a substitute for: an individual assessment. Suitability and results vary, and your doctor will explain the benefits and risks of any option.

Talk to a 23MD doctor

If you are weighing up one of these treatments, or would like an honest view of what might suit you instead, our doctors are happy to talk it through.