Beauty isn't one-size-fits-all: bridging the cosmetic procedure gap between fair and melanin-rich skin

If you’ve ever binge-watched "The Real Housewives" or scrolled through Instagram, you’ve likely seen the influence of cosmetic surgeries. From lip fillers to facelifts, the "Instagram Face" trend has shaped how people, especially women, view beauty. 

But while these trends dominate social media, they don’t always work for everyone, especially if you have melanin-rich skin.  

The truth is that what works for fair skin may not work for darker skin tones. This isn’t just about aesthetic preferences; it’s about biology, cultural narratives, and the risks involved in certain cosmetic procedures. 

To unpack this, "Independent Media Lifestyle" spoke to Durban-based plastic surgeon Dr Kajal Klutch, a respected expert in cosmetic surgery for diverse skin tones.  

The beauty gap: why skin tone matters  

When it comes to cosmetic procedures, one size doesn’t fit all. Aesthetic trends often stem from Eurocentric beauty standards, which don’t always align with the features or needs of ethnic groups. 

For example, ethnic women may aspire to procedures like lip fillers or nose reshaping, but the results often differ due to unique facial structures and skin types. 

She shares an example: “I often see patients who come in with celebrity photos, saying, ‘I want this nose’ or ‘I want these lips.’ But what works for one person won’t necessarily suit another. Our job as surgeons is to guide patients toward results that are harmonious with their natural features.”  

This is especially true for ethnic women, whose facial structures and skin qualities differ significantly from Eurocentric aesthetics. 

For instance, full lips and high cheekbones are already natural features for many African women. In these cases, subtle enhancements rather than dramatic changes are key to achieving a balanced, natural look.  

“Cosmetic surgery should enhance what makes you unique, not erase it,” says Klutch. She explains that darker skin contains more melanin, which impacts how it reacts to treatments like lasers, chemical peels, and even surgical scars.  

One key consideration is the Fitzpatrick scale, which classifies skin tones from Type 1 (very fair) to Type 6 (deeply pigmented). 

“Most African and Indian patients fall in the Type 4 - 6 range, which means their skin is more prone to hyperpigmentation, scarring, and keloids. This is why treatments designed for lighter skin tones can backfire on darker skin, leaving long-lasting damage. "

While social media filters and celebrity transformations drive aesthetic trends, they can be misleading, especially for people of colour. Many procedures commonly marketed as safe can pose significant risks for darker skin tones.  

Take lasers, for instance. They’re often used for skin rejuvenation or hair removal, but aggressive laser treatments can trigger post-inflammatory hyperpigmentation (PIH) in darker skin. PIH causes dark spots that can take months or even years to fade.  

“Lasers can be safe for darker skin, but only when the right technology is used. Unfortunately, many practitioners don’t have the right equipment, which puts patients at risk.”  

Another risky procedure for darker skin is chemical peels, particularly deep peels like TCA or phenol peels. While these are effective for fair skin, they can result in permanent scarring or uneven pigmentation for patients with melanin-rich skin.  

Treatments that work for melanin-rich skin  

Despite the challenges, there are many safe and effective options for darker skin tones.

Here are a few treatments Klutch recommends:  

1. Microneedling with radiofrequency: This treatment stimulates collagen without the risk of hyperpigmentation. When paired with cooling technology, it’s especially safe for darker skin. “The beautiful thing about black skin is its ability to produce collagen,” she says.

“A little treatment goes a long way.”  

2. Non-surgical facelifts: Non-invasive options like thread lifts or injectable fillers can enhance facial contours without the risks associated with surgery. These treatments are ideal for patients who want subtle improvements without downtime.  

3. Skin brightening (not lightening): Klutch emphasises the difference between brightening and lightening. “I’m not here to change someone’s skin tone,” she says.

“But I can help reverse sun damage, even out pigmentation, and restore a natural glow.”  Before undergoing any procedure, patients should invest in a medical-grade skincare routine.

“Healthy skin is the foundation of any good result,” she explains.  

Celebrating individual beauty  At the heart of this conversation is a shift from chasing trends to embracing individuality. Klutch sees her role as helping patients celebrate their unique beauty. She asks, “Why should everyone look like Kim Kardashian? Why not embrace what makes you, you?”  

“Beauty isn’t about looking like someone else; it’s about being the best version of yourself.”  

People are becoming more transparent about their surgeries, which helps demystify the process. "No one wakes up looking perfect at every age. We all have our routines, and that includes some interventions," she adds.

"If something makes you feel good about yourself and you’re not harming anyone, it should be celebrated. I advocate for a culture where people can express themselves without shame.”

"I often find myself advising clients on what suits them best, based on their unique features. It’s crucial to enhance natural beauty rather than push unrealistic standards."

As a doctor to the stars, she recognises the pressures that come with social media, where appearance often dictates perception.

"People in the entertainment industry face scrutiny based on looks. It’s not just celebrities; it’s everyone. Sharing their experiences helps break down barriers and shows that beauty isn’t just about genetics," Klutch says in conversation.

"Whether it’s a teacher or a celebrity, the common thread is that everyone wants to feel good about themselves. It’s not just about the procedure; it’s about the journey to self-acceptance," she explains.

"Many patients come in wanting to replicate a look they saw online. Sometimes, the difference is as simple as a hairstyle adjustment," she said.

Klutch prides herself on being realistic with her patients.

"I’m here to help, not to change who you are. It’s about guiding you to be the best version of yourself."