The cosmetic wave in dermatology dots our 25th anniversary issue, from article to article. Leaders in dermatology over the last quarter century feel about this change in one of two ways: They either encourage the trend because they see it as a new, exciting venue for dermatologists to expand their practices and meet the needs of an aging population known for its vanity, or they discourage it because they feel new-age dermatologists will focus on the trend to the detriment of true clinical practice.