"Aesthetic medicine" vs "cosmetics (home care)" -- which is better? This question itself is actually incorrect. The two are fundamentally different approaches, each with clear areas of expertise.
Aesthetic medicine (laser, injection, chemical peeling) intentionally breaches the skin barrier to act directly on the dermis and deeper layers. Cosmetics, on the other hand, gently care for skin through the stratum corneum (the outermost layer).
The penetration barrier -- the stratum corneum
No matter how excellent cosmetic ingredients are, their effects are limited if they cannot cross the stratum corneum "wall". The stratum corneum is only about 0.02mm thin but functions as a powerful barrier against external substances. Molecules above roughly 500 Daltons are unlikely to pass through (the 500 Dalton rule). Being below 500 Da, however, does not guarantee penetration — charge, lipophilicity, hydrophilicity, the base formulation and stability all matter.
Aesthetic medicine physically (laser) or chemically (peeling) breaches this barrier to deliver agents to the dermis. This is the basis of its "immediate efficacy."
Each has its strengths
Aesthetic medicine excels at deep wrinkles, sagging, pigmentation removal, and volume restoration -- areas requiring structural change. Cosmetics excel at hydration, barrier maintenance, UV protection, and mild aging care -- maintaining the skin's "daily infrastructure."
Complementarity, not opposition
The wisest approach is to view them as "complementary" rather than "opposing". Maintain and maximize the effects gained from aesthetic medicine through daily home care. This integrated perspective is most important for long-term skin health.