I always had to have the biggest amplifier I could get. The problem was feedback and the fact that I worked outdoors in the arctic, in places where the rain just hoses down, in constant wind, salt spray and fog, massive heat and noise, wearing a huge variety of hardhats, raingear, and cold weather, gear. Makes me tired just thinking about it. I could have been a lab study for industrial strength hearing aids. I paid for the hearing aids I destroyed on a regular basis out of pocket. Those were the BTE's of the day. Feedback, large size, lousy sound discrimination, not water or dust resistant, and fragile. Then technology improved and I could get the expensive full size ITE's that were at least protected from some of the problems- they did not freeze easily and the hardhat did not hit them still wind was a problem, rain not so much. They were not hidden well filling up my whole ear and I maxxed out the amplifiers and still was not hearing well enough. Still they made my life easier.
Those little ITE's were never a solution for me even though ?audioligists? trying to sell me on them. There are a lot of costs in those little ITE's.
Then technology improved again and BTE's are now AWESOME. They are not huge but pack a big punch, lots of amplifier, lots of sound discrimination, water resistant, have extra features, different colors, tough plastic, and thank you thank you not much in the way of feedback. The audi can save you money like for phonak brand- I use, by getting you the aid you need with less frills but the same basic amplifier and great sound.
There are people on here that know way more than I and are way smarter than I as well but I can say I have crash tested HA's for a very long time and the BTE's like phonak are doing mighty good.
Still there are a couple things about the full size ITE's I like better- ear protectors go on and off better, and they do not get knocked around. I never did like the way telecoils work but they do it better. I just cannot hear well enough with them all around.
On the cosmetic part I am past that so no help there really though I understand. If your hearing loss is moderate you may find something that works in small ITE aids and you can get pretty clever at positioning yourself and pushing buttons or using a pocket remote for changing sound programs. Technology is really moving now so it is worth checking out what is out there. Miracle Ear? Waste of time and money. Good luck!