frequently asked question (FAQ) concept

Hydrafacial Questions & Answers

~What is the down time?

~There is little to no down time.  The treatment is tailored to your skin type.  You 

may be slightly “pink” immediately after the treatment, which is usually due to the “vortex” fusion (the technology) that allows for medical grade exfoliation, extractions, and infusion of hydrating serum into the skin.


~How is a hydrafacial at Refresh different than a regular facial or microdermabrasion?

~We have a blog on our website that goes into depth regarding this question,

but I feel that the hydrafacial is a “medical grade” facial treatment.  It is not as 

“relaxing”, the machine makes a little noise, the lights are on (so that I can assess your skin and the tolerance to the pressure). So, I would say that in regards to comparing this treatment to a facial you may receive at a different spa environment,the hydrafacial is more aggressive and less about relaxation.  

As a mom, and someone working full time, I want to take care of my skin with 

good exfoliation, peel, extraction and hydration.  However, my free time (me time) allotment is precious. If I have a treatment done that lasts more than 30 

minutes, I can’t stop thinking about everything I need to get done at home/

work, and it is hard to relax.  


~What are boosters?

~Boosters are things that you can add to a signature hydrafacial.  

        ~Brightalive booster which will help minimize dark spots and even skin tone

        prevents new pigmentation formation and restores hydration.

        ~Growth Factor minimizes the appearance of fine lines and wrinkles with a 

        naturally derived growth factor and improves skin health and vitality.

       ~Dermabuilder helps to decrease fine lines and wrinkles and enhance the

       elasticity of the skin.

       ~Rozatrol helps relieve visible signs of red or sensitive skin, helps to hydrate 

       and create a healthy skin barrier and detoxify the skin.

Neurotoxins (Botox, dysport, xeomin), Questions & Answers.

~ What is a neurotoxin/Botulinum Toxin Type A? 

~Basically it is a compound that interferes with with the strength/ability of our muscles to function normally which can help improve the appearance of fine lines and wrinkles.

~What is the difference between the three neurotoxins?  

1). OnobotulinumtoxinA (Botox). 

2). AbobotulinumtoxinA (Dysport). 

3). IncobotuinumtoxinA (Xeomin).


~In my professional opinion, (and according to good research), there are very few differences.  The main difference for patients (there are other differences important to the injector), is really the price and “rewards” that the different companies offer for patients. Some offices have signed agreements with companies which does not allow them to advertise or promote other company’s products.  Often those companies give employees bonuses for selling one product over another company’s product.  Research has proven that  Dysport works faster (on average 2-5 days), while the others take approximately 5-7 days. All of the different compounds take 2 full weeks to reach their full potential and last approximately 3-4 months(depending on the patient). There are other differences that are important to injectors in regards to the amount of “spread” of the neurotoxin (which could influence the area injected and should be determine by the injector).  In my 15 years of injecting I definitely have patient’s that are adamant that one neurotoxin works better for them compared to another.  Essentially, I would listen to your injector and their recommendation (they should always disclose a commitment to a certain company), but also look into the reward systems and what works best for you.


~What are the different reward systems?

~The Allergan Company (Botox) is Brilliant Distinctions.


~The Galderma Company (Dysport) is Aspire.


~They both give different rewards and have different expiration lengths of their

coupons.  It is helpful to sign up prior to your appointment, but if you have

difficulty, we can help:)


~Is it normal for my brows to feel “heavy” after an injection to my forehead?

~If a patient has never had botox or dysport injected to their forehead, it can sometimes feel “heavy”.  It has a lot to do with a persons anatomy (size of the forehead and strength of the muscles), the severity of the static wrinkles, and if a person wants both the vertical wrinkles between their brows (we call them a “one” or “elevens”) injected as well as the wrinkles running horizontal across their forehead.  When a patient has never had injections before, and does both areas at the same time, it can make their forehead feel “heavy” because we have communicated to the majority of the muscles in the forehead to stop moving.  So, while a patient can usually can raise your eyebrow to put eyeshadow on, sometimes after injection you lose the strength to lift your brow as much as you did before.  You want an injector to be somewhat conservative so that you can still make expression, however if an injector doesn’t inject with enough product, it will leave you with expression, but won’t get rid of the wrinkles or won’t last as long.  Basically you want an experienced injector that will appropriately recommend a safe and effective treatment.  The heaviness is often confused with “eye droop”, which is a whole different complication due to over injecting, injecting incorrectly, or a small percent of patients who have unexpected anatomy/muscle strength.  


~Is it better to start injecting when you are younger, or should you wait until you actually have wrinkles?


~Over time, wrinkles produced with movement can transform into “static” wrinkles that are present without movement.  Basically think of your facial muscles like your bicep muscles.  If you go to the gym every day to pump up your “guns”, they will get bigger. Similarly, are facial muscle move every day “building” our wrinkles.  If you stop going to the gym to work on your biceps, the muscle mass will decrease. If we stop your facial muscles from moving, they won’t be able to crease and accentuate/form wrinkles.  That being said, if you have huge biceps, or deep wrinkles, and you only stop “going to the gym” (AKA getting botox or dysport), for a few months and then start up again, then the muscle mass/ wrinkles will come back.  I tell my patients to think of their static wrinkles like a folded piece of paper.  Can they unfold the paper and be wrinkle free?  NO!! You would have to put a lot of work into getting that fold to disappear. Which, as a patient, who wants to soften or get rid of wrinkles, means you have to be compliant with injections every 3-4 months. Basically, the younger you start (within reason:)...the less likely you will form “static” wrinkles.  Now, the caveat to that is....if you start taking care of your skin EARLY with sunscreen, tretinoin or some form of retinol, and exfoliation, the longer you can hold off the injections.


~Is it normal to get a headache after the injection of dysport or botox?


~Yes.  This is common, especially after the first injection, or when people have their forehead injected.  It seems strange that this is a side effect since as injectors we use botox in patients for migraine relief, however, it is something I see especially with patients prone to headaches or migraines.


~It has been a 7-10 days, and I still have movement.  Should I call my injector?

~It takes up to 2 weeks/14 days for your injections to “kick in”.  If an injector would add more too early, you are at risk for over injection which can result in asymmetry and heaviness.  Wait to make a follow up appointment until after 2 weeks to “touch up” or add more.

~I feel uneven after my botox/dysport injection, is this normal?


Everyone is asymmetrical.  As an injector, unless there is an obvious sign of a difference in muscle strength, the FIRST time I inject a patient I use equal amounts (per the patients anatomy and movement).  It is honestly like building a map of a patient’s face.  We use guidelines set by the botox/dysport companies, however through experience, injectors should be aware of when to increase or decrease depending on the individual patient.  At Refresh Med Spa, we offer free “touch ups” after the first injection when a patient comes back for post injection evaluation at 2 weeks.  That way, I know if a certain muscle is stronger in one area and needs more units.  I can re-inject and then I add to the patients “map”/chart that a certain area required more. Hence, the next time the patient comes in for an injection, we are on target.  There is no magical way to determine muscle strength.  It is all about experience, recommended units, and knowing that a patient can always come back for a “touch up”.  If you over inject, then the patient just has to wait it out for a couple months to get movement back.  I err on the side of being conservative (so I can sleep at night :).

Laser hair removal questions & answers

~What should I do to prepare for my laser hair appointment?


1). Shave the area a day or two before the day of your appointment.

2). DO NOT wax or pluck the area 2 weeks prior to your appointment.  If you

      do, there will not be a hair follicle for the laser to target.

3). If you are on an antibiotic, call  the office to make sure that it is

      is not photosensitive.  Some medications are, and make you at risk

      or a burn if you are taking the medication while getting laser hair removal.

4).  Research shows that pain tolerance is lower the week before and during

      menses.  So, if you know when your period/cycle begins, try to schedule

      your appointment avoiding that time.

5). No tanning two weeks before or 2 weeks after laser session

6). No spray tan or self tanner 2 weeks before treatment.


~How many sessions will I need?


~This depends on a person’s age, medical history, and skin type.


~Many spas advertise “permanent” hair reduction.  While this is partially true, it 

can be very misleading without proper education.  Every person has different 

types of hair follicles.  Their are active follicles which are “active” and dormant 

follicles which are “not active”.  Hair follicles grow due to a intricate interaction

between hormones, and other proteins, and cells interaction in the body.  That

being said, it is important that patients are aware of hair cycle growth, as well as

the functions of hair growth.


~The younger a person is, the more “dormant” follicles they have.  So, when a 

person comes to me for Laser Hair Removal, the treatment will target the “active”

hair follicles only.  There is no laser (yet) that can see dormant follicles because they are “covered”, and there is no “color” for the laser to target (the same with blond, gray, or light red hair).  So, if you think about the hormone changes you experience throughout life, it is evident that hair growth is different during certain times.  When a girl goes through puberty, she has hair growth, when a woman gets pregnant, she usually has the most beautiful/thick hair, sometimes not where she wants it:)  It is evident through research that people can have surges of growth during multiple periods of their life.  So, for a provider to tell a patient that hair removal is “permanent”, is both setting the professional up for failure, and the client up for a great disappointment.   If I would tell a 21 year old that her Brazilian bikini will be permanent after 7 sessions, that would absolutely not be true.  The ACTIVE hair follicles targeted (with the appropriate energy), WILL be permanently destroyed.  But the “dormant” follicle remain.  First of all, like I 

said, skin typing is important.  If someone is a higher skin typer, they will need

more session because the energy cannot be set as high.  Also, pain tolerance is different for every patient.  I alway recommend that if a female knows when she is going to start her period, she should avoid the week before and the week of her period.  Research shows that pain tolerance is decreased during this time.So, clients need to know that they will need of touch-ups depending of their age, hormones, health history (polycystic ovarian syndrome for example), and medications they are taking.  This is all discussed at your consultation, and we will give you a realistic view of the number of appointments you will need to start.  We also offer a discounted rate for “touch-ups” after a client has completed a full 7-10 sessions. 



~Skin color/skin typing is extremely important when treating a patient for laser 

hair removal.  Prior to the appointment, we ask every client about their ethnicity,

hair color, eye color, reaction to the sun, etc... These are extremely important

in deciding how to set the energy for a treatment.  I have had many patients 

come to me that have had sessions at another spa and either are upset that 

their treatment wasn’t “permanent”, or the were left with “squares” in the shape 

of the laser head that were either lighter or darker than their original skin color.

Now, this can be due to a couple factors.  One is that a technician is not

experienced, or did not do a complete medical history or skin type assessment.

Another issue is that some client don’t realize how important skin color versus

hair color is. Also, many clients like to tan/spray tan.  However, the darker the skin, the 

more energy the laser places directly on the skin surface resulting in less energy  to the

hair follicle. 


~How often can I have my laser hair removal done?


~Face: Every 4-6 weeks


~Shoulders to the bikini/buttock area: Every 6-8 weeks


~Legs : Every 8-10 weeks


~If I take a break from my laser removal, will that affect my treatment?


~No, people often put their treatments on hold during the summer

months when they might develop a tan/darker skin color.



~When am I not allowed to do a treatment?


~If you are pregnant or breastfeeding.  There is no research that states

that it is safe to do treatments during these times due to “ethical” issues.


~Certain medications are “photosensitive” which can put a patient at risk for a “burn” from the laser.  Always let your provider know if you have started a new medication or antibiotic.


~If you have waxed the area less than 2 weeks before the treatment. The follicles

will be “empty” and you will have poor results from your treatment.

~If you have tanned in the 2 weeks prior to your treatment.


~Always follow the advice/recommendations on the consent form