The HydraFacial™️ system is a patented four-step program that cleanses, extracts, and hydrates the skin using gentle suction, special skin surface tips, and a series of formulated fluids to address your specific skin needs.  Many professionals have found it to be more effective than IPL, microdermabrasion, and chemical peels for maintaining healthy skin, while being painless with no downtime!

I like to say the HydraFacial is to the standard facial what vacuuming is to sweeping.  The HydraFacial employs gentle suction and fluids, rather than abrasive chemicals, and manual extraction to provide you with great results.  I chose to offer the patented HydraFacial at my Medispa because I found it to be safe, comfortable, and effective.  Generally, clients notice a brightness and youthfulness in their face after one treatment, though monthly sessions are optimal.

The standard HydraFacial removes dead skin, painlessly removes debris from pores, nourishes the skin with moisturizers and then saturates the skin’s surface with antioxidants and peptides.  Booster serums, red and blue LED lights, and even Lymphatic drainage can be added to the standard four-part Signature HydraFacial to personalize and expand treatment results.  HydraFacial also partners with Dr. Obagi’s line, which is exclusively sold to physicians, to offer a series of ZO®️ boosters that pair nicely with home care products. To minimize uneven skin tones and lighten brown spots, a ZO Brightalive booster can be added to the HydraFacial and paired with the ZO skin brightener for home use.  To address and reduce fine lines and wrinkles, particularly those around the mouth and above the upper lip, a Connective Tissue Growth Factor booster can be added and paired with ZO Growth Factor Serum for daily home treatment.

For oily or acne-prone skin, two treatments with Beta-HD can help reduce congestion, especially when combined with Blue LED lights which kill surface bacteria.  The combination, along with a good home care regimen, can treat the acne-prone face, which can, unfortunately, return with adult hormonal shifts.  Adding lymphatic drainage to any of the listed protocols turns the HydraFacial into a truly unique, relaxing and rejuvenating experience.  Routine, comprehensive skincare and sun protection are vital to graceful, healthy aging.

Use your sunscreen regularly and consider a HydraFacial.  You WILL see a difference.

ZO®️ Skin Health is an innovative skin line that we carry at Refresh Medispa.  The line was created by Dr. Obagi and is only sold to physicians who then make product recommendations that suit an individual patient’s skin type and therapeutic needs.  Some of the ingredients and concentrations are higher than can be sold over-the-counter.  The line provides both daily care products and therapeutic treatments to optimize patient’s skin health.  Impressed with the quality of these products and the scientifically sound ingredients, I personally used the ZO®️ skin health line on a daily basis for over a month before I decided to carry it at Refresh.  I found it to be extremely effective in improving the overall quality of my skin and, in my case, reducing fine lines and wrinkles.

After determining your skin’s characteristics, areas of concern, and your skin care goals, I will create a unique and personalized protocol for you.  This will include product selection and may include other supportive services to optimize your skin’s health and appearance.  The ZO®️ program is a three-step program.

The first step is simply “Getting Skin Ready” and includes daily care products; cleansers for oily to dry skin, exfoliating polishes that remove dead skin, and toners to control oil or sooth dry skin.

Step Two in the program is to “Prevent and Correct”. Daily Power Defense promotes skin repair with powerful antioxidants delivered in a daily cream creating a more youthful look.  If uneven skin tones are a concern, Brightalive®️, a non-Retin-A skin brightener, can be used to lighten brown spots and soften color differences.  It can be used daily and will not irritate your sun exposed skin like Retin-A can.  If reducing fine lines and wrinkles is the goal this can be achieved with skin rejuvenating Growth Factor Serum.  ZO®️ also has its own self-activating Vitamin C cream, Hydrafirm™️ Eye Brightening Repair Crème and Retinol Skin Brightener.

The Third Step in the ZO®️ program is to “Protect”.  Protect your skin from the damaging effects of the sun with one of Dr. Obagi’s broad spectrum sunscreen products, or you may prefer Flex by Colorescience, a mineral based SPF 50 sunscreen that also acts as a foundation.    Sun exposure can cause color changes, surface texture alterations, and thickening of the skin, which can deepen creases and wrinkles.  We offer a variety of sunscreens with different features including water resistance, tint, and finish.

The ZO®️ line also pairs beautifully with the HydraFacial©️ system at Refresh.


Together, we will tailor a daily home care regimen that will optimize your skin’s health, improve texture, and minimize flaws.  We will create a program that fits your skin needs, your budget, and your life! Healthy skin IS achievable at any age!

Botox®️ or Xeomin®️are commonly injected into 3 main sites; the forehead to treat expressive lines, the outer sides of the eyes to treat “Crow’s Feet”, and between the eyebrows to eliminate frown lines sometimes referred to as “11s”.  But did you know that botulinum can also be used to raise the eyebrows, eliminate horizontal “bunny” lines on the nose, turn up the corners of the mouth, reduce lines above the lip, get rid of chin dimpling and smooth out neck bands?  Read the details below.

Eyebrow Lift

When an elevated brow is desired, botulinum injected into the upper lateral aspect of the circular eye muscle named the orbicularis oculi can achieve this.  By slightly weakening this part of the muscle, the opposing muscle of the forehead literally lifts the eyebrow up. Simple!

Bunny Lines

People use their facial muscles differently. Some people develop vertical “11” lines when they frown while others also contract the muscles on the side of the nose creating a horizontal “bunny” line across the bridge of their nose.  This can be easily treated with a single injection of botulinum to each side of the nose.

Mouth Frown

Do people think you look sad when you are not?  Droopy mouth corners can be improved by reducing the activity of a muscle that pulls the corners of the mouth down, the depressor anguli oris.  This allows the smile muscles that pull up on the corners of the mouth to function, unopposed. Easy as that.

Lip Lines & “Lip Flip”

Nothing makes one feel older than the fine lines that develop above the lip.  Often incorrectly referred to as “Smoker’s Lines”, they can develop in smokers and non-smokers alike.  When low dose botulinum is placed above the lip in the circular muscle that creates puckering, the muscle relaxes, and the lines are reduced creating a more youthful look.  Some people even get the added effect of a slightly wider upper lip leading to its nickname, the “lip-flip”  or the “lip-pop”.

Dimpled Chin

Chin dimpling can occur with age if the mentalis muscles become overactive. Botulinum can be used to relax these muscles thereby reducing the dimpling, giving you a smoother chin.


Teeth clenching and teeth grinding can cause enlargement of the masseter muscle which adds fullness to the face and angulates the jaw. Botulinum into this muscle not only relieves the symptoms of teeth grinding but can have the added benefit of slimming the face.

Neck Bands

The platysma is a broad superficial muscle that spans the neck from the top of the chest to the jawline.  With age, it can develop bands and cords. Botulinum into these bands relaxes them, making them less visible.  The result is a smoother, more youthful neck.

So next time you are in for your Botox®️ or Xeomin®️appointment, let me know if you are interested in treating one or more of these areas.   I will evaluate your unique, expressive face, and we will decide if adding any of these sites would be a good choice for you.

You may remember a picture of Kim Kardashian’s face that went viral a few years ago.  Her face was covered in blood!  Very dramatic!  That was taken after she had a Vampire Facial®️.  But what is a Vampire Facial®️?  Is it as gruesome as it looks and does it have any true value?

Nuts and Bolts

Microneedling is a skin rejuvenating procedure that involves puncturing little holes into the skin using a professional device which delivers tiny needles to a precise depth.  This is done after a topical numbing cream is applied so that the procedure is painless.  The microneedle injuries promote collagen production by the skin which can be further enhanced by the additional  application of platelet-rich plasma.  The PRP is obtained by spinning a vial of your blood in a centrifuge which separates the red and white cells leaving an amber colored serum which is rich in platelets and growth factors.  This serum is then placed on the microneedled skin where it is efficiently absorbed.  It is important to note that the Microneedling procedure is quite effective in promoting collagen production even without the application of your serum as some people prefer NOT to have their blood drawn.

How It Works

In addition to the collagen stimulating effect produced by microneedling, PRP further stimulates collagen production and brings other healing effects to the skin with its growth factors.    PRP has been used in sports medicine for years because of its ability to speed up the healing process. It not only helps the skin produce new collagen, but also new blood vessels and new cells.  The result is tighter skin with visibly improved texture and tone.


Although many people report seeing  immediate improvement in the quality of their skin, a full month is usually  needed for maximum PRP inducing collagen production.  Your skin will look healthier with reduced lines, improved skin tone, less prominent scaring and firmer texture.  Depending on your results,  you may opt for one treatment or choose a series of 3 at one month intervals.

Ideal Candidates

An ideal candidate is anyone looking to modify the appearance or texture of the surface of her skin.  The only clear contraindication to the procedure is a patient with blood or bone disorders such as anemia, blood or bone cancers, those with clotting problems or on blood thinners.  Clients  should avoid any medications that reduce the body’s ability to clot such as aspirin or non-steroidal anti-inflammatory drugs for a few days before the procedure and a few days after.

What To Expect

Following a microneedling with PRP procedure, you can expect some side effects such as swelling, redness and bruising.  You will be sent home with a post-care Collagen infused mask and instructions.  You will be asked to take good care of your skin by using the product you have been given and by avoiding make-up, abrasive skin cleansers, pools, saunas and direct sun exposure.  After a week, you will be able to resume your personal skincare regime while eliminating any Retin-A containing products.


If you want smoother, healthier looking skin and are ready to take the next step (BUT DON’T WANT SURGERY!) micro-needling with or without PRP may be the right choice for you.

(Not Over-done Lips)

Many of us see our lips getting thinner with age.  This is due to a decrease in collagen and elastin formation in our lips just as it decreases in our faces.  Many women would like to have fuller lips like they had when they were younger, but most do not want a fake or over-done look.  Natural, fuller looking lips can be achieved when the right filler is selected, the right amount is injected and in the right way.  Not ready for filler?  Sometimes, fuller lips can be achieved with carefully placed, low dose Botox or Xeomin alone!

Volbella™️ vs Juvederm®️ Ultra XC

(Filler Options)

For those wanting a subtle increase in their lip size, Volbella may be the right choice.  One of Allergan’s newest fillers, Volbella was specifically formulated to be a softer filler with a more natural look.  Alternatively, Juvederm Ultra has been on the market much longer and is the single most popular lip filler.  It adds volume.  Being careful not to overfill the lips (one syringe is usually enough), a natural look can be achieved with either.  Both are FDA approved for lips.  Results are immediate and can last up to a year.  The most common side effects are swelling and bruising in the first few days.


(Not Ready for Fillers)

Botox and Xeomin, both neuromodulators, are most commonly used in the upper face to reduce wrinkles by relaxing muscles of facial expression in the forehead, between the eyes and at the corners of the eyes.  Additionally, they can be used in a low dose to relax or “flip” the upper lip creating a slightly fuller appearance.  Also, Botox can be injected into muscles at the corners of the mouth to flip the down-turned corners up. The results of both of these treatments are subtle but can be enough to make a difference in your look.  Care must be taken to place the neuromodulator in the right muscles and at the correct dose, so that eating and speaking are not affected.


Most of us do not want exaggerated, over-done lips. Most of us do want the slightly fuller lips of our youth.  Whether you are ready to make the leap to filler or would rather try low dose Botox or Xeomin, you have options.

As you age, your skin becomes thinner, especially on the neck.  Concealing your neck with clothing like scarfs or turtlenecks is not a practical solution, particularly in Texas with our hot and humid climate.  Surgical procedures, though effective, come with extended recovery time, expense and risk.  That is why many people are turning to non-surgical procedures that can rejuvenate thin skin and restore a youthful appearance.  We will review a few here.

Botox®️ or Xeomin®️

The platysma is a superficial thin sheet-like muscle that stretches from the jaw-line to the clavicle just below the base of the neck.  With aging, the muscle becomes weaker, separates and forms unwanted platysmal bands.  Injecting these bands with Botox or Xeomin causes the muscle bands to relax and creates a smoother neck.  You can expect results to last 3 months or significantly longer as many of my clients report.

eMatrix™️ Sublative Rejuvination

In addition to muscle bands, the skin on the neck can get thin and crepey with reduced collagen and elastin content.  Sublative rejuvenation causes selective damage to small areas of skin leaving adjacent skin intact to accelerate the healing process. Sublative therapy stimulates fibroblasts to increase production of elastin and collagen which leads to tighter skin.  Amazingly, you will continue to see improvement in your skin texture for up to 6 weeks after a single treatment!  However, usually a series of 3-4 treatments is performed with an impressive cumulative effect.


Almost 2/3 of adults report that they are bothered by fullness under the chin, the so-called ‘double chin’.  In some, the cause is excess fat which can create an unflattering profile.  Treatment for this involves disrupting the membranes of the fat containing cells so that the fat is released and removed from the body.  Kybella is an FDA approved treatment for stubborn fat under the chin.  It is made of deoxycholic acid , a naturally occurring substance in the body.   Kybella is usually administered in a series of 2-3 treatments, scheduled 4 weeks apart.  The total number of treatments can be modified as results are seen.


So, remember to include your neck and décolleté in your skin care regime.  Apply sunscreen and your skin care products to these areas.  If you are not happy with the appearance of your neck, Botox or Xeomin, Kybella or Sublative rejuvenation may be reasonable non-surgical options to consider!

(Using your own blood to grow your own hair!)

Thinning hair in men has long been recognized as an unwanted but frequent component of the aging process. However, many people don’t realize that 80% of women over the age of 60 experience significant hair loss as well.  Thinning hair in women can cause a great deal of emotional stress. In addition, the techniques women use to cope with thinning hair like wigs, weaves, hats and frequent trips to the hair salon can be a financial strain.  Thankfully, a new procedure is now available that can actually reverse the effects of hair loss.

Patient’s progress after 3 PRP treatments
Four stages of hair growth

Platelet Rich Plasma (PRP)  is a natural hair restoration procedure for women and men with mild to moderate hair loss.  PRP uses the person’s own plasma to stimulate collagen and hair growth, which can result in a 39% increase in hair thickness. The procedure is done in the office and can be accomplished in as little as 45 minutes to an hour!  You can return to work or your daily activities immediately after.  The three-step procedure is as follows:

  1. Your blood is drawn.  The blood is placed in a centrifuge and is spun down to separate the cells and the fluids.
  2. The blood is then separated into three layers; platelet poor plasma, platelet rich plasma(PRP!) and cells.
  3. The platelet rich plasma (PRP) is injected very superficially in small amounts into the areas of the scalp where the hair is thinning.

That’s it! Three treatments are performed initially at one-month intervals.  Typically, individuals experience a 19% increase in hair thickness during these first three months with maximum effect at 6 months.  Hair growth can continue for over a year with most individuals requiring single maintenance sessions every 4-6 months.

PRP is a minimally invasive, safe, effective procedure to restore hair volume with no down time, making it a great solution to hair loss for many women (and men)!

The Role Collagen Plays 

Collagen is the most abundant protein in the body and is the main component in our skin, bones, and muscles.  It provides the structure and support that holds the body together.  When we are young, our bodies produce all the collagen we need but as we age, collagen production slows down by 1% per year which can be accelerated even more by exposure to uv light and various toxins like tobacco.  A reduction in the collagen content of skin leads to loss of elasticity and firmness which creates fine lines, wrinkles and a sagging appearance.  So, what can be done?

Collagen Stimulation 

Collagen production is also increased with injury or perceived injury.  Both Sublative Radiofrequency and Microneedling are perceived as injuries by the body and can stimulate the body to increase not only the rate of collagen production but improve the quality of the collagen made.  This increased production can continue for weeks to months after a single treatment leading to firmer, more youthful looking skin.

Replacing Collagen 

One strategy for improving wrinkles and producing a more youthful look is to supplement your body’s collagen either topically in creams and serums applied to the skin or orally by maintaining a diet rich in amino acids or by adding peptide supplements.  Peptides applied to the skin actually stimulate collagen production. Two peptide containing products you may already be familiar with are ZO®️ Daily Power Defense and Recovery Cream.  In addition, two procedures that can improve absorption of these collagen building blocks are a Hydrafacial which exfoliates the skin and Microneedling which allows for direct penetration of the peptides into the deeper layers of the skin.

Secondly, a diet rich in animal and plant proteins can provide the raw materials necessary for collagen production.  If collagen supplements are desired, these should be in the form of peptides which are smaller than collagen and more easily absorbed.


Collagen is the protein that provides structure to your skin creating a smooth, youthful look.  Applying peptides, the building block of collagen, to the skin’s surface increases collagen production and improves texture and tone.  Both ZO®️ Daily Power Defense and Recovery Cream contain peptides.  In addition, a balanced diet rich in peptides or the use of peptide supplements can be another source of collagen building blocks.  And if you want “a little help from your friends,” a Hydrafacial, Sublative RF, or Microneedling can give your fibroblasts a little nudge to step-up collagen production in your skin and turn back the clock, just a little bit!

Millions of people involuntarily grind their teeth or clench their jaw.  Studies have shown that frequent teeth grinding (known as bruxism) affects up to 15% of adults.  Bruxism can lead to aching muscles, headaches, ear pain, jaw problems, disrupted sleep, hypersensitive teeth, tooth wear, and damage to fillings and crowns.  Additionally, excessive use can lead to hypertrophy, or enlargement of the jaw muscle which can change the shape of the face creating a more squared-off jawline.

Fortunately, Botox can be an effective treatment for many cases of bruxism.  Botox is injected into the chewing muscle, the masseter, causing partial paralysis of the muscle and relieving the adverse effects of bruxism without interfering with normal chewing.  A recent 22 patient study performed at the Texas Medical Center in Houston confirmed the value of Botox in relieving the symptoms associated with teeth grinding.  In addition to avoiding any future damage to your teeth, this treatment effectively reduces the size of the chewing muscle and softens the angle of the jaw.

A highly publicized example of this involves Bethany Frankel from ‘The Real Housewives of New York’. In 2016, fans and the media alike noticed a striking change in the size and shape of her jaw.  Bethany explained that the change was entirely due to the Botox treatment she had been receiving for teeth grinding and that she had not had plastic surgery as the tabloids reported.  In a matter of just a few months, I have seen very noticeable softening of the jaw angle in clients I have treated for tooth grinding.  I have even seen it in a member of my family who, not only lost her need for a night guard, but now found she could wake up in the morning without her jaw aching!

Botox is an excellent treatment choice for many people with bruxism, particularly those who find the use of nighttime mouth guards inconvenient and uncomfortable.  If you or someone you know suffers from teeth grinding or teeth clenching, call to schedule a free consultation with me today.  This year, give yourself or a loved one the gift of ”No more teeth grinding!”

Planning to wear those beautiful earrings for the holidays but afraid they are too heavy?

Or maybe you would love to wear your diamond studs but they tend to sit awkwardly on your earlobe?

The earlobes can over time, with age and sometimes with the wearing of heavy, dramatic earrings, begin to stretch and flatten, causing them to lose their youthful volume and support as well as creating a visibly elongated piercing hole.

The earlobes are one area that isn’t often given much attention when it comes to anti-aging treatments.  However, most women would like to make the appearance of their earlobes match their face, and to be able to wear their favorite studs or holiday ornamental earrings with confidence.

Dermal fillers are an extremely versatile type of treatment which can restore the earlobes’ shape and volume. Hyaluronic fillers are perfectly safe to inject into the earlobe and can create a long-lasting natural look.  Small volumes of filler are sometimes all that is required to create the fuller look desired, leaving additional filler to be used in other areas of the face like the nasolabial folds or lips.

Use of a topical anesthetic makes the procedure very tolerable and some patients describe the injections as fairly painless.

So, if you would like to restore a little volume and structure to your earlobes so that your holiday earrings sit well and frame your face nicely, consider hyaluronic filler…quick, easy and effective.