Question 1

What is a med spa?

Accepted Answer

A med spa (or medical spa) is a hybrid practice combining the relaxing, service-oriented environment of a day spa with medical-grade treatments performed under physician supervision. At Hartwater Aesthetics, every treatment plan is reviewed and approved by a full-time on-site Medical Director, distinguishing us from spas that rely on absentee medical directors.

Question 2

What makes a med spa physician-led?

Accepted Answer

A physician-led med spa has a Medical Director who is actively involved in patient care, reviewing treatment plans, supervising injectables, and overseeing complex procedures like BodyTite. At Hartwater Aesthetics, Dr. Brad Burris (35+ years clinical experience) is on-site full-time, which contrasts with most med spas where the medical director rarely sees patients in person.

Question 3

What are the three pillars of facial aging?

Accepted Answer

The three pillars are skin quality, skin laxity, and volume loss. Skin quality refers to surface health (texture, tone, pigmentation). Skin laxity refers to the loosening of skin from declining collagen and elastin. Volume loss refers to the shrinking and shifting of facial fat pads. A complete anti-aging program addresses all three.

Question 4

Why is skin laxity the pillar most providers miss?

Accepted Answer

Skin laxity requires energy-based devices (radiofrequency, microneedling radiofrequency, minimally invasive surgical technologies) that most med spas don't own. Without those devices, providers either ignore laxity entirely or try to compensate with extra dermal filler, which produces the "pillow face" look rather than actual skin tightening.

Question 5

Can dermal fillers fix sagging skin?

Accepted Answer

No. Fillers add volume, they don't tighten skin. Using filler to compensate for laxity is one of the most common mistakes in aesthetic medicine and produces the puffy, overfilled outcome patients are trying to avoid. To actually tighten skin, you need radiofrequency or other energy-based skin remodeling.

Question 6

What is "pillow face" and how do I avoid it?

Accepted Answer

"Pillow face" describes the puffy, swollen, unnatural look that results from too much dermal filler being injected to compensate for skin laxity the filler can't actually fix. The way to avoid it is to choose a provider who treats all three pillars of aging with the right tool for each, rather than relying on filler as a one-size-fits-all solution.

Question 7

Should I get a facelift, or is there a non-surgical alternative?

Accepted Answer

A traditional facelift removes loose skin and pulls the remaining skin tight, but it doesn't actually improve the skin's elasticity. Non-surgical alternatives like FaceTite, BodyTite, and Morpheus8 use radiofrequency energy to regenerate collagen and elastin in the existing skin, addressing the underlying cause of laxity. For most patients in the early-to-moderate stages of laxity, non-surgical options produce more natural, longer-lasting results without scars or downtime.

Question 8

How long do radiofrequency skin tightening results last?

Accepted Answer

Morpheus8 and BodyTite results continue to improve for up to 12 months as new collagen and elastin develop. The exact duration depends on the patient's age, baseline skin quality, sun exposure, and ongoing skin care routine. While no treatment result is permanent, skin tightening results don't "wear off" in the same way as something like a neurotoxin. Instead, think of RF skin tightening as turning back a clock—the clock continues ticking forward at the same rate, just as we all continue aging, but we help your skin set back the time.

Question 9

Is biostimulator treatment (like Sculptra) better than traditional filler?

Accepted Answer

It depends on the goal. Traditional fillers provide immediate, targeted volume in a specific spot. Biostimulators like Sculptra stimulate your body to produce new collagen, restoring volume gradually over weeks and months from your own tissue. For patients who want a more natural-looking, longer-lasting volume result, especially in larger areas like the cheeks or temples, biostimulators are often the better choice. For patients looking for immediate visible results, however, dermal fillers may be a better option. Many patients benefit from a combination of both.

Question 10

How do I know which pillar is the biggest issue for my face?

Accepted Answer

Most patients have all three pillars contributing to the way their face has aged, but in different proportions. A consultation at Hartwater includes a detailed in-person assessment of skin quality, laxity, and volume distribution. From there, our team builds a phased plan that addresses the pillars in the right sequence for your specific anatomy and goals.

Question 11

How many sessions are recommended?

Accepted Answer

For optimal results, we typically recommend a series of three treatments spaced about 4-6 weeks apart.

Question 12

How quickly will I see results?

Accepted Answer

Visible results are typically seen after the first three weeks and continue to improve over time. Improvements can continue up to six months after completing the final treatment.

Question 13

What is the benefit of fractionated radiofrequency energy?

Accepted Answer

Radiofrequency (RF) energy is a scientifically proven method to remodel and rebuild collagen. It is minimally invasive, using a matrix of micro pins to renew the deeper layers of the skin with almost no patient downtime.

Question 14

Can anyone use Morpheus8?

Accepted Answer

Morpheus8 can be used on all skin types, including patients with darker skin tones. Your provider will adjust the energy settings of the treatment depending on your skin type.

Question 15

Can this be used in combination with other treatments?

Accepted Answer

Yes, Morpheus8 can be used in the same treatment session, or a few days after other treatments. Morpheus8 can also be combined with other energy-based treatments, injectables, and skin care to achieve more extensive results.

Question 16

When can I put on make up after treatment?

Accepted Answer

Since patient downtime is minimal, makeup can be applied 1 to 2 days after the treatment. Patients should expect to see micro lesions a few days after treatment and slight redness depending on treatment parameters.

Question 17

What kind of post procedure care

Accepted Answer

Patients should moisturize the treatment area and avoid direct sun exposure. It is also recommended that patients use a broad spectrum sunscreen every day. In addition to reducing the risk of skin cancer, sunscreens also slow the aging process.

Question 18

Will I see results quickly?

Accepted Answer

Results are typically seen within 7-14 days, with full effects seen after two weeks.

Question 19

How long does Botox last?

Accepted Answer

Results typically last 3 to 4 months, depending on dosage. Most patients plan treatment every 3 months to ensure consistent results. Since neurotoxins can take up to two weeks to take full effect, we typically recommend overlapping treatment, so that each dose is received about two weeks before the previous dose wears off. Remember that results vary from patient to patient, so your provider will plan your next appointment based on your results and aesthetic goals.

Question 20

What's the difference between Botox and Dysport?

Accepted Answer

Both are botulinum toxin type A injectables and share the same active mechanism. Dysport diffuses more broadly through the tissue once injected, which often makes it preferred for larger areas like the forehead. Botox has a tighter spread and is often preferred for smaller, precise areas like the glabellar (between the brows) or around the eyes. Dysport also tends to show initial onset in 2-3 days vs. 4-7 days for Botox. Pricing per unit differs (100 units of Botox is roughly equivalent to 300 units of Dysport), so always compare total treatment cost rather than per-unit cost.

Question 21

Does Botox hurt?

Accepted Answer

Most patients describe the discomfort as minimal, similar to a quick pinch. The needles used for neurotoxin injections are very fine and the injections are very shallow. At Hartwater, Lindsey uses additional comfort techniques (such as ice or topical numbing on request) for patients who are particularly needle-sensitive.

Question 22

Will Botox make me look frozen or unnatural?

Accepted Answer

Not when administered correctly. The "frozen" or "overdone" look is the result of over-treatment, not of Botox itself. At Hartwater, our injection philosophy emphasizes precision placement and conservative dosing. The goal is to relax the muscles responsible for expression lines while preserving your natural facial expressions. We will not over-treat, and we will say no if a request is not clinically justified.

Question 23

How much does Botox cost in McKinney?

Accepted Answer

Hartwater Aesthetics publishes transparent pricing: Botox is $13 per unit and Dysport is $4.33 per unit. A first-time forehead and glabellar treatment commonly requires 20-40 units of Botox or 60-120 units of Dysport, depending on individual anatomy. Always compare total treatment cost rather than per-unit cost between the two products, since 100 units of Botox is roughly equivalent to 300 units of Dysport.

Question 24

Is preventative Botox a real thing? When should I start?

Accepted Answer

Yes. Preventative or "baby Botox" refers to starting small-dose neurotoxin treatments before deep expression lines have formed, typically in the late 20s to mid-30s. The theory is straightforward: lines that have never been allowed to form are easier to prevent than to reverse. Whether preventative Botox is right for you depends on your facial expressiveness, your genetics, and your aesthetic goals. Lindsey can advise at consultation.

Question 25

Can men get Botox?

Accepted Answer

Absolutely. Botox for men ("Brotox") is one of the fastest-growing segments in the aesthetic industry. The treatment approach is typically different from women's Botox: men often have heavier muscle mass and require higher doses, and the goal is usually a softening rather than full elimination of expression lines (preserving the more masculine, expressive look). Lindsey has extensive experience treating both male and female patients.

Question 26

Are there off-label uses for Botox like TMJ or migraines?

Accepted Answer

Yes. Botox is FDA-approved for chronic migraines (in patients with 15+ headache days per month) and severe primary axillary hyperhidrosis (excessive underarm sweating). It is commonly used off-label for TMJ and teeth grinding by injecting the masseter muscle. All off-label and FDA-approved indications require an evaluation by your Hartwater provider to determine candidacy.

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