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Resurface, Rebuild, Relax: The November Med Spa Specials I’d Actually Book Before the Holidays

November Med Spa Specials flyer, Renew Restore Revive promotions at The Med Spa at Southwest Plastic Surgery East and West, El Paso Texas, Frank Agullo MD FACS

Resurface, Rebuild, Relax: The November Med Spa Specials I’d Actually Book Before the Holidays

It’s November here in El Paso and Thanksgiving is a few weeks away. The office holiday party happens after that and I bet for some of you visiting your in-laws happens soon after that. Every week this month I get some version of this question: “How do I look rested in six weeks without anybody knowing I did anything?”

Resurface the skin’s surface, stimulate collagen production in the deep layers and relax the facial lines that make you look tired. Three different levels of the face, three different time courses and done in time for Christmas if you start in November. That is the whole November board.

Surgeon-to-surgeon, here are the treatments I’d do if I was on the November board: a Sciton laser treatment I’d do on myself, a microneedling package that I think trumps PRP, and a neurotoxin special with numbers that make sense.

And they’re all worth doing. Let me explain.

Renew. Profrac and the Micro Laser Peel, 20% Off.

Sciton’s Erbium laser (2940 nm) comes in a few flavors but the two I use most often are ProFrac (fractional ablative) and Micro Laser Peel (superficial ablative).

Erbium lasers ablate (vaporize) skin. Erbium laser energy is preferentially absorbed by water, and since skin is mostly water, especially at the surface, there’s very little wasted energy. Ablation happens where you aim it and the heat falls off quickly. That makes Erbium accurate and predictable, with less collateral thermal injury and more predictable healing. This is one of the ways it is kinder than a CO2 laser.

A Micro Laser Peel is a light-based peel. Ablation of the skin’s surface is uniform (not fractional) and the depth is tunable, in microns. A peel done with a laser is more consistent than a peel done with a chemical reaction on a moving target (your face). But a peel is a peel, and in the right hands either one can outperform the other in a given skin.

ProFrac creates columns (fractional) of ablation that can be taken deeper than a Micro Laser Peel, and leaves un-ablated columns of skin in between to speed healing. Patients ask what the point of ProFrac is if we are already doing a Micro Laser Peel. The answer is depth. Micro Laser Peel plus ProFrac is a combo I do a lot: uniform, superficial resurfacing of the face plus deeper fractional ablation to stimulate collagen in the dermis. Two levels of the skin treated in one visit with one recovery.

Facelifts and deep plane neck lifts reposition the deeper structures of the face and neck and tighten the deep investing layers, but they don’t improve skin quality. Laser resurfacing after a facelift or deep plane neck lift is how you improve the skin itself. This is another way Erbium lasers shine: they heal more predictably than CO2 lasers, which is kinder to patients who are already healing from surgery. Micro Laser Peel to uniformly resurface the skin and ProFrac to stimulate collagen production in the deeper layers of the face and neck.

For patients who are not surgical candidates (or who don’t want surgery anytime soon) Micro Laser Peel and ProFrac are great stand-alone treatments to improve skin quality. Micro Laser Peel is great for uniform textural change like sun damage and ProFrac is great for deeper lines. Recovery is a little longer than non-ablative lasers. Expect a sunburn feel for a day or two and pink, flaky skin for three to five days after ProFrac, and just flaky skin (depending on the aggressiveness of the treatment) for about a weekend after Micro Laser Peel. Apply numbing cream for forty-five minutes before treatment. Expect a warm sunburn sensation during treatment. Back to normal makeup by day seven. Do it three weeks before Thanksgiving and you are healed and glowing when the family shows up.

Post-inflammatory hyperpigmentation can happen after Erbium laser treatments in darker skin types (Fitzpatrick IV to VI), but it can often be mitigated by altering the treatment parameters, pre-treating the skin, and sometimes choosing Micro Laser Peel over ProFrac. Always discuss candidacy before booking.

Book a Micro Laser Peel or ProFrac in November and get 20% off. That applies to single treatments too. How many will you need? If you have substantial sun damage I might recommend two treatments three to six weeks apart. If you just want to look your best for an event, one treatment three weeks before should do it.

Restore. The Glow Package: Microneedling with Ariessence Pure PDGF+, $750.

I said this is the quiet upgrade over PRP, and I meant it.

This month, one microneedling-plus-growth-factor treatment is $750. It’s called the Glow Package, and you’ll leave with a goodie bag (skincare worth taking home). Sorry, we can’t tell you what’s in the bag. That would ruin the surprise.

Microneedling stimulates collagen by creating thousands of controlled injuries (microchannels) in the skin at a depth we set for you. Your body responds by sending fibroblasts (the collagen-producing cells) to each microchannel to lay down new collagen and elastin over the following weeks. Skin becomes smoother, firmer and more radiant, and the pores tighten up.

PDGF (platelet-derived growth factor) is arguably the most potent growth factor in human wound biology. PRP (platelet-rich plasma) is made from your own blood in the office: we draw blood, spin it down to concentrate the platelets and apply it to the skin during microneedling. Platelets carry growth factors (including PDGF) that signal cells in the skin to make more collagen. PRP works. I have used it for a long time. Problem: the amount of growth factor varies from patient to patient and even from morning to afternoon. Sometimes PRP is great, sometimes not so much.

Ariessence Pure PDGF+ is a PDGF rich topical that delivers more PDGF than you’re likely getting from your own PRP. It’s consistent from tube to tube and visit to visit. No blood draw required. It’s my favorite upgrade for patients who have already tried PRP microneedling or are hesitant about sticking themselves for their own blood.

Expect pink skin for a day or two after treatment, glow two weeks later and continued collagen production for four to six weeks thereafter. Best results after three treatments four weeks apart followed by one treatment every three to four months for maintenance.

Revive. Buy 50 Units of Neurotoxin, Receive 10 Units Free.

Straight from me on the November math: pay for 50, get treated for 60.

Neurotoxins relax muscles to keep dynamic lines from becoming permanent wrinkles. All four neurotoxins we offer (Botox, Dysport, Xeomin, and Daxxify) have slightly different times to onset (time until you start noticing changes), time to peak effect (when it’s working the best), and duration. When choosing which neurotoxin to use for you I take those factors into account as well as which areas we’re treating, how much I plan to inject, and your goals and timeline for seeing results. The special works with any of the four.

Sixty units is enough to treat all three upper-face areas in most people: the forehead (frontalis), the horizontal forehead lines; the frown (corrugators and procerus), the vertical lines between the brows; and the crow’s feet (lateral orbicularis oculi), the lines at the outer corner of the eyes that flare out when you smile. Wrinkles form where the skin repeatedly creases when the muscle underneath contracts, which is why we assess muscle activity before injecting. It is also why I’ll ask you to raise your eyebrows, frown and smile when you’re sitting in my chair.

Underdosed Botox doesn’t soften lines enough. Overdosed Botox leads to a frozen appearance on camera. For most patients, 60 units injected strategically softens lines in the upper face and restores a refreshed appearance.

Neurotoxin peaks at seven to fourteen days after injection and lasts three to four months (sometimes more or less, depending on which product we use, the dose, and your individual biology). If you have holiday pictures coming up, plan on getting it done two weeks before so it is fully effective before you hit the town.

A Clean Comparison

Special What it is Investment Best for
Renew Sciton Erbium platform: ProFrac (fractional) and/or Micro Laser Peel (full-field) resurfacing 20% off, single sessions qualify Sun damage, fine lines, dullness, surface texture
Restore Microneedling with Ariessence Pure PDGF+ (Glow Package) $750 per session with a complimentary goodie bag Collagen rebuild, brightness, firmness, pore quality
Revive Botulinum toxin injectable for the upper face Buy 50 units, receive 10 units free Softening forehead lines, frown lines, and crow’s feet

Where to Come, East or West

All of our November specials can be done at either of our El Paso locations.

Eastside: 1387 George Dieter Drive, Building C, El Paso, Texas 79936.

Westside: 5925 Silver Springs Drive, Suite C, El Paso, Texas 79912.

Same team, same protocols, same device inventory on both sides of town. Pick whichever side fits your week. The Med Spa page has the full menu, the laser treatments page has more on the Sciton platform, and the injectables page covers the neurotoxin menu.

A Note on Who Is Doing the Work

The name on the door matters here. Mine. I’m Mayo Clinic plastic surgery fellowship trained, double board-certified, a Clinical Associate Professor at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine and a Castle Connolly Top Doctor for thirteen years running. The Med Spa at Southwest Plastic Surgery practices medicine the way I practice medicine, on protocols I designed and with staff I trained.

Medicine is complicated, and procedures like ablative laser resurfacing, microneedling with PDGF or neurotoxin injections deserve to be done by an expert. The hand on the device is the whole treatment.

Ready to Talk?

Call our Med Spa at (915) 590-7907 to book any of the November specials at the Eastside (1387 George Dieter Building C) or Westside (5925 Silver Springs Suite C) office, or text 1-866-814-0038. For surgical or combined consults, call my main office at (915) 590-7900 or book online at agulloplasticsurgery.com/appointments. Follow me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook. #StayBeautiful

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Reading the Ambassador Face: A Candid Surgeon’s Breakdown of Layered Aesthetic Work

Black and white editorial comparison of two portraits side by side. Aesthetic analysis commentary by Dr. Frank Agullo, MD, FACS.

Reading a face from photos is one of the more interesting things I do, and influencers make it easier. So much of their work gets documented, especially when they are a brand ambassador for a med spa and probably get a lot of their care in exchange for the publicity. Let me read one of these faces candidly, the way I would talk it through with a colleague. This is an educational read, not a diagnosis. I have not treated her, and a photo is not a consultation.

What We Can Be Fairly Sure About

We know for a fact that she’s had neurotoxin to the upper face, which includes the forehead, crow’s feet, and glabella, in hopes of making her eyes more open. She’s had Sculptra to the temples to fill in her temporal recession, hollowness, or temporal wasting. She’s also had Renuva to the temples, also for volume. This is a fat graft. It’s a donor fat graft that is processed, and it encourages ingrowth of fat in that area.

She also had hyaluronic acid filler in the lips, which it seems she did not like and then had dissolved, even though I still see some hints of more volume than she previously had. There is some filler still there that wasn’t completely removed. She had a Botox lip flip. She’s also had PDGF for the under eyes, which is platelet-derived growth factor, which encourages collagen ingrowth. She’s had various lasers and radiofrequency, including Tixel, a thermal resurfacing device, Moxi, a resurfacing laser, and Agnes RF, which is very similar to Morpheus8.

The Weight Loss Is Doing a Lot of the Work

Judging by her earlier photos and her photos now, she’s definitely lost too much weight. I’m not sure if she’s been using a GLP-1, but this has caused her to lose a lot of the good fat in the face, which is the reason she had to fix the temporal wasting. You can notice in the current pictures that she has a lot less lower cheek fat and a lot more angulated jawline. This could all be from weight loss.

Now she has a lot more anterior malar volume, so she may have had some Sculptra and Renuva in the upper cheek area. I’m sure she maintains the skin also with broadband light, like BBL. And I think she’s probably had neurotoxin also to the masseters and lower face, which you can see from her slimmer jawline. She probably has good skin quality maintenance with medical-grade topicals, so tretinoin, vitamin C, but this has never been disclosed.

Why the “She Had X” Take Is Usually Wrong

When you read a face like this, the honest answer is never one thing. It stacks many small treatments over years, plus a real weight change, plus maybe one well-chosen surgical step. The internet wants “she had a facelift” or “she had buccal fat removal.” The truth is messier, and from a photograph you can only ever offer a careful, hedged read.

The One Thing That Hints at Surgery

Now, what calls my attention the most, and I’m not sure she’s had any surgical work, and she is rather young, under forty, is that her brow position is significantly different from her earlier days. It’s pulled up and laterally, which actually opens her eyes. Although a certain degree of this can be achieved with botulinum toxin, the degree she’s showing looks more pronounced. She may have had an endoscopic brow lift, the ponytail type, which can help with brow shaping, and it’s very effective and looks very natural.

Other than that, I don’t see any other signs of actual surgical work. You can see that her nose is unchanged. Although she may have had a rhinoplasty in her early life, you can see that it is off the midline and could actually use improvements. It does look unchanged from her previous photos to now.

The Credential Behind the Opinion

Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, American College of Surgeons Fellow, Mayo Clinic plastic surgery fellowship, Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, Editorial Board Member at Aesthetic Plastic Surgery, and Castle Connolly Top Doctor for thirteen consecutive years. The technical read is fair game. The flat “she had X” diagnosis is not.

Ready to Talk?

If there is a look you are chasing, the real question is which of these layers applies to your face, and in what order.

For the patient-facing treatment-by-treatment guide, see the companion post on agulloplasticsurgery.com. For the treatment menu behind this kind of work, see the version on swplasticsurgery.com.

Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.

@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.