Morpheus8 is one of the most popular treatments we perform in our med spa. The only drawback was that it is a procedure that can be painful for some individuals, or when we’re treating multiple body areas.
Morpheus8 Cool changes that dramatically. The treatments are the same, the depth of treatment is the same, the power is the same. It just makes the procedure so much more comfortable.
I Had It Done First
I myself had to try it before deciding to offer it in our med spa and in our surgery center. When I tried it, it was night and day. The pain level I perceived was a one or two out of ten, without any topical anesthesia or medications on board. This made the treatment a lot faster. I noticed less swelling of the tissues because of the cooling technology. I did feel a little, almost needle-like sensation every so often, but very tolerable. I also noticed that the handpiece vibrates as it’s performing the treatment, so that camouflages the pain even further.
One of the people who made Morpheus8 so popular is Kim Kardashian. You can actually see my first treatment on Instagram as well, and although I’m not as popular, I think you’ll enjoy it.
What You Feel
You will feel the cool head of the applicator on your face. You will feel some vibration, and every now and then you may feel a small needle prick, similar to when you get Botox.
In terms of recovery, you may have some redness depending on how aggressive the treatment is and the depth of the treatment, and you may feel some itchiness or mild burning on the skin. Depending on the depth and aggressiveness of the treatment, the recovery could be anywhere between 24 and 48 hours, at which time you’ll start noticing the results. You will see the skin is smoother and tighter, the pores are smaller, and the skin looks refreshed.
Nothing Was Traded Away
It’s important to realize that Cool has the same power and effectiveness as the latest Morpheus8. There are several versions of Morpheus8, and we’ve always had the latest one, which includes Burst, which can treat multiple layers with each activation. So the difference between Morpheus8 and Morpheus8 Cool really is that it is much more comfortable. Everything else is the same.
Morpheus8 will not be replaced, because we can still use it in the operating room when the patient is under general anesthesia or IV sedation and won’t experience the pain related to the procedure. But in the med spa, I really don’t think any patient is going to choose Morpheus8 over Morpheus8 Cool, because it’s just so much more comfortable and just as powerful.
We still recommend two to three sessions with Morpheus8 Cool. It’s also one of the few treatments that has successfully treated festoons, which can be very stubborn.
Pricing is the same as Morpheus8 and is on the fees page. The full write-up, with the comparison table and the festoons section, is on the Southwest Plastic Surgery site.
Why Me
Double board-certified, Mayo Clinic trained, Clinical Associate Professor of Plastic Surgery at Texas Tech, Castle Connolly Top Doctor 2014 through 2026. I run the device in the operating room and in the med spa, and I was the first face in my practice to get the Cool version.
Ready to Talk?
Call (915) 590-7900, text 1-866-814-0038, or book online. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
After the Needles: The Growth Factor That Earned Its Spot Next to My Morpheus8
Last month a longtime patient sat down on my Morpheus8 table, looked at the small kit on the tray, and asked me where the blood draw was. We had done platelet-rich plasma after every one of her treatments for the past five years. Tube, centrifuge, twelve-minute wait, supernatant painted onto freshly needled skin, small bandage on the inner arm at the end. That was the rhythm of the visit.
I told her we were doing something different this time. A small kit, mixed in a minute, no needle in the arm. Same idea as PRP. A cleaner version of the same idea.
The product is called Ariessence pure PDGF+. The molecule inside is recombinant platelet-derived growth factor BB. I have been using it on a subset of my Morpheus8 patients since the start of the year, and over the past few months it has quietly replaced PRP in my MedSpa for most post-procedure protocols. This is the long version of why.
What PDGF actually is
Platelet-derived growth factor is one of the body’s lead first-responder proteins at any tissue injury. When platelets release at a wound site, PDGF recruits fibroblasts to lay down collagen, calls in the cells that build new microvasculature, and helps coordinate the rest of the early healing response. It is the most studied tissue growth factor in regenerative medicine. Four FDA-approved drug products contain it. Over the past twenty-eight years, more than five and a half million patients have been treated with PDGF-containing FDA-approved products in non-cosmetic medical indications such as periodontal regeneration and diabetic foot ulcer healing. The molecule has a long safety record.
For most of the past decade, the way clinicians delivered PDGF to skin in an aesthetic context was indirect. We drew the patient’s own blood, spun it down, and applied platelet-rich plasma to freshly microneedled skin. PDGF was in there. So were dozens of other proteins, in concentrations that varied with the patient and the centrifuge run.
Recombinant pure PDGF is the next step. The protein is produced in cultured cells from a human gene sequence and purified to a single active species. The label calls it sh-Polypeptide-59 Dimer. There are no human-derived components in the formulation. The dose is controlled by the manufacturer and is the same in every kit.
Why topical, and why right after a microchanneling procedure
Topical PDGF on intact skin is a moisturizer with an interesting label. The protein is too large to cross an intact stratum corneum in a meaningful concentration. Healthy skin keeps macromolecules out. That is the barrier doing its job.
Topical PDGF in the brief window after Morpheus8, RF microneedling, fractional laser, or a medium-depth peel is a different story. The procedure has just opened thousands of microchannels into the dermis. The growth factor reaches the compartment that is asking for it. The window closes within hours.
That is why this product is sold to clinicians, not on a shelf at Sephora. Without a procedure to pair it with, you have an expensive serum.
The Gold 2025 study
In September 2025, Gold and colleagues published a randomized, evaluator-blinded, controlled trial in the Journal of Cosmetic Dermatology. Subjects between thirty and sixty years old got a single Morpheus8 session and were randomized to receive either bland Aquaphor or topical recombinant pure PDGF-BB immediately after. Patients were graded at seven and thirty days using the Clinical Global Aesthetic Improvement Score and Canfield Visia objective imaging.
The PDGF group did better. The difference on the global aesthetic score at thirty days was statistically significant. The PDGF group performed favorably on six of the seven Visia metrics. Patient-reported outcomes were better on the experience measures. No serious adverse events were reported.
The manufacturer is explicit about one caveat in the published reprint, and I will repeat it. The exact formulation in the Gold trial is not identical to the marketed Ariessence product. The trial supports the use of topical recombinant pure PDGF-BB after RF microneedling as a category. It is not a label claim for a specific commercial bottle. I tell patients this clearly. They appreciate it.
Where it sits next to PRP, PRF, and exosomes
The regenerative aesthetics category is crowded. Here is how I sort the actual contenders in my room.
What it is
Source
Blood draw?
Predictability of dose
Where it fits in 2026
Aquaphor (bland emollient)
Petroleum jelly
No
Total, no biological signal
Default barrier, comparator in trials
PRP (platelet-rich plasma)
Patient’s own blood, single spin
Yes
Variable, patient to patient
Reasonable. Less predictable than recombinant.
PRF (platelet-rich fibrin)
Patient’s own blood, slower spin
Yes
Slightly more consistent than PRP
Some practices prefer it. Not a step change.
Exosomes
Cultured stem cell media (donor-derived)
No
Manufacturer-dependent. Regulatory status unsettled.
I have not adopted these.
Ariessence pure PDGF+
Recombinant rhPDGF-BB in HA serum
No
Identical dose every kit
Default after Morpheus8, RF microneedling, fractional laser, or medium-depth peel.
The table is not exhaustive. Topical recombinant epidermal growth factor preparations also exist, for instance. But it captures the choices a patient is realistically being offered today.
Who is the right candidate
Anyone scheduled for Morpheus8, RF microneedling, fractional laser resurfacing, or a medium-depth chemical peel who wants the cleanest possible thirty-day skin. Anyone who has always disliked the blood draw side of PRP. Anyone who has had wildly different PRP results over the years and wants to know whether a controlled dose evens out the experience.
It is not a stand-alone serum. It is not an injectable. It is not a substitute for sunscreen, a retinoid, or the procedure itself. Patients with active facial infection, active inflammatory dermatoses on the treatment area, or any contraindication to the underlying procedure are not candidates until those issues resolve.
What it is not
Ariessence pure PDGF+ is sold as a topical cosmetic. It is not an FDA-approved drug. The Cosmetic Product Listing number is on file with the agency. Cosmetics in the United States do not require FDA pre-market approval. The agency does require honest labeling, prohibits drug-style claims, and oversees safety and adverse-event reporting. Ariessence operates within those constraints.
The product is not approved to diagnose, treat, cure, mitigate, or prevent any disease or condition. It is not for injection. The four FDA-approved PDGF-containing drug products (GEM 21S, Augment, Augment Injectable, Regranex) are unrelated formulations approved for non-cosmetic indications. Their decades of safety data inform the molecule’s general safety profile. They do not transfer regulatory approval to the cosmetic.
I tell patients all of this before we add it to a treatment plan. The Ariessence label does the same.
Why I added it to my MedSpa stack
PRP after microneedling has earned its place over the years. I am not knocking it. A controlled, recombinant dose of the lead growth factor in the platelet release is, on the data we have today, a little better.
Workflow is the second piece. PRP requires a draw, a centrifuge, a twelve-minute wait, and a patient who is okay with a needle in her arm before a needle in her face. Ariessence is mixed in under a minute on the same tray as everything else. My MedSpa team prefers it. My patients prefer not having to roll up a sleeve.
The third piece is consistency with how I think about aesthetic medicine. Preservation, precision, controlled dosing, predictable outcomes. PDGF is the most studied tissue growth factor in regenerative medicine, with more than a hundred clinical trials and a twenty-eight-year FDA-approved drug heritage in non-cosmetic indications. Bringing the recombinant pure version into the cosmetic side of the practice fits.
From Vampire Facials to recombinant pure PDGF
If you have followed me for a while, the throughline matters. The 2019 piece on this blog argued for PRP after microneedling. The science was right then. The recombinant era is a refinement, not a refutation. The molecule is the same lead actor in the platelet release. The vehicle is cleaner and the dose more dependable. I would rather a patient be reading a 2026 update than a 2019 piece pretending to still be current.
Why choose Dr. Agullo for skin in El Paso?
Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery. Fellow of the American College of Surgeons. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Affiliate Professor at the University of Texas at El Paso. Castle Connolly Top Doctor for thirteen consecutive years. Texas Super Doctors Hall of Fame, 2025. Aesthetic Everything Top Plastic Surgeon, 2026. Morpheus8 in active rotation in our MedSpa, paired with Ariessence pure PDGF+ as the post-procedure topical when the indication fits.
We run a clinic and a MedSpa under one roof for one reason. The arc of facial aging is decades long, and you should not have to drive across town to handle it.
Ready to talk?
If you are thinking about Morpheus8, an RF microneedling course, fractional laser, or a peel, and you want to understand what your skin care protocol should look like in the thirty days after, the most useful forty-five minutes of your year is a consultation with the surgeon who would actually plan it. I will tell you whether Ariessence pure PDGF+ is the right add-on for your treatment, whether you are better off with a different combination, or whether the procedure you are asking for is not the one you actually need.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. Follow along on social at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook. #StayBeautiful
