Six categories of treatment, six different mechanisms. Understanding which one addresses your concern is more useful than knowing brand names.
Medical spa treatments fall into six categories: neurotoxins (relax muscle movement), dermal fillers (add immediate volume), biostimulators (build your own collagen gradually), energy-based devices (remodel skin surface and structure), corrective procedures (release scars, dissolve filler), and medical wellness (physician-supervised weight management). Matching your concern to the right mechanism matters more than choosing between brand names within a category.
Most patients arrive asking for a product — Botox, filler, a laser they saw on Instagram. That's a reasonable starting point, but it skips a step. The more useful question is what's actually causing what you see in the mirror, because the cause determines the category, and the category determines the product.
A line that appears only when you smile has a different cause than a line that's there at rest. Hollowness under the eyes has a different cause than darkness under the eyes. Treating the wrong mechanism produces disappointing results even when the treatment itself was performed well.
Temporarily reduces signaling between nerve and muscle, softening the muscle contraction that creates movement lines.
Botox, Dysport, Xeomin, and Jeuveau are all Type A botulinum toxins. They differ in formulation and onset but work the same way. Myobloc is a Type B toxin, structurally different, and used primarily for patients who have stopped responding to Type A products.
Best for:
Not useful for: lines that are fully visible at rest with no movement, or volume loss of any kind. Those are filler or biostimulator problems.
Hyaluronic acid gel physically occupies space beneath the skin, adding volume immediately at the point of injection.
The defining characteristic of HA filler is reversibility — hyaluronidase dissolves it. That makes filler the appropriate choice for areas where precision matters and where being able to undo the result has real value: lips, under-eyes, and any first-time treatment in a delicate area.
Best for:
Worth knowing: filler doesn't build anything. When it metabolizes, you return to baseline. It also isn't a substitute for skin quality treatment — volume in poor-quality skin still looks like poor-quality skin.
Triggers your own body to produce new collagen over weeks to months. The product itself is absorbed; the collagen it stimulated is what you keep.
Sculptra (poly-L-lactic acid) and Radiesse (calcium hydroxylapatite) are the two main biostimulators. Sculptra adds essentially no immediate volume and works purely through gradual collagen building. Radiesse provides some immediate volume from its gel carrier in addition to stimulating collagen.
Best for:
Critical distinction: biostimulators cannot be dissolved. Where HA filler mistakes are correctable within days, biostimulator placement errors surface over months and are far harder to address. This is the treatment category where who performs the injection matters most.
Delivers light, laser, or radiofrequency energy to create controlled injury or target specific structures, prompting the skin to repair and remodel itself.
This is the broadest category, and the devices are genuinely different from one another. Grouping them as "lasers" obscures that a pigment laser and a resurfacing laser do almost unrelated things.
Ablative resurfacing (CO2, Erbium) — removes surface layers to treat texture, deeper wrinkles, and scarring. Meaningful downtime, strongest results.
Non-ablative and pigment lasers (Pico, IPL, Thulium) — target pigment and vascular concerns without removing surface skin. Minimal downtime, requires a series.
RF microneedling — combines microneedling with radiofrequency energy delivered at depth, for collagen remodeling and mild to moderate laxity. Marketed under device names including PiXel8 and Morpheus8.
Best for:
Physically releases, removes, or reverses something already present — scar tissue tethering the skin, or product placed previously.
This category is distinct because it's subtractive rather than additive, and because it's frequently diagnostic before it's therapeutic. You have to understand what's there before you can correct it.
Subcision uses a cannula beneath the skin to sever the fibrous bands tethering rolling acne scars downward. It's the only treatment that addresses that specific mechanism — no laser or filler releases a tether.
Filler dissolving uses hyaluronidase to break down HA filler. Done blindly, it relies on the provider's estimate of where product sits. Done under ultrasound, the filler is visualized before enzyme is placed.
Best for:
Physician-supervised medical management rather than a procedure — prescription therapy with ongoing monitoring and dose adjustment.
GLP-1 medications such as tirzepatide work on appetite regulation and metabolic signaling. This is genuinely medical care requiring physician oversight, dose titration, and side effect management — not a cosmetic procedure.
Worth knowing: significant weight loss frequently causes facial volume loss. Patients pursuing both goals benefit from a practice that can address the metabolic and the aesthetic side together rather than in isolation.
Acne scarring is the clearest case. A patient may simultaneously have tethered rolling scars (corrective), volume loss in the scarred region (biostimulator), rough surface texture (resurfacing), and flat brown marks left from the original inflammation (pigment laser). Four mechanisms, four categories. A practice offering one of them will treat one quarter of the problem and the patient will conclude nothing works.
Two things, and being clear about them saves patients time. Medical spas don't perform surgery — if you have significant excess skin that needs removing, no injectable or energy device replaces a lift. And medical spas don't diagnose or treat skin disease. Suspicious lesions, changing moles, skin cancer screening, and medical dermatologic conditions belong with a dermatologist. See our provider comparison guide for where each concern belongs.
The most common consultation I have is with someone asking for a specific product when their concern sits in a different category entirely. That's not a patient error — nobody should be expected to know which mechanism causes what they see. But it's the reason I examine before I recommend, rather than the other way around.
What treatments does a medical spa offer?
Medical spa treatments fall into six main categories: neurotoxins that relax muscle movement, dermal fillers that add immediate volume, biostimulators that gradually build your own collagen, energy-based devices including lasers and RF microneedling that remodel skin, corrective procedures such as subcision and filler dissolving, and medical wellness services such as physician-supervised weight management.
What is the difference between filler and a biostimulator?
Hyaluronic acid filler adds volume immediately by occupying space, and can be dissolved with hyaluronidase if needed. A biostimulator such as Sculptra contains poly-L-lactic acid and adds no meaningful immediate volume — it gradually stimulates your own collagen production over weeks to months, and cannot be dissolved.
What is the difference between Botox and filler?
Botox and other neurotoxins temporarily reduce muscle movement, which softens lines caused by facial expression. Fillers add volume to areas where tissue has been lost or where structural support is wanted. They treat different problems, and many patients use both for different areas of the face.
Which medical spa treatment is right for my concern?
It depends on the mechanism behind the concern. Lines from movement respond to neurotoxins. Hollowing and volume loss respond to fillers or biostimulators. Surface texture, pigment, and scarring respond to energy-based devices. Skin laxity responds partially to RF microneedling and biostimulators, but significant excess skin requires surgery.
Can medical spa treatments be combined?
Yes, and many concerns require it. Acne scarring in particular often needs subcision to release tethered scars, a biostimulator to rebuild lost volume, and a resurfacing laser for surface texture — sequenced correctly. Whether combination treatment is possible depends on whether the practice offers all the required modalities.
What can a medical spa not treat?
Medical spas do not perform surgery, so significant excess skin requiring removal, structural repositioning, and implants are outside scope. They also do not diagnose or treat skin disease — suspicious lesions, skin cancer screening, and medical dermatologic conditions require a dermatologist.
That's what the consultation is for. Dr. Mortazavi will assess what's actually driving your concern before recommending anything.