Anna Petropoulos, MD, FRCS

Hello 49er, The recommended spacing between treatments is approximately 4 weeks, as this timing aligns with the peak of your body's natural healing and collagen remodeling process, helping to maximize your results. If your first and second treatments need to be spaced 8 weeks apart because of travel or scheduling, it may result in a slight reduction in your overall outcome, but it does not mean the treatment won't be beneficial. We have many patients in our practice who have needed to adjust their treatment schedule for similar reasons, and I still encourage them to move forward rather than postpone indefinitely. My recommendation would be to have your second treatment as soon as you're able and avoid extending the interval beyond 8 weeks if possible. It's also important that any remaining treatments are completed according to the recommended schedule, as consistent treatment intervals help achieve the best possible results. Hope this helps! My name is Jeanine Oteri and I am a medical esthetician/laser technician with 25 years experience answering on behalf of Dr. Anna Petropoulos, MD, F.R.C.S. If your travel plans allow, waiting to begin your treatment series until after you've returned would likely provide the most predictable and optimal outcome.

Hello Creative929132, Congratulations on your weight loss! While it's a wonderful accomplishment, it's very common to notice a loss of facial volume afterward. As we age, we naturally lose collagen and fat in the face, and weight loss can make these changes more noticeable, especially around the cheeks and eyes. Based on your concerns, I would likely recommend a combination approach rather than relying on a single treatment. Starting with a neurotoxin such as Botox can help relax the muscles around the eyes and soften the appearance of crow's feet and dynamic wrinkles. About two weeks later, I would consider a series of radiofrequency microneedling treatments, such as Morpheus8 or Sylfirm X. These treatments create brand new baby skin cells in the treated area. They stimulate collagen production and help improve skin laxity and texture over time. Most patients benefit from a series of three treatments, with results continuing to improve over the following several months. If volume loss is contributing to your concerns, a hyaluronic acid filler such as Voluma may also be an excellent option. Placing filler along the cheekbones can restore lost volume, provide support to the midface, and create a more refreshed, natural appearance. The best treatment plan depends on your anatomy, skin quality, and aesthetic goals, so I recommend an in-person consultation with a board-certified aesthetic provider. They can determine which combination of treatments will give you the safest and most natural-looking results. Best of luck on your continued journey! My name is Jeanine Oteri and I am a medical esthetician/laser technician with 25 years experience answering on behalf of Dr. Anna Petropoulos, MD, F.R.C.S.

Hi Nattt123, Morpheus8 is a radio frequency microneedling device that is used to reproduce new skin cells and make new collagen stores by remodeling the layers of the skin. The microneedles make small channels in to the skin layers and deliver radio frequency energy. I have been performing Morpheus since it's debut onto the aesthetic market in August of 2020 and used it's predecessor Fractora before that starting in 2016 performing hundreds of treatments a year. I can promise you that Morpheus8 does not do hair removal. This may have been a misprint on their site. Maybe the web designer put in the wrong name. The link you attached is from 2024. If you are looking for laser hair removal, I would for a company using a laser device that is dedicated specifically to laser hair removal. Please make sure you are asking for the credentials of your provider to make sure you are getting the best and safest treatment possible ! I hope this helps! My name is Jeanine Oteri and I am a medical esthetician/laser technician with 25 years experience answering on behalf of Dr. Anna Petropoulos, MD, F.R.C.S.

Hello J Paterson43, My name is Jeanine and I am a medical esthetician with 25 years experience working with physicians doing medical grade skin, laser and medical grade cosmetic devices. I have been performing IPL procedures for those 25 years. In my professional opinion, I would give it more time after sun exposure. Even with SPF and a hat you can get sun exposure. I think the risk out weighs the benefit. I would give it 2-3 weeks and exfoliate the area being treated in those 2-3 weeks to rid any possible darkened skin cells. It would be the safest practice. 4-6 weeks is ideal, but given the fact that you are so cautious I think 2-3 weeks would be ok. I have seen people who have sworn they have no tan in the area being treated get reactions from the IPL. It's just not worth the discoloration and irritation that could potentially occur. My name is Jeanine Oteri answering on behalf of Dr. Anna Petropoulous, M.D., F.R.C.S

Hello Ashley7586, I have been working with pigment disorders and laser/IPL devices for the last 25 years. I would not touch your skin with another heat based device. You are clearly, like you said, highly reactive to heat based devices. If you were to a patient in our plastic surgery practice, I would just do a light blend of chemical peels and a targeted at home skin care regimen. The idea that the white areas may represent a combination of true hypopigmentation (loss or reduction of pigment) and surrounding hyperpigmentation (darkening) is plausible. Contrast between lighter and darker areas can make the lighter areas appear more dramatic than they actually are. It's also possible that the lightened areas are just your regular skin tone. I think it's likely a mix of both. This can be improved by lightening up the darkened skin cells, but you need to find an experienced esthetician or dermatologist that has experience with pigment disorders. A multimodal approach—sun protection, targeted topical therapies, carefully selected chemical peels, and long-term follow-up—is commonly used for pigment disorders. Improvement often takes months rather than weeks. A big factor in how successful your results are will be how consistent you are with the recommendations given to you. There will be at home skin care routine consistency that will need to be done in order to be achieve the best results. I tell my patients "You see me once every 4-6 weeks, what you do in between will make a huge impact on how quickly you see changes!" I wish you success in improving this! My name is Jeanine Oteri and I am a medical esthetician/laser technician with 25 years experience answering on behalf of Dr. Anna Petropoulos, MD, F.R.C.S.

Hello sk2023, Morpheus8 is often an excellent starting point for addressing sagging jowls and age spots. In our plastic surgery practice, we frequently combine Morpheus8 with other procedures to optimize results, but we typically begin with a series of three treatments. Morpheus8 is a radiofrequency (RF) micro-needling treatment designed to remodel the deeper layers of the skin. The microneedles stimulate the production of new skin cells, while the RF energy creates controlled heat that triggers the body's natural repair response, leading to the formation of new collagen. Patients begin producing new skin cells quickly after treatment. However, collagen remodeling takes longer—approximately four weeks to begin and up to 90 days to fully develop. For this reason, we recommend spacing treatments 4–6 weeks apart and completing a series of three sessions. Most patients see their peak results about 90 days after their final treatment. The collagen-building process gradually slows and typically plateaus around the six-month mark. To maintain and potentially enhance your results, we recommend a single maintenance treatment every six months. Consistent maintenance treatments can help preserve the improvements achieved during the initial series and may lead to even better long-term outcomes. I have had patients who have been with me for the last 10 years maintaining their RF micro-needling results. If brown spots remain a concern after Morpheus8, an Intense Pulsed Light (IPL) treatment may be beneficial. IPL is specifically designed to target pigmentation issues such as brown spots, as well as redness and visible blood vessels. Depending on the degree of skin laxity and the size of the jowls, some patients may require additional treatments to achieve optimal lifting and contouring. We offer more advanced options for these concerns, but we generally recommend starting with Morpheus8 and then reassessing your results before considering further treatment. My name is Jeanine Oteri and I am a medical esthetician/laser technician with 25 years experience answering on behalf of Dr. Anna Petropoulos, MD, F.R.C.S.

Hello Texasgirl27, IPL/BBL treatments are highly effective for addressing uneven pigmentation and broken capillaries. These technologies target melanin in dark spots, as well as hemoglobin within visible blood vessels, helping to reduce discoloration and redness. The result is a brighter, more even skin tone. However, it’s important to note that IPL/BBL is not a skin-tightening treatment. We favor Radio Frequency treatments for our skin tightening procedures. You would need to be careful with certain RF treatments because you have fillers. Topical RF may be fine, but some RF microneedling can melt fillers. That would be something I would make sure to let your practitioner know up front before starting any heat based device treatments. The recommendation to avoid sun post treatment is sound advice. For safety reasons, I do not perform IPL treatments on patients with an active tan, as this increases the risk of burns. I generally recommend scheduling IPL during the fall, winter, or spring months when sun exposure is lower. The only exceptions are patients who have minimal sun exposure or those who have undergone a light chemical peel to remove superficial tanning. Ultimately, you’re making an investment in your skin. You don’t need to avoid the outdoors entirely, but adopting simple habits—like wearing a hat and applying daily SPF—helps protect and maintain your results. I hope this is helpful. Good luck! Jeanine Oteri, LME, LT answering on behalf of Dr. Anna Petropoulos, M.D., F.R.C.S

Hello Optimistic873479, In our practice after your Morpheus8 treatment, we typically recommend planning for about 48 hours of social downtime. Immediately following the procedure, your skin will appear red and feel warm—similar to a sunburn—for the first couple of hours. As that heat sensation subsides, the redness usually diminishes as well, though you may still notice a mild pink tone. By the next morning, it’s normal to experience some blotchiness and mild puffiness. This generally improves and resolves by the end of the day. Patients with more sensitive skin may experience slightly longer downtime. If the resurfacing tip was used during your treatment, you can expect tiny pin-dot scabs to develop around day 3. These typically last about 3–5 days before naturally shedding. Overall, most patients find their skin returns to normal within 7–10 days. However, the main period where you may prefer to avoid social events is within the first 48 hours. To support healing, we offer specialized post-treatment products, including topical exosomes. These are very soothing and may help accelerate recovery time. I have patients that will not do the procedure unless they're available. I hope this information helps! My name is Jeanine Oteri, LME, LT and I'm answering on behalf of Dr. Anna Petropoulos, M.D.,F.R.C.S.

Hello Gentle820813, A CoolSculpting session for the flank area in our office typically lasts approximately 60–75 minutes. This timeframe includes preparing the patient for treatment, applying the applicator, the treatment time on the skin (about 35 minutes), and post-treatment care and instructions. Our office uses the newest CoolSculpting technology with dual applicators, which allows us to treat both flanks simultaneously. If a provider uses only one applicator, the treatment time may be longer since each side would need to be treated separately. We charge per applicator so one session for flanks would be a 2 applicator charge per session. The number of treatment sessions varies by patient and depends on factors such as the amount of fat in the area and the patient’s desired results. This is typically determined during the initial consultation. On average, patients may experience up to a 25% reduction in fat in the treated area per session. Full results from a single treatment are generally visible within approximately 12 weeks. For patients who require additional treatments, the area can be safely retreated as soon as 4 weeks after the first session. My name is Jeanine Oteri and I am a medical esthetician/laser technician with 25 years experience answering on behalf of Dr. Anna Petropoulos, MD, F.R.C.S.

Hello Alexandra98, My name is Jeanine, and I am a Master Medical Esthetician and Laser Technician with over 25 years of experience. I have been working with IPL systems since the very start of my career in aesthetics. Looking at your photos, I do see a bit of inflammation in that area. Since you’ve had IPL treatments before without any issues, it’s possible that this new practitioner is using a different type of machine. In the plastic surgery office where I work, we have two IPL devices from different companies, and I’ve noticed that one consistently creates more post-treatment inflammation than the other. From what I can see, your response looks normal for either a stronger machine or a more intense treatment. If you had red marks that matched the exact shape of the IPL crystal on the handpiece, I would be more concerned. This is why we do not recommend treating with IPL if you have a tan or have had recent sun exposure. It will increase the skin sensitivity because the IPL is attracted to melanin and tan is an elevated level of melanin all over. What you’re experiencing looks like a typical inflammatory response—something you might not be used to if your past treatments were gentler. Mild redness and slight puffiness for 24–48 hours post-procedure is actually a good sign that the treatment worked. Your body is simply responding to the light energy and using lymphatic activity to repair the tissue. Cool compresses may alleviate the discomfort and puffiness more quickly. I often tell my patients not to be surprised if they notice some puffiness the next day, especially around the eye area—it’s very common and should resolve on its own. I hope this helps! Best of luck! Jeanine Oteri, LME, CLT answering on behalf of Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA