In answer to your question, yes a Hydrafacial MD treatment can definately be combined with other treatments. In regard to microneedling the combination of the two is like a super facial. While some practices will do in different orders we prefer CIT (microneedling) to be done after the Hydrafacial MD treatment. We like this order as the microneedling is being done on fresh clean surface and we use serums with microneedling to infuse into and don't want them then extracted by doing a face cleaning after. All the hydrafacials include a "peel" as even the Gysol Prep is a very mild peel to help break up the bonds, so depending on the reaction to the "peel" chosen if its your first time we would just make sure after the hydrafacial your skin feels ok and isn't having any reaction that the microneedle would irritate further.