We vow to never succumb to peer pressure. At Blue Water Spa, we’ve spent years educating our community on the unnecessary risks of RF Microneedling.

Blue Water Spa in Raleigh, NC has been recognized as Best Medical Spa in America by American Spa Magazine. Blue Water Spa is owned and operated by Michael Law MD. voted best plastic surgeon in NC. He received his plastic surgery training from the University of Southern California (USC) which is rated the number one plastic surgery residency training program in the United States by the Plastic Surgery Research Council. His training includes 10 years of formal surgical training post medical school, and a prestigious plastic surgery fellowship.

A Medical Spa should be in a medical environment with a Medical Director onsite or nearby. The responsibility of the Medical Director is to create safe and consistent protocols, to oversee training, to review results and to be available to both the medical professionals they oversee, but also the patients’ receiving treatments in their medical practice..  When aesthetic and medical professionals are well-trained, and when the best technology and protocols are employed, the chance of complication is minimal. Plastic surgeons have unique training in that their years of formal surgical training encompasses a deep understanding of the vascularity, nerves and muscles of the face.  At Blue Water Spa, Dr. Law is very involved in training and the nurse injectors may have a chance to regularly observe facial surgery and literally see under the skin when facelifts, facial fat grafting, or other facial surgery is being performed.

At Blue Water Spa, like other top medical spas, the aesthetic ideal has always been a natural look that does not appear “done” with a goal to make each guest look like the best version of themself and not to look like that have had work done.  

What you won’t find in most of the top medical spas are fleeting trends or “cash grabs”. Even the most accomplished and well-trained surgeons do not work alone. They rely on a team of medical experts to provide safe outcomes for their patients. Look for a team of experts when seeking aesthetic services. 

The concept of facial balancing is an approach to facial aesthetics that focuses on creating harmony and balance in facial appearance, and it describes exactly what we have been doing at Blue Water Spa for over twenty years. The goal is to create enhancements in facial proportions, often ones that are relatively subtle, that combine to make a face appear more youthful and appealing.

Facial balancing requires a thoughtful and systematic approach to facial assessment for the planning of aesthetic treatments. Too many think of facial balancing as over-filling the face, when in fact, facial balancing, when performed;with expertise, should be undetectable.

The initial assessment for facial balancing treatment planning looks at the face as a whole, and then looks at the degree to which the upper (forehead and eyes), middle (midface and cheeks) and lower face (mouth, chin and jawline) are in balance and harmony with each other. For example, the midface may be less prominent compared to the brows and jawline, and expansion of the midface by placement of filler can create a greater sense of harmony.

Facial balancing looks not only at the face as a whole, but also at the proportions within each facial area. For example, the temples or the brow/upper lid junction may be hollow, making otherwise youthful-appearing eyes seem older. Expanding these areas rejuvenates the eye area in a way that is both subtle and dramatic.

The upper lip may seem thin and lifeless compared to a full lower lip, and conservatively expanding the upper lip volume with filler and neuromodulator injection can create aesthetically ideal lip harmony that did not exist before. No one is going to specifically recognize that a person has had volume added to their upper lip with filler and a lip flip with neuromodulator, like Botox or Dysport, or that they have had volume added to their temples or their brow/upper lid junction with structural fat grafting. But they will recognize that the mouth area and the eye area are more alluring and youthful-appearing, or that the face as a whole has a more harmonious and therefore more aesthetically ideal appearance.

Both genetics and the aging process can contribute to a reduced sense of balance and harmony in the face. A genetically less prominent chin can make the lower third of the face seem overpowered by the middle and upper thirds of the face, and strategic placement of filler can enhance jawline and chin projection which allows the lower face to better match the midface and eye area.

Some changes might be to restore a more youthful look, like softening lines on the forehead or addressing marionette lines, aka DAO’s that pull down;on the sides of the mouth. Both of these changes, when performed by an injector with true expertise can make a beautiful and profound result with the face looking happier and kinder. Too much, or performed incorrectly, people can look; frozen or just weird.;

Aging changes that reduce facial harmony are related to both changes in volume and loss of tone in the skin and subcutaneous soft tissues. The less mobile upper cheek fat pads typically lose volume over time, while the more mobile lower cheek fat pads increase in volume over time. Mild to moderate changes in these volume relationships can be changed in a positive way by a skilled nurse injector, while more advanced aging changes generally require a surgical approach to achieve facial balancing.

Facial balancing can be accomplished both in the medical spa treatment room and in the plastic surgeon’s operating room. A skilled aesthetics provider will be able to let you know what can be accomplished with injectables and associated aesthetic treatments, and what requires surgical treatment in the OR. Some mildly ‘weak’ chins can be expanded with filler, while others may require placement of a chin implant to create a more balanced facial appearance.

There are great advantages to receiving your facial balancing care in a plastic surgery medical spa. The nurse practitioners and aesthetic professionals who provide your non-surgical treatments are supervised by a board-certified plastic surgeon who is on site and provides their training. They learn facial assessment from an experienced surgeon and observe the surgeon performing surgical facial balancing procedures in the operating room. Additionally, your nurse injector will understand very clearly what they can accomplish with non-surgical treatment, and what can be accomplished by surgical treatment with their supervising plastic surgeon.

The goal of facial balancing is not to make you look like someone else. The goal is to create more balanced and harmonious facial proportions, which result in a refreshed and more youthful-appearing version of you.

Be careful with too much filler in the chin or lower face. It may look fine temporarily, but too much filler in the lower face can make the lower face look heavy and can contribute to an appearance that makes one look older.  In time it can actually contribute to more jowls.; Too much filler in the chin may cause the chin to droop and to have a ‘witch-like appearance.

What to look for when selecting a medical professional to perform facial balancing

1) Are they a plastic surgeon, or do they work with a plastic surgeon who provides training

2) Look for a medical professional who will go slowly and will not overfill

3) Are they proficient with all fillers and biostimulators including Hyauluronic acid products like Juvederm, Resylane and RHA products, and biostimulators like Sculptra, PRF and PRF EZGel. 

4) Are they proficient with the use of both cannulas and needles?

5) What is their specific protocol in case of an emergency or undesired result?

6) Do you have photos to show of the work you have performed yourself and work that your colleagues have performed?

If you feel pressure of any kind to get a treatment on the spot, or to get more than makes you comfortable, leave. An excellent medical provider will want to provide

Facial Balancing Review

“I went to Blue Water Spa for facial balancing. At first, I thought I would need surgery. But the nurse injectors are amazing and provided me with the change I wanted! They added a little Botox to lift my brows, a bit of Sculptra to my hollow areas of my temples. Then some PRF EZ gel for under the eyes and a bit of filler for my cheeks. They told ;me to wait on the jawline and even the lips.Instead of lip;filler, they used Botox for the lines that pulled the corner of my lips down. I’m so glad I listened and did not; do too; much. The transformation is incredible but totally natural looking. I had zero bruising and only a little swelling for a day under the eyes. My friends and family have asked about everything from my hair to teeth whitening. I look amazing but I don’t look like I’ve had injections. I actually told a few people and they couldn’t believe how great and natural I look”

In a word, no. First, these devices are not lasers at all. Medical lasers are not only extremely powerful and expensive. But without proper eye protection, eye damage could take place. At Blue Water Spa and Blue Water Plastic Surgery Partners, the lasers for hair removal have been evaluated as most powerful and safest in peer reviewed medical journals.

There are actually cases of people ending up with MORE hair following home laser hair removal than they had before. How could that happen? This is a phenomenon called paradoxical hair growth. Basically instead of having hair destroyed at the root, the home device can stimulate new hair growth because the device is not powerful enough to destroy the root of the hair, and instead, the hair follicles are stimulated. This can happen with anyone. But this phenomenon is most often observed in people with darker skin tones. It is also commonly observed in the face, areas and the jawline. Individuals with hormonal sensitivity issues like PCOS, polycystic ovarian syndrome seem especially at-risk for additional hair growth following treatment with these devices.

Paradoxical hair growth is most often observed in people who have used at-home laser hair removal systems. Bu it has also been observed in people who have been treated with lasers that heat the skin and tissues., but that do not have significant power to target the root of the hair and provide sufficient energy to the root of the hair for it to be disabled.

One reason for this issue might be that very few lasers are both safe and effective for dark skin. Laser hair removal for dark skin requires a specialized laser that is both very powerful and precise. The laser must have a long pulse with a very specific target. The lasers used at Blue Water Spa / Blue Water Plastic Surgery have a very long pulse. Therefore, these lasers will bypass the surface of the skin, even in people with very dark complexions. The laser energy with then be absorbed by the root of the hair which will disable the hair follicle, leaving the skin smooth. Because the laser energy is not absorbed by the skins’ surface, no damage will occur on the surface of the skin, but treatments will successfully eliminate unwanted hair.

If you are looking for laser hair removal, look for a medical facility owned and operated by a board-certified plastic surgeon where lasers are operated by medical professionals. At Blue Water Spa, a true medical spa owned and operated by board-certified plastic surgeon Michael law, safety, patient comfort and consistently excellent results are our priority.

Looking back on that recognition now, 14 years later, I feel something deeper than just pride. I feel grounded. Settled. Confident in the skin I’m in not just personally, but professionally.

So much has changed since then. The treatments have evolved. The technology is faster, smarter, and more refined. The aesthetics industry itself has grown in ways we couldn’t have imagined in 2011. And Blue Water Spa has grown with it. But what hasn’t changed and what I see and feel every single day is the heart behind it all.

We’re still owned and operated by Dr. Michael Law and Kile Law, and we still offer the full spectrum of medical and spa treatments. We continue to lead in neuromodulator and regenerative treatments in the Raleigh area, and we’re proud to serve a wide, inclusive clientele including more men than ever before. But more than any service we offer, what sets us apart is the care. The safety. The trust our patients place in us.

When I talk to patients today some who’ve been coming for a decade or more it reminds me that awards are great, but longevity, trust, and transformation matter more. Being a part of someone’s journey, helping them feel confident, safe, and seen… that’s what makes me proud to be part of Blue Water Spa today.

So yes, 2011 was a beautiful moment. But 2025 feels even better. Because this version of Blue Water Spa and this version of myself feels more aligned, more confident, and more capable than ever before.

Here’s to continued growth, evolving beauty, and always, always putting people first

Blue Water Spa Named Best Medical Spa in the Southeast by National Magazine.Les Nouvelle Estetique, LNE & SPA AWARD WINNER FOR MEDICAL SPA

Amaris Balkus, COO of Blue Water Spa traveled to Florida to accept the prestigious award of Best Medical Spa in the Southeast. Blue Water Spa is a true medical spa, owned and operated by board-certified and fellowship trained plastic surgeon Michael Law MD. Guests can be assured of their safety, comfort and outcomes at Blue Water Spa.

Medical esthetics is a consistently growing sector of the spa industry. A medical spa operates under the full-time, on-site supervision of a licensed health care professional. The collaboration between medical and esthetic professionals enables a scientific approach to esthetics, an exciting development in the industry with far reaching possibilities.

LNE & Spa’s choice for the Southeast Medical Spa Award is the Blue Water Spa of Raleigh, NC. Owned and operated by board- certified plastic surgeon Michael Law, M.D. and his wife Kile Law, the eight-year-old facility is a fully integrated plastic surgery medical spa that provides services in every area of esthetics, from laser hair removal and skin rejuvenation to facial treatments and pampering body therapies. Blue Water Spa’s menu of services is extensive, covering every area of the face and body. Men are definitely not an overlooked segment of Blue Water Spa’s clientele, as the substantial variety of avail- able male-specific treatments demonstrates. The Blue Water Spa is distinguished as the top provider of Botox® and Juvederm® in the Raleigh triangle area, and it is one of the leading Botox providers in the country.

The vast selection of esthetic plastic surgery procedures conducted at the Blue Water Spa includes everything from facelifts and liposuction to otoplasty (ear reduction) and facial fat grafting. Patients are in qualified hands, as Dr. Law himself performs all major surgeries. Surgical patients receive one complimentary overnight hospital stay with supervised care and monitoring to ensure their safety, as well as peace of mind for their loved ones.

The combined expertise of a board certified plastic surgeon, nursing staff and medical estheticians equip clients and patients at Blue Water Spa with the best resources available to address all of their esthetic goals. The broad, inclusive selection of services and outstanding quality of care that patients and clients experience at Blue Water Spa are distinctions of true excellence.

1. What is breast implant explantation?

Explantation is the medical term for breast implant removal. During an explantation surgery, breast implants are removed and not replaced. Because breast implants are subcutaneous foreign objects in a relatively superficial position, in most cases they can be removed as a minor procedure under local anesthesia, or with light oral sedation if patients prefer that.

Explantation is a simple and straightforward procedure with very little downtime. Patients are back at full-effort exercise in just one week. While I recommend taking it easy for at least 24 hours post-explantation, I have had patients tell me that they went out to dinner the night of their explant and one actually admitted at her one-month follow-up appointment that she went to a concert that evening and felt fine.

There are a number of reasons that may lead a patient to elect to have their implants removed. When the procedure is limited to breast implant removal only, deep IV sedation or general anesthesia is not required. In some cases, additional procedures may be indicated such as capsulectomy or mastopexy (breast lift). Capsulectomy with explantation and mastopexy procedures are usually performed under general anesthesia, but the majority of explantation patients do not require capsulectomy.

2. Why do women have breast implant explantation?

There are wide-ranging reasons that women who have undergone breast augmentation in the past seek treatment in our practice for breast implant removal. One very common scenario that we encounter is the patient who has really never felt comfortable with their augmented breasts. I frequently hear patients report that “my surgeon did not listen to me”, that high-volume implants were placed, and that these patients have never been comfortable with their overly large (and often abnormally-shaped) augmented breasts.

Frequently we see patients who actually needed a breast lift rather than a breast augmentation in the first place, and over time the breast implants have stretched out the breast skin even more and in doing so have made the pre-existing breast droopiness even worse. Many of these patients share that they have never felt comfortable with the result of their breast augmentation in form-fitting clothing or in a swimsuit, and are relieved to have the implants removed. These patients need a breast lift procedure as well, of course, and it is deeply rewarding to help patients make the transition from ‘problem breasts’ which interfere with their lifestyle to breasts that are lifted, youthful-appearing and natural-feeling.

Some patients we treat simply feel ‘done’ with their breast implants and want to return to being ‘all natural’ again. Some patients have dealt with a series of reoperations for complications of breast implant placement and wish to put the breast augmentation phase of their life behind them. These complications often include on or more of the following problems: implant shell failure, implant malposition, capsular contracture, animation deformities, implant size dissatisfaction, breast implant-related pain and discomfort, and visible implant folds and ripples.

We have seen several patients with breast implant illness (BII), and these patients elect to have their implants removed over the concern that their implants may be creating systemic symptoms. Most of our BII patients have reported complete resolution of symptoms following breast implant removal, although that outcome of course cannot be guaranteed, as in some patients the systemic symptoms they are experiencing may not be directly related to their breast implants.

3. How do I know if I have breast implant illness?

Breast implant illness (BII) is a clinical diagnosis based on symptoms. There is no laboratory test or imaging study that can prove or disprove the presence of BII. The patients I have seen and treated for breast implant illness notice the onset of systemic symptoms in the weeks, months, or years following breast implant placement. Symptoms of breast implant illness can include but are not limited to the following: fatigue, joint pain, muscle pain, insomnia, skin rash, headaches, hair loss, gastrointestinal problems, brain fog and anxiety/depression.

Many of the symptoms of BII are also associated with autoimmune disorders such as rheumatoid arthritis and lupus. Some patients who are diagnosed with BII may have an autoimmune disorder, so it is important for patients to look into that possibility as well with their primary care physician.

If you feel that you are experiencing significant systemic symptoms that may be related to your breast implants, you may want to consider having them removed. The majority of our breast implant illness patients have reported dramatic improvement in and often complete resolution of symptoms following breast implant removal.

4. What will my breasts look like after breast implant explantation?

Breast appearance following breast implant removal varies a great deal from patient to patient. Larger breast implants have a more profound effect on breast skin and breast tissue, as the deforming effect of the implant increases with implant volume. Breast implants not only stretch the breast skin but also cause breast tissue atrophy over time, and that effect can be profound in some patients, particularly in the upper pole of the breasts. Smaller-volume implants have a lesser impact on breast appearance following implant removal.

When I evaluate patients for breast implant removal, I make an effort to help the patient clearly understand how much of their current breast volume is created by the implants and how much of their breast appearance is represented by natural tissue. This gives them some idea of what their breast volume will be following implant removal.

If the breast skin is not lax or droopy, most patients elect to have implant removal only. Patients with significant skin laxity or breast ptosis (droopiness) often elect to have a mastopexy procedure performed as well.

For patients who so not have much natural breast tissue volume in the upper aspect of their breasts, and in patients who have experienced significant upper pole breast tissue atrophy because of their implants, we consider and can perform breast fat grafting to enhance the natural fullness of the upper poles. Fat is harvested by means of a liposuction procedure, commonly of the trunk and/or thighs, and the fat is processed and then grafted into the upper poles to enhance volume. This is an effective means of creating additional natural breast tissue volume, while also creating a body contour improvement at the ‘donor’ site, and can be repeated if patients desire additional breast volume enhancement over time.

5. Will I need a breast lift after explantation?

In some breast augmentation patients, the size and weight of the implants have stretched out the breast skin, resulting in the need for a breast lift (mastopexy) surgery. Breast skin laxity has been present in some patients since their breasts developed, and they have never enjoyed a ‘perky’ breast appearance. In other patients, the volume of the implant has stretched the breast skin out over time. Pregnancy/lactation is a contributing factor in some, and so is the natural aging process as breast skin naturally thins with each passing year.

Many patients have breast skin laxity and already know they want to have a breast lift performed along with implant removal. Other patients are not sure and prefer to have the implants removed and spend some time getting accustomed to their natural breasts and thinking about whether or not they want to have breast lift surgery performed. Patients with smaller volume implants and younger patients with good skin tone generally are happy with their breast appearance following explantation only, and often do not require a breast lift surgery.

6. Can explantation and breast lift be performed the same day?

For patients that need a breast lift, it is important to understand that it is challenging to accurately plan a mastopexy surgery with breast implants in the way. Determining the ideal new position for the nipple-areola complex is of paramount importance, and implants make that determination difficult to impossible in most cases.

That issue can be easily addressed by removing the implant volume a week or two before the breast lift surgery. For patients who have saline implants, this is accomplished by means of preoperative implant deflation, an office procedure that takes five or ten minutes. For patients with silicone gel implants, we plan removal of implants as a minor surgical procedure which can be performed under local anesthesia only.

It is extremely helpful for the patient and for me as the plastic surgeon to evaluate the natural breast appearance with the implant volume removed, by means of saline implant deflation or by silicone gel implant removal under local anesthesia. That allows both of us to have a clear understanding of the natural breast tissue that we have to work with, what to expect in terms of the results of the mastopexy surgery. It technically is possible to perform explant and mastopexy the same day, but in my experience it is very useful to perform saline deflation or gel implant removal prior to mastopexy to clearly set expectations, make decisions about whether or not fat grafting is desired, and to accurately plan the ideal position for the nipple-areola complex on the lifted breasts.

For patients who are not sure if they want to have a breast lift performed, we perform explantation only and let the patient decide over the next several weeks or months if they are satisfied with their breast appearance. For those that are dissatisfied and prefer to have a lifted and more youthful breast appearance, mastopexy can be scheduled at any time, and for those who desire a partial restoration of breast volume, fat grafting can be planned as well.

When did people start looking so overfilled? What has been the norm in the facial filling community isn’t really normal at all. In fact, too much filler makes people start to look odd and people weirdly start looking alike. The problem is not only too much filler but filler placed improperly. Filler can be addictive, and when it’s easily available some people just want more, more, more. When others around them seem to have a similar look, it normalizes an appearance that is unnatural. Ideally placed filler can provide balance and a youthful fullness. Too much filler is actually aging. The new trend amongst aesthetic professionals is slowly leaning towards a more natural look. At Blue Water Spa, natural looking results have always been our goal. So, if you’ve been holding off on getting filler for concern about a natural look, the team of expert injectors at Blue Water Spa can provide a beautiful, and natural looking result. Learn more about dermal fillers

Adding Fullness to Lips and Cheeks

For decades, people have been looking for ways to add fullness to the face, specifically to their lips and cheeks. The evolution of products for filling and rejuvenation of the face is here. It is important to remember that even the products currently used and that are thought of as safe, and not necessarily ideal for every part of the face. Areas of the face where there is significant mobility, like the lips, nasolabial folds and marionette linked need a soft material. Areas like the temples, and cheeks could possibly be safely injected with filler material that is more dense. It is important to remember that no matter the products that is used, the end result is all about the expertise of the medical professional performing the treatment. A physician, or nursing professional who has a deep understanding of the vascular system of the face, understand the nuance of soft tissue augmentation and understands anatomy including the location of nerves and muscles will be able to provide patients with a safe and beautiful result.

• Free Silicone was one of the very first products to be used for soft tissue augmentation of the face and lips. In some cases, the initial appearance could be pleasing, but the complications were so significant that the product was banned in the early 1990’s
• Bovine Collagen –, known in popular culture as “collagen injections” were extremely popular throughout the nineties. This type of collagen derived from cows, may cause allergic reactions in some individuals. Therefore, allergy testing was required before patients could experience Collagen injections, the brand names, Zyderm and Zyplast. The fill did not last long and many people were allergic to these products, so the search continues for the ideal product
• Cadaveric Materials – Tissue or biomaterials derived from human cadavers, were an option used by some after bovine collagen had fallen out of favor. Cadaveric products used for soft tissue augmemtation included AlloDerm – A human-derived acellular dermal matrix (ADM) from donated cadaveric skin, often used in reconstructive and cosmetic procedures, including lip augmentation.Dermaplant – A similar product to AlloDerm, made from cadaveric dermal tissue. Cymetra – A micronized form of AlloDerm that could be injected, making it a viable option for lip enhancement, and fascia, and acellular cadaveric gastrocnemius fascia material.
• PMMA (Polymethyl Methacrylate) – A synthetic biocompatible material used in dermal fillers. PMMA was known to create a lot of granulomas and therefore quickly fell out of favor.
• Hyaluronic Acid (HA) – A naturally occurring substance in the body that retains moisture and is widely used in dermal fillers. Hyaluronic acid fillers were absolutely revolutionary and changed soft tissue filling forever. Restylane was the first hyauluronic acid filler, followed by Juvederm and many others.
• Other products like porcine (pork) products, Calcium Hydroxyappetite and others have come and gone over the years.
• Other than hyaluronic acid products, the other mainstay has been structural fat grafting. Fat grafting is thought by some to be the absolute best product for filling. Others find it controversial. It is arguably the most challenging product to use, It is always administered with cannulas and generally, is a procedure administered by board-certified plastic surgeons.
• The newest injectable that looks like it is here to stay is injectable PRF, or platelet rich plasma. Many patients like the idea that it is their very own tissue, with results that can look and feels natural when administered by a medical professional with expertise.

Microneedling at Blue Water Spa is a non-invasive skin treatment designed to refresh and revitalize your skin. Microneedling, also known as collagen induction therapy, is a minimally invasive cosmetic procedure that involves the use of fine needles to create tiny punctures (controlled micro-injuries) in the skin. These micro-injuries stimulate the body’s natural wound healing process, leading to increased collagen and elastin production, which helps improve the overall texture and appearance of the skin.

Skin Care Specialists

Our highly trained skin care specialists use a high-speed pen with sterile tips to create micro-injuries trigger the natural healing response which firms’ skin and smooths texture. This is an excellent option for darker skin tones that cannot tolerate thermal skin firming methods. Microneedling improves scars, wrinkles, and pore texture for a result of smoother, more luminous skin.

Microneedling therapy, also known as percutaneous collagen induction therapy, is a relatively new treatment that encourages the growth of collagen tissue in the skin by physical or mechanical methods. This therapy uses a device with many fine needles to create micropunctures on the skin, promoting collagen regen-eration. This approach preserves the epidermis’ integrity and considerably improves the percutaneous absorption of post-treatment product applications, like PRF, Platelet Rich Fibrin, or even chemical peels. It is imperative to select the correct product as absorption of products post microneedling is significant. The right post-treatment product can help in providing good clinical results in the treatment.

At our Medical Spa in Raleigh

At Blue Water Spa, we see extraordinary results in skin texture, tone and youhtfulness when combining microneedling with PRF Most of us learned about PRP or PRF by seeing folks with faces covered in what looks like dried blood following professional microneedling. A trademarked name for this procedure was The Vampire Facial. PRF. When used after microneedling can help significantly with texture, tone and clarity of the skin. PRF can also be injected through a cannula in a way that can provide some filling of the area, and will actually [produce additional collagen to provide better structure to the deep layers of the skin. Unlike other injectible fillers, PRF is not only safe before facial surgery, but it can help strengthen the skin and help one prepare for facial rejuvenation surgery.

PRP and PRF

PRP (Platelet Rich Plasma) and PRF (Platelet Rich Fibrin) are both platelet-rich therapies that use your own blood to promote healing. However, there are some key differences between the two treatments. PRF is the gold standard in blood product treatments as PRP technology has adapted since originally introduced to aesthetic practices. There are some basic similarities between PRP and PRF.

PRF Platelet Rich Fibrin is a type of platelet-rich therapy that is derived from your own blood. It involves the extraction of a small amount of blood, which is then spun in a centrifuge to separate the platelets and fibrin from the rest of the blood components. The resulting PRF is a gel-like substance that is rich in growth factors and other healing properties. PRF is often used in dental and oral surgery, as well as in the treatment of musculoskeletal injuries and skin rejuvenation. Unlike PRP, PRF does not require the addition of any additives or anticoagulants, making it a more natural and biocompatible option for certain treatments. It is the differences between these two products that makes PRF a distinctly superior product for skin rejuvenation, hair growth, wound healing and a plethora of other uses. PRF is even used in dentistry, orthopedics and other medical specialities due to the regenerative and healing powers of PRF.

PRF has a higher concentration of platelets and growth factors compared to PRP, which can lead to more effective healing and regeneration. PRF also forms a fibrin matrix, which acts as a scaffold for tissue regeneration, promoting better results. Overall, PRF Platelet Rich Fibrin treatment is a safe and effective option for those seeking medical treatments.

PRF Platelet Rich Fibrin is a type of platelet-rich therapy that is derived from your own blood. It involves the extraction of a small amount of blood, which is then spun in a centrifuge to separate the platelets and fibrin from the rest of the blood components. The resulting PRF is a gel-like substance that is rich in growth factors and other healing properties. PRF is often used in dental and oral surgery, as well as in the treatment of musculoskeletal injuries and skin rejuvenation. Unlike PRP, PRF does not require the addition of any additives or anticoagulants, making it a more natural and biocompatible option for certain treatments.

Because PRF is simply centrifuged blood with no additives. This allows more WBC’s, more growth factors,
and longer lasting fibrin matrix, with a slower release over 7 to 10 days. At a molecular level, PRF contains 20 different growth factors including:

• Platelet derived growth factors (PDGF)
• Stem cell factor (SCF)
• Dermal papilla (IGF and fibroblast growth factor)
• Vasculature VEGF and PDGF
• Neural cells (Nerve Growth Factor)

These growth factors serve as an elixir to heal and promote collagen.

So, one question is, “Why doesn’t everyone use PRF instead of PRP?” The reason is that the fibrin from the PRF is thicker and it requires more training and expertise. It needs to be administered quickly by a practitioner who is very skilled with cannulas.

Here are questions any prospective patient should ask of an aesthetic injector:

1) Tell me about your training. Expert injectors will have formal and ongoing training including time in the OR with a board-certified plastic surgeon

Cadaver Training is also essential. Other than being in the OR observing surgery, it is the only way for medical professionals to truly see what is under the skin.

Understanding the details of the anatomy of the face including vascularity, nerves and muscles is the only way that injectors can truly perform safe and effective procedures. 

2) Who is your Medical Director? What are their credentials? Is the Medical Director onsite?

In some states, a Medical Director may not need to be onsite. In fact, being in the same state, many hours away can effectively “check the box” Additionally, in some states, any physician,of any specialty can be a Medical Director whether or not she or he has received formal surgical training. A psychiatrist, a pediatrician, an ER doc or a family practice physician can all legally serve as  medical Directors, even if they have no formal training on the vasculature of the face.

3) Which product lines do you offer?

Multiple products are available for providing enhancement to the face by enhancing with filler. Likewise, multiple neurotoxin options are available today.  It is ideal to select a practice that can customize a treatment plan for you based on having a full spectrum of products available 

4) Tell me about our protocols for adverse reactions or unsatisfactory results?

At Blue Water Spa, our highly trained NP injectors work as a collaborative team. We offer ALL products as some products work better for some indications than others. By having expertise, often less material can be used in the right place, to provide a better result with less product and therefore, less cost. 

In the event of a patient with a unique situation, or an adverse reaction of any kind, there is a full team of NP’s available to work together. Dr. law, a board certified, fellowship trained plastic surgeon is available to oversee treatments and a full administrative staff is available to get information to the right people quickly.

The expert injectors are available to educate you on what is best. No pressure, no quotas, and no performing treatments until a very intensive training process has been completed.  

In the event that a patient would experience a vascular occlusion, how would you manage that?

Vascular occlusion is a rare but potentially serious complication of hyaluronic acid filler injections. It results from accidental injection of the product into an artery, and it can also be due to compression of the artery from surrounding filler. “In certain circumstances, when filler is injected near or into the blood vessel, they become occluded due to the pressureTo put it plainly, the artery or capillary is constricted due to pressure of the filler or injected with filler. As a result, it is unable to function properly. The lack of blood flow causes the skin to suffocate and thereby can be damaging to both vision and skin

The best way to treat a vascular occlusion is to have very well trained professionals administering treatment. That will significantly limit the possibility of a vascular occlusion. Should a vascular occlusion take place., time is of the essence. This is often an “all hands on deck moment. You want to be certain that many hand are available, and that those hands are very capable

Aesthetic injections, when performed by well trained medical professionals in a safe and appropriate environment can be a quick way to make natural looking, yet transformative changes to the face. With skilled injectors, treatments are comfortable with little to no down time and the result is very natural looking

Let’s discuss sun protection factor, SPF. I mean this is a term that we hear all the time. Do we all
understand what it means? Sun protection factor is a mathematical comparison , it’s a ratio, of the
amount of time it takes for the skin to turn red wearing a sunscreen versus the amount of time it takes
without the sunscreen on. So let’s take a simple example. I have a bottle of SPF 10 sunscreen. I’m going
to go outside. I’m not going to put it on yet. I’m going to go outside at noontime in the summertime and
maybe it will take, let’s say, one minute for me because I have a rather low Fitzpatrick type skin to turn a
little red. Let’s say I go back inside, I wait a day and repeat this experiment, apply the sunscreen the next
day, do the same thing, bright sunshine, noontime. It will take ten minutes for me to turn red. That’s
what an SPF 10 means. It’s the multiple of the amount of time it will take me to get red when you
compare it without wearing a sunscreen.

When we talk about sunscreens, we should also understand the two different classes of sunscreen
ingredients. We have chemical ingredients and physical ingredients. Chemical sunscreens are
compounds that absorb ultraviolet energy. They are chemicals, things like PABA, which stands for para-
aminobenzoic acid. That’s an old-fashioned sunscreen. Avobenzone – that’s in a lot of modern
sunscreens. It’s a powder, more like a wax. You have to melt it. It doesn’t dissolve in water, and
avobenzone also known as Parsol 1789. When it was first introduced, it had a brand name Parsol 1789.
This is really a fairly good, not great, but fairly good UV-A absorber. And there are also chemicals that do
varying degrees of jobs in protecting us against UV-B – homosalate, octocrylene, octisalateoxybenzone,
octinoxate. Octinoxate is a very common one. These are all clear oils. You may have heard the issue with
octinoxate. Octinoxate can damage coral and harm marine life, and there are now places where it is
banned in sunscreens and there probably will be more bans because it is a problematic ingredient. All Blue Water Spa products are Reef Friendly, meaning the sun protection products we carry do not contain ingredients known to damage coral or other marine life

Studies show that ultraviolet rays account for about 80%

of skin aging, no matter whether the patient is a sun worshiper or a sun avoider. So it really teaches us
that it’s the sunshine we get simply living our lives, driving in our cars, walking around outside, sitting in
our homes next to an open window. All of these things actually contribute. They build up, they
accumulate in our skin and represent photoaging. And what that also teaches us is that we need to use a
sunscreen more than just at the beach, more on just those occasions when we are getting a lot of
sunshine doing outdoor activities. We need to use sunscreens every single day, rain or shine. That’s
really the message of this slide, and that is a great challenge that we all have as skin care professionals,
you in particular dealing directly with patients. When asked the question what is the very best thing I
can do to try to look younger, you may have younger patients asking that question, and the answer is
really simple. And that is the very, very first step is to use broad spectrum sunscreens every single day,
rain or shine.