SkinScience
Book
How she works

What actually happens in the room

What people arrive asking for, and what they are told instead. Several of these end with a cheaper treatment than the one requested — or with nothing at all.

These are presentations, not patient records. No individual client, unit count or outcome on this page belongs to a real person — a medical practice cannot publish patient histories, and inventing them would be worse.

Dermal fillerfrom $550 / syringe

“I want a full syringe in my lips”

What people say

The request is almost always for volume. Often the actual problem is a border that has lost definition and an upper lip that has shortened — which volume alone does not fix, and can make worse.

The approach
  • Assessment at rest and in movement before any product is discussed
  • Half a syringe is the usual starting point, not a full one
  • Placed along the border and philtral columns rather than into the body of the lip
  • Cannula wherever the anatomy allows — fewer entry points, far less bruising
  • Reviewed at two weeks, when more can be added if it is genuinely wanted
Why

Most people who arrive asking for a full syringe leave having used half, and come back at two weeks having decided they do not want the rest.

Dermal Fillers
Botox$12 / unit

“I don’t want to look frozen”

What people say

By far the most common hesitation, and usually based on having seen over-treated faces rather than well-treated ones. The fear is reasonable; the answer is dosing, not avoidance.

The approach
  • First treatments are deliberately under-dosed
  • Frown lines treated before the forehead, so the brow keeps moving
  • Every injection point explained before it is placed
  • A complimentary review at two weeks — the point at which more can be added
Why

Adding is straightforward. Removing is impossible. Starting low means the two-week review is a choice rather than a rescue.

Botox & Neurotoxins
Masseter Botox$400

Morning headaches, worn molars, a squared jaw

What people say

Three complaints that turn out to be one problem: clenching. People usually arrive for the jaw shape and only mention the headaches when asked.

The approach
  • Considerably more product than facial work — the masseter is a large, strong muscle
  • A night guard is continued; this reduces force, it does not replace protection
  • Told plainly that slimming is a muscle-atrophy effect and shows over months, not weeks
  • Reviewed at three months rather than two
Why

Relief from clenching comes first. The change in the shape of the lower face comes later — which is exactly why nobody should judge it at two weeks.

Botox & Neurotoxins
Dermal fillerfrom $550 / syringe

Structure first, folds second

What people say

A deep nasolabial fold is usually a symptom. Filling the fold directly can weigh the cheek down further, because the volume was lost above it, not in it.

The approach
  • Support rebuilt in the mid-face first, where the volume actually went
  • Only a conservative amount placed into the fold itself, if any
  • Staged across visits so the result can be judged at two weeks before more is added
  • Photographed at each stage in the same position and light
Why

The fold softens because the cheek is supporting it again, rather than because it has been packed. It also uses less product than treating the fold directly.

Dermal Fillers
XERF$1,500 · one session

Early laxity, and a surgical quote

What people say

A lower face that has softened over a few years, in someone whose skin quality is still good. Surgical consultations at this stage are common and often premature.

The approach
  • Assessment of whether the laxity is early enough for radiofrequency to be worth trying
  • Full topical numbing before anything begins
  • No filler on the same day, so the collagen result can be judged on its own
  • Reassessed at twelve weeks, before deciding whether anything further is needed
Why

Contraction is visible early; the meaningful change builds through months two and three. Where it is not enough, that is known at twelve weeks — and a surgical referral is the honest answer.

XERF Skin Tightening
Microneedling + PDGF$600 + $250 add-on

“I can’t take three days of redness”

What people say

The most common reason microneedling gets postponed indefinitely. The usual workaround — treating more gently — buys less downtime by delivering less result.

The approach
  • Treatment performed at full parameters; nothing softened to shorten recovery
  • Ariessence pure PDGF+ applied immediately, while the channels are still open
  • Nothing else on the skin for 24 hours
  • Scheduled with a buffer day, which is often not needed
Why

Healing is accelerated rather than the treatment being diluted. This is the pairing the published randomised trial actually studied.

Ariessence pure PDGF+
Microneedling$600 per session

“I tried microneedling and it did nothing”

What people say

Almost always a protocol problem rather than a treatment problem. Scarring needs depth and repetition; a single shallow pass is a glow, not a correction.

The approach
  • Depth set for the concern — deeper for scarring than for texture or dullness
  • A course of three, spaced a month apart, agreed before starting
  • Photographed at baseline and after each session in the same light
  • PDGF added where downtime is the barrier to completing the course
Why

Texture changes across a course, not a session. Anyone sold one session for scarring was sold the wrong thing.

Microneedling
PRP$600 per session

Under-eyes where filler is the wrong answer

What people say

Dark under-eyes get treated as hollows by default. Where the darkness is pigment or thin skin rather than lost volume, filler adds a bluish cast and puffiness instead of fixing anything.

The approach
  • The distinction made in front of you: overhead light versus flat light
  • Filler declined where the shadow does not change with the light
  • PRP instead, as a course, for skin thickness and circulation
  • Assessment at twelve weeks — there is deliberately nothing to see at two
Why

Where the cause is colour rather than volume, this is slower and less immediately satisfying than filler. It is also the treatment that works.

PRP Therapy
Mesotherapy$500 per session

Skin that has gone flat, not loose

What people say

“I look tired in photographs” is often read as needing volume. Where structure and volume are intact, the actual problem is hydration and how the skin reflects light.

The approach
  • Filler declined where the face does not need volume
  • A course of mesotherapy instead, spaced a few weeks apart
  • Retinol paused for the course, daily SPF made a condition
  • Anything structural discussed only after the course, if still wanted
Why

Skin quality and skin volume are different problems. Treating the first often removes the reason someone came in asking for the second.

Mesotherapy
Melasmaquoted at consultation

Melasma that got worse after peels elsewhere

What people say

Melasma is hormonally driven and sits deep. It is routinely treated as though it were surface pigment, and aggressive peeling provokes exactly the rebound darkening it was meant to clear.

The approach
  • A peel is not the primary treatment — PRX is a poor choice for melasma specifically
  • A prescription compounded melasma cream, dispensed for use at home
  • Strict daily SPF made a condition of treatment, not a suggestion
  • Reviewed before anything resurfacing is considered at all
Why

Managed rather than blitzed. Melasma recurs when the trigger is still present, so the plan is long-term control, not a course with an end date.

Chemical Peels
PRX-T33 peel$120 per session

An event six weeks away

What people say

A wedding, a milestone birthday, mother-of-the-bride. Six weeks is not enough runway to risk a treatment that can leave pigment behind if it goes wrong.

The approach
  • Deep peels declined at this timeline — the downside sits too close to the date
  • PRX-T33 instead: no visible shedding at any point
  • The final session scheduled a full two weeks before the day, never closer
  • No new products introduced in the last fortnight
Why

Brightness and evenness improve with no social downtime, and nothing is left to chance in the final two weeks.

Chemical Peels
Medical weight loss$50 / visit + medication

On a GLP-1, exhausted, and losing the wrong tissue

What people say

A telehealth subscription mails the pen and stops there. Weight comes off fast, energy drops, and nobody has discussed protein, resistance training or body composition.

The approach
  • Full intake and labs before anything is prescribed
  • Dose held rather than escalated while side effects are brought under control
  • A protein target per meal, and resistance training twice a week, treated as non-negotiable
  • Monthly review of body composition — not just the number on the scale
Why

What you keep depends on what you protect. Rapid loss also deflates the mid-face, which is flagged from month one rather than discovered in the mirror.

Medical Weight Loss

Don't see yours?

Describe it in your own words. Alla Yusim will tell you what she would do — including when the answer is that she would not treat it.

Book a consultation (917) 279-4371

Your details go straight to Alla Yusim and are never shared. A consultation is required before any treatment.

Call Book