Most of what we do in Aesthetic Medicine falls into what I would call Combination Therapy. Combination Therapy is the use of multiple modalities of care to achieve one’s optimal aesthetic goals- i.e, helping you look your best. I say that much of what we do falls into this category because many of our patients, over time, receive more than one type of treatment. In this day and age, it is rare for one of our patients to be just a Botox patient, ONLY a filler patient or solely a laser patient. The simple truth is that there isn’t a single modality that does it all. They each have their place and when done in concert provide an incredible result. Botox does a great job at softening dynamic action lines and wrinkles such as the frown, squints, forehead wrinkles and more – but it doesn’t help the resting wrinkles, folds and volume loss that occurs with age. This is where filler comes into play.  Fillers are great at giving back the youthful upper face contouring that we lose with age- but it doesn’t help as much with the quality of the skin. In comes products and energy modalities, such as IPL (Intense Pulsed Light/Photofacial); Lasers, such as the CO2 Resurfacing, ReSurFX and PicoSure Focus; Radio Frequency, such as ThermiSmooth; and advanced skincare with products and routine Hydrafacials. For those concerned with skin laxity, we use Ultherapy to tighten the skin with no downtime. Ultherapy uses focused ultrasound waves to bypass the skin’s surface and deliver energy deep into the tissue to create a tightening that improves over time. If advanced laxity is an issue, surgery is a good option & one we offer as well.

We have learned how to blend these treatments together to give our patients a significant, yet natural improvement. To look your best, maintenance is required and our team of dedicated skincare professionals from aestheticians, laser techs, nurses, physician assistants, physicians and surgeons are here to help you along the way. Once more, starting while you are younger is a great benefit because many of the effects of aging can be prevented or delayed. If you are older, as many of our patients are, do not fret- we can help everyone look their very best in an age appropriate manner.

As I mentioned, most of our patients receive Combination Therapies over time, but I want to highlight a few of our most frequent combination therapies that we often perform to achieve great results faster than before. One such therapy is the Total FX. I cannot claim to have invented this one-but I can say that we have mastered the technique. PA Patsy Colvin is our “go to” provider for this treatment here at Medispa Maui and has extensive experience with this device specifically and in the field of aesthetic medicine in general. Total FX is a version of CO2 Laser resurfacing that combines the narrow but deeper resurfacing of DeepFX with the shallower but greater coverage resurfacing of ActiveFX. In certain instances, we will add a 3rd depth- but I don’t want to give away all our secrets! The result is a multi-layered resurfacing that can take 10 + years off your appearance. Down time is about a week with this  treatment, but the results are amazing. For more information, talk with our Patient Coordinator Flecha and PA Patsy.

If you are looking for great results but don’t have time for downtime, consider a treatment invented by yours truly, Brian Stolley, MD – The PicoBright! The PicoBright is a combination treatment of an IPL and the PicoSure Focus done concurrently.  The IPL aids in treating pigmentation, blood vessels and texture while the PicoSure Focus treats pigment and has an amazing smoothing/tightening effect to the skin. The combination works synergistically to amplify the results. I dreamed this treatment up a few years ago and since then, my team, including Sally Bilodeau RN, has perfected it. Ask our laser techs and nurses for details.

Another combination therapy that we have done for several years now is known as the PhotoFractional. This treatment combines the benefits of the IPL with those of the ReSurFx. IPL as mentioned, improves pigmented lesions, blood vessels and texture. The ReSurFx is a treatment in the category of ‘Non-Ablative Resurfacing’. Through a series of ReSurFx treatments, the surface of the skin can be replaced, but done so with limited downtime. The benefits of the ReSurFx alone are improvement in skin texture, pore size, fine lines and such. Combining the treatment with the IPL adds even better results with pigment and blood vessels diminished as well as a synergistic effect of skin texture, wrinkles and overall skin health.

Another combination therapy created by Dr. Stolley and perfected by one of our amazing laser techs, Kristina Beverung, is the Black Diamond Lift & Glow RF-Hydrafacial. This treatment has quickly become a favorite of our patients and is part of our core Aesthetics Menu performed by our Advanced SkinCare Aestheticians. This treatment incorporates the skin firming effects of RF (radio frequency) technology with the deep pore cleaning and nutrient delivery of the HydraFacial. I recommend to all my patients that they have this treatment monthly for skin that is smooth, firm and has a healthy glow. In fact, RF is a great treatment to add on to almost any treatment- be it an IPL, a facial or a Hydrafacial. Make the most of your time in the office by combining treatments to get the best results and best bang for your buck.

In the arena of injectables, we are masters at using various products to achieve optimal yet natural results. Combining neuromodulators such as Botox, Dysport and Xeomin with fillers is a great way to soften active lines and wrinkles while smoothing more etched in lines and wrinkles and returning lost youthful contouring. The neuromodulator works on the action lines while the fillers treat the etched in lines & folds and replace the ‘Pyramid of Age’ with the ‘Triangle of Youth’.

In addition to these, we host the world-class surgeon Dr. Carlo Honrado and have seen the great benefits of combining our therapies with facial plastic surgery. Plastic Surgery can do great things like dramatically tighten the skin in the lower face, raise the brows, remove excess skin from the upper and lower eyelids or the ever-popular contour of the nose. It is amazing how appropriately placed fillers look after a face and neck lift. Surgery is the fastest way to lift and tighten but it cannot give back volume that is lost with age. That is where fillers and our expert injectors ( including Courtney Tsark, Rn, Patsy Colvin, PA-C and myself, Brian Stolley, MD) come into the picture. Studies have shown better results when Botox treatments are done before brow lifts. We always tell our patients that we want to heal smoothly, so we treat the muscles and take tension off the surgery sites by using a neuromodulator ahead of time.

Another area where Combination Therapies are frequently uses is when combining the benefits of fillers with Kybella. Fillers, as I have already discussed, are used to treat fine lines, wrinkles, skin folds and to give more youthful contouring to the cheeks, temples, lips, jawline and chin. Kybella can be used to reduce unwanted fat in the area under the chin, laterally along the jawline and even in the jowl area. Combining these products, when used with precision, precaution and care, can dramatically improve one’s appearance – Giving back youthful contouring in the upper face, softening facial lines, fold and wrinkles, and decreasing volume in the lower face that occurs with age. The end result is a restoration of the Triangle of Youth!!!

Finally, there is the crucial benefit of working from the inside out.  We are blessed to be able to offer the wellness and nutritional services of Terisa Jackson, ND. Dr Jackson is an expert in hormone balancing, gut health, cardiovascular wellness, the immune system and how these systems and others all tie together. Inflammation is a common link to multiple illnesses and conditions and Dr. Jackson is a superhero when it comes to determining what underlying imbalances are present and how to treat them at the source. I feel that no patient is complete without seeing Dr. Jackson. My own mother was able to drop her blood pressure and cholesterol considerably without taking medications after seeing Dr. Jackson. Her MD was astonished at what resulted after following Dr Jackson’s diet recommendations, as well as specific prescribed herbs and supplements.  

Speaking of supplements, VASAYO products can help you lose weight, look good and feel great. I can attest to these products and use them daily. After slowly gaining weight over a few years and starting to feel my age with aching bones and joints, I have found great benefit from regular use of VASAYO products. I am always a skeptic, but after using these products I can say that I have never felt better. I have been able to lose about 15lbs and maintain great energy and mood by combining 3 of their products – V3, VSlim and Core Complete. I lead a very active lifestyle surfing, snowboarding and just keeping up with my wife and teenagers and over the years I have started to feel it in my joints. RENEW microgel has helped me considerably. I no longer have pain when I get up in the morning and it’s potent anti-inflammatory compounds of turmeric, ginger, acai, shiitake mushroom and resveratrol are excellent at treating INFLAMMATION – linked to many diseases like cancer, diabetes, heart disease, stroke and arthritis. So, while I feel dramatic improvement in my joints, I know that this is just a sign of all the other improvements that I am receiving. This line of products uses advanced delivery systems like enzymes and liposomal technology once only used in chemotherapy. These dramatically increase the actual absorption of these amazing nutrients.

This blog reviews and highlights some of our most popular Combination Therapies. Book your appointment with our Patient Coordinator, Flecha Tovar, or one of our amazing providers to get in-depth and customized recommendations on how we can help you look and feel your very best.  


Brian Stolley, MD