“Ask Our Aesthetique”

Ask The Aesthetique

Debbie Marinucci, RN, CPSN, LT and Emily Dunn, LME
represent The Austin-Weston Center for Cosmetic Surgery in Reston, Virginia.

Both Debbie and Emily are available to answer any questions you may have in regards to clinical skin care by using the form provided below:

Any information in the publications, messages, postings or articles on this website should not be considered a substitute for consultation with one of our board-certified plastic surgeons to address individual medical needs. Your particular facts and circumstances will determine the plastic surgery treatment which is most appropriate for you.

Ask Us


  1. I have sebaceous hyperplasia, small broken capillaries and small red spots on my face. I have heard radio frequency would be a good treatment. Do you provide this treatment? How do you treat sebaceous hyperplasia.

    Emily Dunn Reply:

    Radio Frequency is designed to reduce cellulite and tighten skin. It is recommended that you see your dermatologist for the treatment of sebaceous hyperplasia.

  2. I would like to have a raised mole on my face (size of a small pencil eraser) removed using radiofrequency since I understand that scarring is minimal. Is this the best approach and how much would that cost?

    Dr. Robert Sigal Reply:

    I’ve not heard of using RF to remove raised mole. Other modalities are much more useful. The best approach would be to come in for an evaluation. The next best would be to send us photos.

    Christopher Knotts Reply:

    Thanks for the question. It is true that radiofrequency procedures involve minimal to zero scarring, but it cannot be focused in such a way to remove a raised mole.

    Any pigmented lesion needs to first be evaluated by a physician to make sure it doesn’t have any malignant characteristics. Depending on that finding, options for removal could be shaving the lesion off flush at the level of the skin and then cauterizing the base, freezing it with liquid nitrogen, cutting it out completely, or simply letting it be and making sure it is not changing. All this depends on how the lesion looks, your willingness for a scar, and where the lesion is at on the face.

    Please call 703-893-6168 for a complimentary consultation and we can figure out the best way to take care of you.

  3. If you were to choose between Juvederm or rejuvapen, which would be the most effective?

    Christopher Knotts Reply:

    Hi Rose,

    Thanks for the question. Each modality has its own place. Juvederm is best to fill a hollow area or an area that has lost volume. The most common areas for this are the nasolabial folds, marionette lines and lips. These are areas that tend to lose volume with age, and Juvederm can replace that volume and restore a more youthful appearance.

    The Rejuvapen has more to do with collagen remodeling. We try to achieve tightening in an area, or to re-organize collagen in a healed scar. If you would like to come in for a complimentary consultation, we can discuss the exact areas of your face that are concerns for you, and come up with a specific plan to address them.

    Hope that helps!

  4. Hello,

    I’m inquiring about the radio frequency treatment for under the eyes. I have solid silicone cheek implants and would like to know if it would be advisable for me to have RF treatment under the eyes, considering my cheek implants.

    Thank you.

    Dr. Robert Sigal Reply:

    Our RF doesn’t have a hand-piece for use under the eyes (I’m not sure that do!)

    It may be that RF is not the answer. Can you send us some photos (close-up face is best).


  5. I’ve watched the video on the TNS Essential Serum and would like to know if it can be used in conjunction with the AW Precision Skin Care products?
    Thank you.

    Debbie Reply:

    Dear Alexis,

    Thank you for your question! Yes, it is certainly possible to use the TNS Essential Serum at the same time as AW Precision Skincare products. The combination may be very beneficial. As all of our skincare is medical-grade, it is important that your skincare and product regimen be evaluated and customized just for you to ensure the highest levels of safety and results.

    Please call us to make an appointment for your complimentary personal skincare consultation with one of our licensed skin care specialists.

  6. I have freckling, stubborn hyperpigmentation, and basic wrinkling on my face. Over the last 8 years or so, I have done significant skincare regimens, Fraxel re: store, and Fraxel Dual. My skin looked great for a while. But now, it has been about 2-3 years since Fraxel Dual. My freckling and wrinkling (e.g. between eyes) is returning as well as some of the stubborn hyperpigmentation spots.

    What are my options now? Will I need to continue fraxel every few years to keep the skin ‘clear’? Are there concerns about repeatedly doing Fraxel to your face?

    The Fraxel Dual healing time for me was quite significant. Are there any new options on the market? Do no have as much of a healing time as Fraxel Dual?

    Emily Dunn Reply:

    Dear Sheila,

    Thank you for your question. Fraxel re:store and Fraxel Dual do not stop skin aging; they reset the aging clock, so to speak. Time, sun exposure, genetics and environmental factors all influence how any freckling, wrinkling, and hyperpigmentation re-appear after treatment. It is recommended to have Fraxel “maintenance” treatments periodically, and since it has been several years since your last treatment, another or more Fraxel treatment(s) may be indicated.

    Regarding your healing time for Fraxel Dual, everyone heals differently, and all Fraxel treatments are customized to the individual. Fraxel Dual is considered the gold standard for hyperpigmentation, and remains the treatment that we recommend to appropriate candidates with this concern. We would be delighted to see you in our Medical Aesthetique for your complimentary Fraxel consultation. Please call 703-893-6168 to schedule your appointment.

  7. Hi,

    I have pitted acne scars from severe cystic acne. Do you offer acne scar treatment?

    Thank you,


    Debbie Reply:

    Dear Miranda,

    We do treat acne scars routinely in our Aesthetique. Depending on the depth and severity of the scars, treatment can range from chemical peels to microdermabrasion to laser. The Fraxel re:store laser we use is considered the gold standard for treating acne scarring. Since Fraxel is a non-ablative (it doesn’t burn off the top layer of skin, like old CO2 resurfacing lasers) and fractional laser, several treatments are needed to allow the Fraxel laser energy to cause collagen to form and fill in acne scars.

    Everyone’s Fraxel treatment is customized to their skin and their aesthetic desires. Your treatment plan will take into account your skin health, history, and habits, as well as whether your acne is active and if you have taken Accutane. Please call us at 703-893-6168 for your complimentary Fraxel consultation and we would be delighted to meet you!

  8. What is the downtime for a chemical peel vs. the downtime for a Fraxel Dual treatment? I have brown spots from sun damage I would like to address. What type of chemical peel would you recommend for this, or is a Fraxel Dual treatment more effective for hyperpigmentation? Thank you!

    Emily Dunn Reply:

    Thank you for your question! We have a wonderful chemical peel exclusive to our Austin-Weston Precision Skincare line designed specifically to address hyperpigmentation. The gentle, effective Mela-B-Gone peel dramatically reduces dark marks, freckling, hyperpigmentation and uneven tone caused by sun damage, hormones, genetic predisposition and post-inflammatory pigmentation from acne breakouts. Even very sensitive and darker skin types can be safely treated with this peel. One treatment is usually all that is needed to treat hyperpigmentation. After treatment, you can return to work right away. Peeling begins in 36 to 48 hours and lasts for about a week.

    Fraxel Dual is a highly effective fractional laser for dark marks, hyperpigmentation, sun spots and pigmented scarring and done over a series of several treatments. After treatment, your face may look and feel sunburned and be swollen. This will subside over a few days and you may apply cold packs and take over the counter analgesics at the direction of your Austin-Weston Center physician. Your face will begin to peel within 48 hours and will continue to peel for about a week. It is very important to avoid sun exposure and apply broad-spectrum, non-irritating sunscreen such as our Precision Skincare UltraShield-E. You may need only one treatment with Fraxel Dual to resolve hyperpigmentation. If you require a second treatment, you may be treated in another six weeks’ time. Fraxel Dual may be used on all areas of the body as well as the face.

    To discover which hyperpigmentation treatment may be right for you, we invite you to call our plastic surgeon-supervised Medical Aesthetique to schedule your free consultation at 703-893-6168.

  9. How many miraDry treatments will I need?

    Emily Dunn Reply:

    The recommendation is two treatments for lasting reduction of excessive underarm sweating, but some individuals have good results with just one treatment. Dr. Poindexter has experienced a significant reduction in underarm sweating with just one treatment. Please call 703-893-6168 for your free miraDry consultation.

  10. Hi Ladies, I had a consultation with Dr. Poindexter last week and am considering a mini face lift in the fall. In the meantime I would like to have botox and or filler and a skin regimen to help brighten my complexion. Should I make an appointment with one of you or with one of the doctors? Thanks

    Debbie Reply:

    I would be more than happy to have a complimentary consultation with you regarding skincare. I can discuss different skin care treatments such as peels or laser treatments that would help to meet your specific needs as well and prescribe you a customized home care regimen to maintain in between treatments.

    Dr. Poindexter would be able to meet with you regarding fillers and Botox as he performs these types of procedures. I have knowledge of these procedures, however, getting a professional opinion from your doctor is advised as you may also be have these enhancements at the same time as your consultation.

    I recommend you book two appointments on the same day and see me first because having a facial treatment before injections is more appropriate.

  11. Can the Miradry be used on the face to control facial sweating?

    Dr. Byron Poindexter Reply:

    Dear Jenny,

    miraDry is FDA-approved for excessive sweating in the underarm area only, so it would not be an option for your facial sweating. Botox injections to the forehead may temporarily control facial sweating in that area. If you would like, please call 703-893-6168 for a free consultation with me to see if you are a candidate for Botox treatment.

    Dr. P

  12. I’ve been using obagi nu-derm system for one month and seeing results. How long will I have to keep using this? For life? And if so, do I use the entire system or just certain steps for maintenance.

    I’ve read that around 3-4 month mark, we should switch to glycolic products. Thanks for your response.

    Nikki Reply:


    Obagi Nu Derm is as medical grade skin care line that helps to even out skin tone and improve the texture of skin resulting in smoother, softer, clearer skin.

    I can create customized skin care plans for each of my patients depending on what they would like to achieve. The Obagi system entails four phases of transformation. Phase one is weeks 1-6 Out with the old, phase 2 is week 7-12 in with the new, phase 3 is week 13-18 healthy glow, and phase 4 is creating lasting results through maintenance.

    Please call 703-893-6168 to schedule a consultation with me so I can create a customized regimen to help meet your specific skin care needs as every patient is different.

    Debbie Reply:


    In response to your questions regarding the Obagi Nu-Derm system you are currently using. My recommendation is to be sure you are under the care of a qualified skin specialist when using this system. They should be following you and your progress on a regular basis. Depending on your goals ultimately will depend on the amount of time you will be using the system.

    In regard to the Glycolic products, you may already have some in the product you are currently using depending on the cleanser you use. Your skin care specialist should be able to recommend what would be best for your individual skin care needs after using the Obagi Nu-Derm system.

  13. Debbie,
    I had the fraxel dual-laser treatment about a year ago. I was surprised at the long “down time” I experienced. I was very red and peeling for several (5) days, even though I followed all the instructions for post-laser care. I am considering a second treatment. Should I expect the same (long) post-laser recovery?

    Debbie Reply:

    Dear Annie,

    Yes, this is a normal response to Fraxel Dual. Everyone experiences different responses to Fraxel depending on their own skin and on the level of treatment. You should plan to have the same response after your next treatment – if your recovery is shorter, that’s great, but past experience is the best predictor of future results.

  14. How can I remove small moles from my face?

    Debbie Reply:


    The moles should be evaluated by a physician and treatment done accordingly to their recommendation. You can either seek the advice of a dermatologist or plastic surgeon for evaluation, and either of them for removal, if that is what they recommend.

  15. A year ago I used corn remover which left my toes very unattractive, I’ve try everything in the book but nothing worked I was surfing the web and run across Mayo Clinic which suggest that laser resurfacing can restore the skin color back to normal. Can you tell me if this is true or any advice.

    I have lots of pretty sandals but refuse to wear them because of the way my toes look.


    Debbie Reply:


    I am not familiar with using lasers on the toes to restore discoloration from using corn removers. You may want to check with a dermatologist office to see if this is something they may offer.

  16. How is Fraxel Laser different from the Co2 laser? I have had the Co2 done by a prominient Dermatologist and Surgeon, 4 years ago. It was painful and took 2 weeks of healing and hiding out.

    Is the Fraxel less of a prep and what is the down time? What is the cost? I would like to get a touch up but maybe a chemical peel would be better?

    Debbie Reply:

    Fraxel is a non-ablative procedure whereas a CO2 laser is ablative and should be performed by a physician only. The Fraxel procedure has minimal to no down time. Please see the manufacturers web site at: http://www.soltamedical.com for specific details.

    The Fraxel has various levels of prep if needed, however, we need to evaluate your skin to see what would be most appropriate for you. The cost varies on these procedures. We will be happy to answer any of your questions or concerns at the time of your appointment.

  17. Do you treat sun spots?I have a few sun spots on my face for which I am seeing a dermatologist in a few weeks, but was hoping to get a second opinion from you prior to my appt.

    Debbie Reply:

    Yes we do treat sun spots. Please feel free to make a complimentary consultation so that we may evaulate your skin.

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