Energy-based treatments improve skin texture, tone, and overall collagen production. At our practice, we offer RF Microneedling and Tixel, both powerful tools that work in their own way.

A common question patients ask is: “Can I do Botox or fillers if I’m also doing RF Microneedling or Tixel?”

People want to make sure they’re layering their treatments correctly, without affecting results or doing too much at once. Combining the right treatments can actually enhance collagen stimulation and lead to smoother, firmer, healthier-looking skin.

Understanding RF Microneedling and Tixel

RF Microneedling

RF Microneedling combines traditional microneedling with radiofrequency energy. Together, they improve:

• skin texture

• acne scarring

• fine lines and wrinkles

• overall firmness

• mild lifting

Tixel

Tixel is a skin resurfacing treatment that uses controlled heat to stimulate collagen production. It helps with:

• crepey skin

• pigmentation

• enlarged pores

• superficial lines

• overall smoothness

Treatments You CAN Combine with RF Microneedling or Tixel

Biostimulators pair well with these devices because the heat does not break them down. When you combine them, you get “double” collagen stimulation. The devices and the biostimulators each stimulate collagen in their own way, so they enhance each other and amplify the overall result.

1. Sculptra (PLLA)

Sculptra gradually stimulates collagen production while also improving skin elasticity, firmness, and overall thickness.

When paired with RF Microneedling or Tixel, you’re supporting collagen on multiple levels. Skin becomes firmer, smoother, and looks healthier over time.

2. Hyperdilute Radiesse (CaHA)

Hyperdilute Radiesse is diluted calcium hydroxyapatite that stimulates collagen while improving:

• firmness

• elasticity

• crepey skin

3. PRF, PRP, Exosomes

These regenerative boosters are commonly applied immediately after RF Microneedling or Tixel. They help with:

• calming inflammation

• faster healing

• enhanced collagen response

• reduced downtime

• improved overall glow

They don’t stimulate collagen the same way biostimulators do, but they significantly enhance post-treatment recovery and results.

Treatments You SHOULDN’T Combine with RF Microneedling or Tixel

Energy-based treatments are contraindicated immediately after Botox because the heat can affect how the toxin settles. It may cause the Botox to break down faster or diffuse into areas we don’t want, which can impact your final result.

1. Botox and Other Neurotoxins

Energy-based treatments should not be done the same day as Botox because the heat can interfere with how the toxin settles. It may cause it to break down faster or diffuse in one area, which can affect your results.

It’s best to get Botox after you complete your full treatment series. If you need to get it done, schedule either two weeks before or two weeks after your treatment.

2. Hyaluronic Acid (HA) Fillers

HA fillers (Restylane, Juvederm, RHA) aren’t ideal to combine with RF Microneedling or Tixel in the same session.

Heat can:

• reduce longevity

• change how the filler settles

• make the filler metabolize faster

It’s best to do HA fillers after your finished your treatment series. 

How Traditional Microneedling Is Different

Microneedling without energy is purely mechanical, with no heat involved.
Because there’s no thermal component, it pairs safely with:

• Botox

• HA fillers

• Sculptra

• Radiesse

• PRF/PRP

• Exosomes

This is a great option when someone wants rejuvenation and also needs injectables within the same timeframe.

The Bottom Line

When done correctly, stacking treatments can significantly enhance your collagen response and overall skin quality.

Safe combinations:

• Sculptra

• Hyperdilute Radiesse

• PRF / PRP

• Exosomes

Avoid combining during the same session:

• Botox

• HA fillers

At Dr. Olga Zilberstein Medical Aesthetics, we create treatment plans around your skin goals, timing, lifestyle, and upcoming events so everything works together effectively.