Med Spa Methods

When Mark Koepsell thinks of what makes working in the medical spa business so fulfilling, he thinks of a soon-to-be bride he worked with. She got some simple microneedling to take care of her acne scars. 

After her last treatment, Koepsell remembers she looked up at him with tears in her eyes. Soon they spilled down her cheeks. 

“She said, ‘I didn’t know it was possible for me to look this beautiful on my wedding day,’” Koepsell says. “That story–that’s why I do what I do.” 

It didn’t start out that way, Koepsell admits. He took over as owner and operator of Xanadu Med Spa as a business investment. But since then, it’s become a career he loves. 


Antonia Bartecchi providing a customized facial. Photo courtesy of Xanadu Med Spa.

What exactly is a medical spa? 

Medical spas are the Goldilocks of skincare. They’re a step above a day spa, which might offer facials and chemical peels, and they’re a step below the kind of plastic surgery involved in a facelift. 

Jessica Friedt, general manager of TEN Salon and Spa in Loveland, said med spas offer clients the best of both worlds. 

“(You get) the wellness and relaxation experience that you receive at a day spa with the medical procedures and products to target concerns our clients have to feel their best and most beautiful,” Friedt says. 

Med spas, in addition to normal day spa services, specialize in offering nonsurgical aesthetic treatments such as botulinum toxin injections (think Botox), body sculpting, laser hair removal, tattoo removal, laser skin resurfacing, nonsurgical fat reduction, injectable dermal fillers and more.  

Med spas are overseen by licensed medical professionals, depending on state requirements, according to The American Society of Plastic Surgeons, ranging from nurses to plastic surgeons. 

Being located in Northern Colorado, Friedt said many clients come in with concerns about skincare. The dry air combined with active, outdoor lifestyles means many clients are concerned about hyperpigmentation, loss of elasticity, overall dryness and texture of the skin.

“Our clients are also very busy people, so treatments with minimal downtime while also offering results that save them time during their day-to-day is one thing we really specialize in,” she says.

Where to start 

Get a consult. Consults are generally free. 

This is the time and place to talk about your goals, expectations and budget. It’s the time to start asking questions to see what treatment options are available for the things most important to you. 

At Xanadu, that means starting with a 3D imaging machine that scans your face. 

“That way you and your providers have an understanding of what you’re working with,” he said. “It allows us to make a very educated approach to your treatment plan as opposed to looking at your face and making our best guess.” 

Once you have an idea of what you want and how you might be able to achieve it, there are different approaches at different price points. 

Friedt echoed this advice. “Because there isn’t a ‘one size fits all’ approach to meeting the needs of our clients, our focus is truly on a thorough consultation and creating a customized plan to meet their needs,” she says. 

Best bang for your buck treatments to try:


This procedure can help to reduce acne scars, stretch marks and wrinkles by using tiny needles to puncture your skin, jumpstarting the skin’s natural healing process. 

It encourages your body to produce more collagen and elastin, the proteins that keep your skin smooth and firm.  

Worried about enlarged pores, fine lines, wrinkles, loose or crepey skin, mild scars, discoloration, uneven skin tone or stretch marks? Microneedling may be a good choice. 

“We are definitely seeing a trend in clients looking into chemical peels, lasers and microneedling treatments which offer immediate and long-term improvements in skin appearance and texture,” Friedt says. 


Botox as a beauty treatment has been around for just about 20 years, but its popularity is undeniable. And there’s a reason it’s such a mainstay in the beauty industry. 

“Botox is so affordable and almost everybody gets it,” Koepsell says. “It just plain works.”

Botox injections work by temporarily preventing muscle movement–reducing the appearance of wrinkles. 

There’s generally no downtown time with Botox, and results can last for months. 

Of course, there are risks to the procedure, but according to the Mayo Clinic, Botox injections are relatively safe when performed by an experienced healthcare provider. 

IPL laser treatments 

The Intense Pulsed Light (IPL) photofacial procedure is another skin rejuvenation favorite. The treatment uses, as the name suggests, intense pulses of light to get deep into the skin. 

The light from IPL is less focused than a laser. It also gets deep down into the dermis, the second layer of skin, without damaging the top layer, the epidermis.  

It works by causing collagen and blood vessels below the epidermis to constrict. This can help to reduce redness, age lines, age spots, sun damage, varicose veins, broken blood vessels, rosacea and more. 

The procedure takes about 30 minutes. While there may be some redness and swelling afterward, the treatment requires no down time. You’ll get the most out of an IPL facial by scheduling follow up treatments. 

Newer, advanced procedures:

Body sculpting and contouring 

Body sculpting and contouring treatments can help get rid of stubborn fat and unwanted excess skin without the surgery or the downtime something like liposuction would require. 

The EMSculpt Neo, for example, which Xanadu uses, offers a chance to simultaneously reduce fat and grow muscle without an invasive procedure. The tech mimics the effect of hitting the gym and doing more than 1,000 crunches in 30 minutes. 

It uses a combination of radio frequency and high intensity focused electromagnetic energy to get the desired effect. The results? Reduced fat in stubborn areas and improved muscle tone. It can be used to strengthen the core, reduce cellulite, firm up the booty and more. 

Other Methods for Fat Reduction are Cavitation, which uses ultrasound waves to break up fat cells, radio frequency therapy, which tightens skin, and laser lipo to shrink fat cells and more. 

Having a variety of options available, Koepsell says, allows for a customized treatment plan. 

There have been some horror stories that have made headlines recently–namely when former supermodel Linda Evangelista said she had become disfigured and unrecognizable after a CoolSculpting procedure.

According to the New York Times, Evangelista filed a lawsuit in 2021 against Zeltiq Aesthetics Inc., seeking $50 million in damages for distress and loss of work. She claimed treatments received between August 2015 and February 2016 resulted in hard, bulging, painful masses under her skin. Those masses, according to the suit, were permanently disfiguring, even after several attempts at corrective surgery. 

Koepsell says that many of the horror stories are due to the error of the person doing the procedure rather than the procedures or machines themselves. The many procedures that fall under the umbrella of body sculpting and contouring, he says, are generally safe when done by an experienced, licensed practitioner.

While estheticians are a critical part of what medical spas do, he adds, they aren’t all trained on sculpting and contouring procedures. 

“If everybody who comes out of esthetician school starts using these devices, you’re going to find that lots of them don’t actually understand physiology,” he says. “At Xanadu, we have advanced trainings required if estheticians are going to do those procedures or we have one of our team of registered nurses who do it.” 

He recommends making sure those providing the service are not only trained and certified but are also experienced. To get an idea for how experienced the providers are with the procedures, he recommends reading reviews and getting referrals. 

Koepsell also says it is important to remember that while the procedures may make stubborn fat disappear, they won’t automatically keep new fat cells from appearing. 

He recommended folks work with a nutritionist and develop a regular exercise plan to get the most out of whatever sculpting procedure they choose to use. 

Non-invasive facelifts 

Similar to the EmSculpt NEO, Xanadu offers EmFace. It also utilizes radio frequency and high intensity focused electromagnetic energy to tighten and lift skin while working facial muscles. 

The idea is that stronger, more toned muscles in the face mean fewer wrinkles and more lift–without needles. 

The most noticeable results from this treatment, according to Xanadu, are in the corners of the mouth and eyes, as well as the brows and cheeks. 

For the best results, most clients need four 20-minute treatments spaced a week apart. 

Harmony Skin & Wellness Clinic in Fort Collins offers another kind of non-surgical facelift called Scarlet RF. Using a short-pulse microneedling radio frequency, this is a minimally invasive skin tightening treatment that encourages the body to produce hyaluronic acid, elastin and collagen. 

These are good options for those looking for an alternative to fillers and Botox. 

Pelvic floor strengthening  

Some med spa procedures may even be able to help with the struggles we don’t make polite conversation about–including urinary incontinence, erectile dysfunction and unsatisfactory sex. 

Emsella treatments last around 30 minutes. During them, you remain fully clothed. Using high intensity, focused electromagnetic energy, the Emsella chair creates pelvic floor contractions that strengthen muscles. These are not your mother’s Kegels–but they should feel about the same. 

According to Xanadu, most clients get the best results after about two or three sessions. 


Kelly Ragan is a writer based in Greeley.