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A robust experience fully reflective of Moxie’s values and goals.
We will have the capabilities for blood draws and a more comprehensive wellness approach in addition to highly executed aesthetics. We take results seriously. Seriously.
Alex Foley - Advanced Practice Registered Nurse and Certified Nurse Midwife. Over ten years of delivering high-quality obstetrical, gynecological, and primary care. Over 50 educational hours in weight management with hundreds of success stories. Certified in bioidentical hormone replacement.
Sasha - Registered Nurse, Nurse Injector, Experienced in laser treatments. Ten years of nursing with a diversity of medical and aesthetic experience. Very experienced in specialized aesthetic care in both Wisconsin and Texas.
Tox
There are four neuromodulators on the market. Botox, Grupo, Dysport, and Zeeman. Botox is like Kleenex for all facial tissue, but there are four that exist on the market.
I almost exclusively use UVO since it is just as effective as Botox. It's just as precise, and it's the same price, but it sets up faster and lasts a bit longer. It is FDA-approved to temporarily treat moderate to severe frown lines, crow's feet, foreheads, and lines in adults. There is no downtime during these appointments.
Some bruising can be expected with some treatments in more vascular areas. Although bruising is not routine, you may start to notice results in the first 24 to 48 hours, but they peak in 7 to 10 days, so no adjustments are made until that ten-day mark has come. Results last three to four months.
It targets the underlying cause of frown lines, crow's feet, and forehead lines. The repeated muscle contractions from frowning, squinting, smiling, and raising the eyebrows over the years cause these lines that stay, and the neurotoxin breaks up the synthesis of the proteins that make that muscle move.
So basically temporarily not allowing the muscles and the proteins to communicate. That's kind of an over simplistic way of saying it. There is no FDA-approved substitute for neurotoxin that is effective or technically interchangeable.
No, that is the entire goal. As long as you go to somebody licensed, trained, and well-versed in providing natural-looking results, it is absolutely possible. And in fact, that is Moxie’s number one philosophy. So we don't like overdone or unnatural. You walk in, you ask to be frozen. I'll give you what you want. But that is not our baseline understanding of what the average woman walks in, or man wants walking in.
Heck no. We see just as many men as women.
You need to be 18 years or older. People are starting younger and younger in their early 30s, and that is actually what's recommended at this point to ultimately get less, by starting early and preventing a lot of stuff from occurring.
But if you're just new to it and you're in your 50s, it’s never too late to start. I've got plenty of people who come in their 60s and 70s and say this is the best thing they did for a confidence boost, and they don't know why they didn't start younger, but they're happy they did now.
No, not really. I mean, it's a little 31-gauge insulin needle. If, for some reason, we do a couple of injections and you are sensitive, we can stop and put on numbing cream. But the average person doesn't need numbing cream. The average length of treatment is 5 to 10 minutes. Appointments are 15 to 30 minutes, but the actual injection part is very, very quick.
None. We always say technically none. You can return to your daily routine immediately after you leave the office. There are some restrictions for the first 4 to 12 hours that we will cover in full before you leave.
Well, that depends on the treatment plan you come up with your provider and how many units you do. It's the price per unit. The average person on the low end is getting 20 units, and some people go all the way up to 100 units if they've got a lot of treatment goals and areas that they like addressed. So, we usually say the range is 20 to 100 plus. But I usually stress that you won't get any noticeable results with less than 20 units.
You know, some people walk in, and they're like, I only want to spend $100 or $150 in Botox. I'm like, girl, that's not you're not going to get anything. You're wasting your money. You need at least a minimum of 20 units.
Well, there's always a potential. Three percent of patients in studies have experienced eye drooping in the frown line area that's treated, it's very rare. If done properly, and with the right products, the risk is highly eliminated. We do everything to mitigate the risk of a negative side effect or poor outcome. Another side effect is just discomfort or pain at the injection site, which is very, very temporary. Less than 3% of people get a low-grade headache with their first injection ever.
No, no, no. We are using FDA-approved therapies only. For your safety, we need peer-reviewed products and information.
The number one thing I stress is that there is a treatment option for everybody. If it's your first time getting Botox, we can start low and go slow, and that's the way it should be done.
It's just like getting your hair colored, you know? Let's put a few highlights in here. Oh, I like that. I liked it more around my face and in the back. Can we put more in front of my face and frame my face next time? Right. The more you do it, the more you come back and work with your practitioner, and the more you can zone in one what you like, and two, how to get those results. You play around with what you like, and in the meantime, you're just conservative in how you execute the treatment plan. So if it's not something you love, you're like, “Man, it wasn't bad, but let's skip that one next time. I might want to concentrate on putting my units in this location instead.” You're working with your provider, so it's fun.
Fillers
Instantaneously. When you get filler, you will likely leave the clinic slightly “underfilled.” We call it underfilled because over the next 24 to 48 hours, the filler will pull in liquid to hydrate that area, and you'll get a more exaggerated response. So it's always best to slightly underfill.
Well, it depends. If you want a soft, natural-looking lip, it is best done as a journey. So come in, get half a syringe, put in the lips, and let it settle. Come back, get another half syringe, and let it settle.
The whole philosophy of Moxie is to give natural conservative results, and this is always best achieved one, by doing it in stages and two, by eye, making sure that we're not freaking you out when you look at your face.
Not only will your results be better with a conservative approach in layers, therapies, and different sessions, but it also is an easier adjustment for you psychologically. You know, when you look in the mirror, you're like, “Who is this? I didn't want this.” It can be a little unsettling and a bit jarring at first. So again, results are instant, but how many times and how much you need depends on your consultation with your injector. We usually say if you want really big lips, you're probably looking at two sessions.
Mid-face filler can usually be accomplished in one session, although, layering in that area allows you to evaluate what you like and what you would like to stay away from after things settle.
Pricing is per syringe, but at Moxie, we offer pricing by half syringes: half syringes are $350, and full syringes are $550.
Yes, they are! All of them are gel-like substances injected underneath the skin to restore volume. They're made up of ingredients such as hyaluronic acid, calcium, hydro pellet bike, and compatible substances such as polyols, AXS, and polymethyl methacrylate. But at Moxie, we only use hyaluronic acid fillers because they're the safest, most natural, and reversible if we need them to be.
There are but zillions of different types of fillers, but at Moxie, we tend to use a filler called Versa. It’s soft and natural but still provides enough structure for noticeable results. A couple of others we carry are Jupiter and Restylane Radiate Sculpture Bella fill.
What are your treatment goals? They will vary from person to person, depending on the location we are putting them in, how long they last, and whether they can migrate. Please talk to your provider for more information.
Most dermal fillers last 12 to 18 months. If you're getting filler in the lips, it might not last quite as long. In the mid-face, you're going to get closer to 18 months. Dermal fillers should not migrate if done properly.
You can come in, we can dissolve the existing filler and start fresh.
Please do not get filler if…
you are allergic to any of the components
you are pregnant or breastfeeding
you take blood thinners or an immunosuppressant
exercise caution if you have a severe history of scarring.
Yes, you can, but if you're getting your lips injected and you have a history of cold sores, we recommend pretreatment - our cycle with an antiviral, first or immediately thereafter to help prevent, exacerbation of cold sore.
Neither, not necessarily. Dermal fillers and Botox both address similar needs, but in different areas of concern, and one modality is not necessarily the same as the other.
Well, before the procedure, you will have a full consultation to ensure your goals and concerns are being addressed. You will also take a health history to ensure you're a good candidate. Signed consent for treatment and numbing cream will be applied during the procedure, usually lasting anywhere from 30 minutes to an hour.
Then that's where the art happens, right? You lay back, you get just to relax and let your artist do the work. fill in the filler in the aliquot into the appropriate place. After the procedure, you will be instructed to take it easy for the next 24 hours for any strenuous exercise, refrain from excessive sun exposure, and elevation of body temperature. You should stay away from NSAIDs, for a week to help reduce the risk of bruising pain and refrain from using any retin or retinol cream in the face for a couple of days. But other than that, you can go back to work immediately. There's no actual downtime, and a little bruising and swelling is expected. Depending on which area you're injected, the post procedure anticipatory guidance will be provided.
Yes, it can. The type we use can be reversed with, hyaluronidase or a substance that we keep in that dissolves filler.
If accidentally injected into a blood vessel, dermal fillers can cause permanent damage to the face that you can't get back, so going with an experienced provider is essential. Safety is a big deal, so you want to make sure your practitioner is qualified. Here at Moxie, we are!
Weight Loss
Semaglutide is the same as brand-name Ozempic and Wegovy, and that works off of one hormone receptor called GLP-1s. Tirzepatide is the same as brand-name Zepbound and Mounjaro, and that works off of two hormone receptors. So the GLP-1s and G1P. So you can essentially think of Tirzepatide as everything Semaglutide has plus an additional hormone mechanism. The hardest thing about prescribing these medications is managing expectations on how quickly you can get results, the rate that people lose, how long they need to be on it, and so on and so forth.
When we look at the clinical body of research and data, the Tirzepatide is more predictable. With the Semaglutide, there's a lot more variance. Two people who look identical on paper same BMI, lifestyle, calorie intake, and so forth can have two wildly different responses, even though I'm optimizing their dosing in both regimens and touching base doing everything we can. Some of that is just genetic predisposition and some of that is based on intrinsic insulin resistance that we must compete against. So it’s multifactorial in how people respond. Now with Tirzepatide it's a lot more predictable. This means people tend to lose faster and have a higher total body percentage throughout their journey on it.
So Semaglutide starts at $300 a month, and Tirzepatide starts at $500 a month.
That $500 a month makes people cringe a little bit. They're like, oh, that's a car payment. Yeah, well, if you zoom out and you're on it for six months, you only need to be on it for six months, whereas on Semaglutide, you may need to be on it for eight, nine, or ten months to get the same results.
All in all, you've spent less on the Tirzepatide, even though it's a higher monthly amount than on the Semaglutide because it's more predictable. So a lot of times, what we'll do if people are undecided and the $500 per month kind of freaks them out, is I will start people in the Semaglutide. And if by the two, two and a half, three-month mark, they're what I call low responder. then I have a conversation about switching them over to the Tirzepatide. So as far as response, I categorize people in average response, above average response, and below average response. The average response is when you are losing 1 to 2 pounds per week after the first month. Clinical data says the average person can lose about 30 pounds in six months.
So I really, really emphasize to people that oftentimes when we're on social media and we're learning about these medications, we are getting a picture of the outlier and not the median response of the average person consuming these medications. So the expectation, since we're being exposed to these high performers or above-average responders, is that these outliers are having massive amounts of weight loss very quickly.
Now, it's possible it's just not the average response, and I'd much rather prepare people for the most conservative outcome and manage expectations that way. They're not disappointed. They can have a more realistic psychological portion of their journey because weight loss is honestly just as much psychological as it is physical. So, the first month, take it or leave it.
Some people lose, some people don't. I prepare everybody not to lose the first month. Maybe they've noticed that they're losing inches and the clothes are fitting better, but the scale doesn't necessarily reflect that yet. So somewhere around the second month, people really start to notice those numbers moving. Now, of course, inevitably, I get text messages from people giving me updates, and they're like, I know you told me not to lose, but I'm down three 4 pounds already. I'm like, well, great, you know, let's have a glass of wine. Let's celebrate. That's amazing. But again, I would much rather prepare people for the conservative outlook. So those are the two differences between the two methods. That's kind of the rundown on what to expect.
So, I do tell people to expect to be on this for at least three months. Some people have a lot of weight to lose. You know, you can expect to be on this for a lifetime or a year to reach that goal really more acutely.
The side effect profile tends to be on the GI spectrum, so low-grade nausea. I do prescribe, anti-nausea medication for everybody who gets prescribed this medication just to have it as a safety net so then, if that does happen, you sort of method to deal with that.
Constipation is pretty common, especially in the beginning, but it does seem to get better the longer people are on it. A little bit of acid reflux can be pretty normal. Some people feel the urgency to defecate immediately after the injection, and then the next couple of days are usually completely normal.
A little bit of fatigue is normal. Some people experience some sort of injection site reaction that is not an allergic reaction. You know, some people get headaches, but that's not really a highly reported symptom.
And some people feel amazing on this. Especially people who have high amounts of insulin resistance. Many postmenopausal women feel absolutely fabulous. I over-counsel people on side effect profiles so that if it happens to them, they're not panicking, but 90% of the people feel just fine. A lot of that has to do with the fact that we're making small incremental dosing increases versus doing huge dose jumps.
I am sympathetic to the pharmaceutical industry. They do not want to manufacture 18 different dosages of pre-loaded pens. But when you're doing the program through me, and the advantage of doing it with compounding, where you're customizing your dose every week, is that we can get to the same dose in the same amount of time as the brand name, but we're going up, you know, a little bit at a time each week.
So, it's not these big drastic jumps, and that does seem to mitigate most of this medication's side effects profile, which has been lovely to see.
Don't plan on anything. The first month is usually slow; results may appear in the second month.
Your goals are moving targets, so whenever you reach a healthy point that you feel is sufficient to maintain, that's where you need to be. Everybody is going to have different responses, and that can be discussed more in detail during personalized consults.
Weight is a very common thing that I like to talk about, right? Great. I've been on it for six months. I'm at my goal weight now. What? I'm worried I'm going to regain everything. Well, yeah. If you stop intermittent fasting, if you start marathon training, if you stop eating low carb, low sugar, and you go back to your previous lifestyle, you're going to gain the weight back. Regardless of what methodology is used to lose weight. So, about half of my clients will get to their goal weight and come off and maintain with lifestyle factors. And we're always having an exciting conversation like, hey, this is what we know about you being on these meds and this is what you're going to need to do to remain successful. Being off of these meds. It is possible. Then, the other half of my clients go on a maintenance dose. So at Moxie, I offer the option for maintenance dosing, which is only open to those who have gone through the progressive weight loss progressive dosing system in the weight loss program I have, but it's basically a financially affordable way to sustain your weight loss and be on a low dose.
So you continue to inject once a week. Maybe they end up on 60 units by the time they're done. I put them on 20 units per week. They continue to inject once a week, and the cost goes from $300 or $400 per month down to $150 per month. So it's a again, financially sustainable way for people to stay on a maintenance dose and basically maintain their weight loss with very little effort.
it's administered once a week subcutaneously. So that's another one. People ask like, how is it administered once a week into the abdomen or subcutaneous tissue? People want to know if they need to come to the clinic every week. No. So I am teaching people how to self-inject, whether they come in person for their first visit or if we're doing fully virtual and I'm shipping off meds and doing remote prescriptions, they can scan a QR code, and they get virtual Alex instead of in-person Alex.
And there are instructional videos that go over it, and I'm always available for support if they are struggling or, you know, the anticipation is worse than the actual injections. So sometimes people just need to get over that mental hurdle.
The short answer is yes. As long as you are going with a responsible prescriber and they are sourcing it from a responsible single compounding pharmacy, then the answer is yes.
The active ingredient in compounded generic Semaglutide is no different than the active component in brand-name Semaglutide. Legally, you cannot take away an ingredient and call it Semaglutide. So the way some get around patent laws is by adding an ingredient. For example, compounded Semaglutide is always compounded with something, B12, levocarnitine, or other supplements. People often see the vial and say, oh, it's Semaglutide plus levocarnitine. What's levocarnitine? And I'm like, well if you Google it, it'll tell you it's good for transporting fatty acids blah, blah, blah. It's really just getting around patent laws. You just care about the Semaglutide.
So, the short answer is yes. We have no evidence to support that it is unsafe as long as it's coming from an accredited compounding pharmacy. There is zero evidence to support that. People are getting equally good results with compounded semaglutide as they are with brand-name Semaglutide and Tirzepatide as long as they are going with a responsible and ethical prescriber and sourcing it from a responsible compounding pharmacy.
I always remind people my background is in medicine and then I made the leap to the Medispa world, not the other way around. I didn't start in the esthetics and medi spa world and then started dabbling in prescriptions and medications. My background is rooted in safe, responsible, ethical prescribing and procedures. Even though HIPAA is not necessarily required for non-insurance patients, people will get HIPAA. That's the expectation for me.
A lot of people are super focused on the appetite-suppressing element or craving-control element of this drug, and it is amazing. So much so that they're using it in drug and alcohol addiction programs and gambling addiction programs. So it works off of the GLP-1 and G1P hormone system. It’s basically asking your pancreas to increase insulin production, decrease glucagon synthesis, delay gastric emptying, and decrease food noise.
So, the first place it works is in the pancreas responding to increased glucose levels. It normalizes blood glucose levels and reverses any amount of insulin resistance.
The second place is delayed gastric emptying. Food sits in your stomach longer, sending signals to your brain that you're still full and don't need to eat again.
The third place is the hypothalamus of the brain, the craving control center of the brain. The appetite suppression and decrease in food noise are not consistent and are not the main mechanisms by which you are losing weight on this drug. Oftentimes, people will message me and say, “Hey, I had appetite suppression for the first day or two, or maybe I had it for my first injection. I'm not getting it anymore this medication's not working for me.” The food noise and the decrease in appetite is considered a positive side effect but it is not the main way you're losing weight on this, so that will fluctuate the entire time you're on it.
You may experience more appetite suppression in the first half of the week than in the second, which is normal.
You are not a candidate if you…
are pregnant or breastfeeding.
Have a history of medullary thyroid cancer
history of endocrine neoplasia syndrome
history of pancreatitis or current kidney or liver dysfunction
Those are the largest restrictions, but a full health history will be collected on the consult to ensure that you have no other risk factors that may make you a poor candidate for this program.
It doesn't mean you're not a candidate, period. You might be able to try it with your PCP, but may need regular blood work, which I am not offering at maximum.
Microneedling
Microneedling is best done in a series of 3 treatments 4 weeks apart for most aesthetic goals
Minimal downtime with a mild sunburn look for 24-36 hours.
It is not painful and numbing cream is applied to the face to ensure comfort during the entire procedure.
Microneedling should be avoided for individuals with active skin cancer in the treatment areas, open wounds, sores, or irritated skin in the treatment areas, allergies to stainless steel or anesthetics, bleeding disorders or hemostatic dysfunctions, those who are pregnant or nursing, or those currently taking medications containing isotretinoin (such as Accutane).
Our Microneedling has been clinically proven effective for both women and men with all Fitzpatrick Skin Types I – VI. Additionally, unlike lasers or chemical peels that may cause long-term skin damage, Microneedling treatments can be safely used for years when properly spaced and supervised by a physician.
Hormone Therapy
Hormone Replacement appointments are for in person only at this time. Medications can then be shipped directly to your door or dispensed in the clinic.
Hormone Therapy uses "natural" hormones that share the same chemical structure as the hormones that your body naturally produces. These hormones will help create balance throughout your body because they perfectly fit your bodies receptors sites. This limits the harmful side effects often associated with synthetic hormone therapy.
Follow up is usually every 3 months until a therapeutic goal is achieved and then every 6-12 months (depending on condition treated).
Short-term side effects are sometimes reported, but most commonly occur due to the body adjusting to the increase in hormone levels. Long-term negative effects of hormone therapy occur rarely, if ever.
Prescription medications are very reasonably priced and a customized care plan will be put in place for you at the time of consultation.
Stay tuned for more pricing information. We am currently contracting with labs and can’t hone in on a set price until we know our costs.
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