The American Society of Plastic Surgeons reports more than 28.5 million minimally invasive procedures in 2024 (ASPS).
But more options also means more homework.
Medical aesthetics covers cosmetic procedures that use injected medications or substances or prescription medical devices, such as injectables, lasers and body contouring devices. In Texas these are medical procedures regulated by the Texas Medical Board, not cosmetology services (TDLR). They carry medical risks and need a trained provider.
Texas Rules
Why "medical" matters in Texas
The Texas Medical Board has determined that nonsurgical medical cosmetic procedures, including injecting medications or substances for cosmetic purposes and using a prescription medical device for cosmetic purposes, are the practice of medicine and may be delegated and supervised (22 TAC §169.25). The board's current rules for these procedures took effect January 9, 2025 (Texas Medical Board). Anyone providing medical treatments at a med spa must hold the appropriate license or work under the delegation of a licensed physician (TDLR).
A physician (MD or DO) may perform these procedures or delegate them. A delegation to a physician assistant or advanced practice registered nurse must be registered with the Texas Medical Board (22 TAC §169.5). Before a delegated procedure, a physician, or a PA or APRN acting under a physician's delegation, must establish a practitioner-patient relationship with the patient (22 TAC §169.26), and the delegation requires a written order (22 TAC §169.27). The person performing the procedure must also sign and date a written protocol (22 TAC §169.26). An esthetician, cosmetology operator or barber license does not authorize injecting Botox or other substances (TDLR).
Why does this matter to you? Because you can look up the physician's license yourself before your first appointment.
Treatment categories
How to think about the eight major categories
Houston med spas typically offer treatments across four groups:
- Injectables (Botox, fillers) — injected treatments for wrinkles and volume loss.
- Energy-based treatments (lasers, microneedling, chemical peels) — using light, heat, or chemistry to resurface and remodel skin.
- Structural treatments (body contouring, thread lifts) — reshaping contours without surgery.
- Wellness therapies (IV therapy, hormone optimization) — IV and prescription treatments offered alongside cosmetic care.
Below is a short summary of each treatment: what it is, what the evidence says and what to ask.
Injectable
Botox & Neurotoxins
Botulinum toxin — most people just say "Botox" — is a purified protein injected in tiny doses into facial muscles to temporarily relax them, smoothing expression lines like frown lines, crow's feet, and forehead wrinkles. Neuromodulator injections such as Botox ranked first among minimally invasive procedures in the ASPS 2024 statistics, at 9,883,711 procedures (ASPS).
Botox is one brand of botulinum toxin; ask which brand you will receive. The BOTOX Cosmetic label states that its effect on frown lines (glabellar lines) lasts approximately 3 to 4 months (BOTOX Cosmetic label).
Prices: Each neighborhood page on this site lists the regular prices that med spas there publish on their own websites, with a link to each. The American Society of Plastic Surgeons gives a national average cost of $435 for botulinum toxin injections; that is a national figure from plastic surgeons, not a Houston med spa price (ASPS).
The BOTOX Cosmetic label lists two contraindications: known hypersensitivity to any botulinum toxin preparation or its components, and infection at the injection site. It warns of an increased risk of clinically significant effects in people with pre-existing neuromuscular disorders and states there are no adequate data on developmental risk in pregnancy. Its boxed warning states that the effects of BOTOX Cosmetic and all botulinum toxin products may spread from the area of injection; the label also states that no definitive serious adverse event reports of distant spread have been associated with dermatologic use at the labeled doses (BOTOX Cosmetic label).
Full guide to Botox in Houston →
Injectable
Dermal Fillers
Where Botox relaxes muscles, dermal fillers add volume. The FDA describes dermal fillers as medical device implants approved to create a smoother or fuller appearance in areas including the face, lips and back of the hands; some are made of hyaluronic acid (HA) (FDA).
How long a filler lasts depends on the material and where it is injected. Absorbable fillers are temporary; non-absorbable (permanent) fillers are approved only for nasolabial folds and cheek acne scars (FDA).
Prices: Each neighborhood page on this site lists the regular prices that med spas there publish on their own websites, with a link to each. The American Society of Plastic Surgeons gives a national average cost of $715 for hyaluronic acid fillers; that is a national figure from plastic surgeons, not a Houston med spa price (ASPS).
The FDA calls unintentional injection into a blood vessel the most concerning risk of fillers; reported complications include tissue death, vision problems including blindness, and stroke (FDA). Ask your injector how they would recognize and treat a blocked blood vessel.
Full guide to dermal fillers in Houston →
Energy-based
Laser Treatments
Laser treatments use focused light energy to target specific skin concerns — sun damage, pigmentation, acne scars, fine lines, redness, and unwanted hair. Different wavelengths treat different problems, and treatment intensity ranges from gentle (IPL) to aggressive (ablative CO2).
Options include intense pulsed light (IPL, including BBL), fractional lasers such as Halo and CO2, and laser hair removal. The laser treatments guide explains how they differ.
Prices: This site does not publish a Houston price range for laser treatments. The American Society of Plastic Surgeons gives a national average cost of $697 for "laser skin treatments like laser hair removal"; that is a national figure from plastic surgeons, not a Houston med spa price (ASPS).
Skin tone matters. The American Academy of Dermatology says laser hair removal must be performed very carefully in people with darker skin, lists skin lightening or darkening among possible side effects and notes that some color changes are permanent; it recommends choosing a board-certified dermatologist for laser treatments (AAD). Ask whether the provider regularly treats your skin type.
Full guide to laser treatments in Houston →
Energy-based
Microneedling
Microneedling devices create many small puncture holes in the skin (FDA). The American Academy of Dermatology says it works by stimulating the body to make collagen (AAD).
Radiofrequency (RF) microneedling adds heat to the treatment (AAD). The FDA has issued a safety communication about potential risks with certain uses of RF microneedling (FDA).
Prices: This site does not publish a Houston price range for microneedling.
The American Academy of Dermatology says microneedling is safe for all skin tones and notes that studies of RF microneedling included few people with darker skin (AAD).
Full guide to microneedling in Houston →
Structural
Body Contouring
Nonsurgical body contouring uses devices to reduce fat or build muscle without surgery. Two devices covered in the body contouring guide are CoolSculpting (cryolipolysis) and Emsculpt NEO.
Cryolipolysis, the technology behind CoolSculpting, uses cold to break down fat cells, which the body eliminates over four to six months. The ASPS reports an average fat reduction of about 20 percent in the treated area. Rarely, in less than 1 percent of patients, it causes paradoxical adipose hyperplasia (an increase in fat at the treated area), which the ASPS says is three times more likely in men than in women (ASPS).
Prices: This site does not publish a Houston price range for body contouring.
Full guide to body contouring in Houston →
Energy-based
Chemical Peels
Chemical peels apply a chemical solution to the skin. They range from light ("lunchtime") peels to medium and deep peels (AAD).
Light or superficial peels that do not penetrate the dermis can be performed by licensed estheticians; medium and deep peels penetrate the dermis and are medical procedures regulated by the Texas Medical Board (TDLR). The American Academy of Dermatology gives healing times of 1 to 7 days for a light peel, 7 to 14 days for a medium peel and 14 to 21 days for a deep peel; a deep peel is done one small section at a time to limit effects on the heart and lungs (AAD).
Prices: This site does not publish a Houston price range for chemical peels.
The American Academy of Dermatology says people with darker skin should see a dermatologist experienced in using chemical peels on darker skin tones, because without that expertise they can develop permanent pigment problems. Some patients follow a pre-peel skin care plan for 2 to 4 weeks to improve results and reduce side effects (AAD).
Full guide to chemical peels in Houston →
Structural
Thread Lifts
Thread lifts use absorbable, barbed sutures placed under the skin to lift the face and neck; the ASPS says they also stimulate collagen production (ASPS). The FDA regulates lifting threads as Class II medical devices (FDA 510(k) K220549).
The ASPS says results generally last one to three years and that thread lifts lift the face only a few millimeters (ASPS). Studies have found shorter results: in 160 patients the improvement was absent by one year (Bertossi et al., 2019), and a 2018 systematic review found at best very limited durability in all but two studies, both manufacturer-sponsored (Gülbitti et al., 2018). PDO threads dissolve in about 4 to 6 months according to the ASPS (ASPS), or 6 to 8 months according to a 2024 review (Hong et al., 2024).
Prices: This site does not publish a Houston price range for thread lifts.
A 2021 meta-analysis of 26 studies reported pooled rates of swelling (35%), skin dimpling (10%), numbness or tingling (6%), visible or palpable threads (4%), infection (2%) and thread extrusion (2%) (Niu et al., 2021).
Full guide to thread lifts in Houston →
Wellness
Wellness & HRT
Some med spas also offer IV vitamin therapy, NAD+ infusions and hormone replacement therapy (HRT).
IV therapy delivers fluids, vitamins and minerals through a vein. In Texas, HB 3749 ("Jenifer's Law"), signed June 20, 2025 and effective September 1, 2025, sets rules on who may prescribe, order and administer elective intravenous therapy (Texas Legislature).
HRT (such as estrogen or testosterone) is prescription hormone treatment. Ask the prescriber what condition it treats, what tests support it and how it will be monitored.
Prices: This site does not publish Houston prices for IV, NAD+ or hormone therapy.
Full guide to wellness & HRT in Houston →
Guidance
How to choose between treatments
With eight categories to consider, the right starting point depends on your primary concern, timeline, and budget.
If your concern is wrinkles and aging, injectables are the most common entry point. Botox addresses expression lines (forehead, crow's feet); fillers restore volume in cheeks, lips, and nasolabial folds.
If your concern is skin quality — texture, tone, pores, scars, sun damage — the options include chemical peels, microneedling and laser treatments. They differ in depth, downtime and risk for darker skin tones; see each guide.
If your concern is body shape, CoolSculpting and Emsculpt NEO are nonsurgical options. The ASPS describes cryolipolysis as a treatment for a localized fat bulge that has persisted despite diet and exercise (ASPS).
When to see which provider type: A dermatologist is a medical doctor who specializes in conditions of the skin, hair and nails, and the AAD warns that what looks like an age spot could be skin cancer (AAD). See one for a skin condition or a changing spot. A board-certified plastic surgeon can advise on surgical options. For treatments at a med spa, check the delegating physician and the person who will treat you, as described below.
Guidance
How to choose a med spa provider in Houston
Start with credentials. Every other consideration is secondary.
Step one: Verify the physician's license. Go to the Texas Medical Board's Look Up a License page and search by name. Confirm the license is active and check for any disciplinary actions.
Step two: Check board certification. Use the American Board of Medical Specialties' Certification Matters site (ABMS) to confirm the physician holds certification from an ABMS member board. Member boards relevant to aesthetics include the American Board of Plastic Surgery, the American Board of Dermatology and the American Board of Otolaryngology – Head and Neck Surgery (ABMS). None of the 24 ABMS member boards is a board of "aesthetic medicine" (ABMS).
Step three: Ask the right questions at your consultation. Who specifically will perform your treatment, and what are their qualifications? Is a licensed physician, PA, or NP present during your procedure? What emergency protocols are in place — and does the facility stock hyaluronidase for filler reversal? What specific products will be used? Can you see before-and-after photos from this provider?
Red flags to walk away from: no identifiable medical director; staff who can't (or won't) show credentials; pricing dramatically below market; high-pressure sales tactics; willingness to treat you without a medical history review or consultation; any provider offering services in a non-clinical setting.
Under Texas Medical Board rules, the delegating physician's name and Texas license number must be posted in each public area and treatment room (22 TAC §169.28). If you don't see it, ask — or leave.