Dr. Karen Horton has either authored or reviewed and approved this content.

Chronic sun exposure, environmental stressors, and the natural aging process gradually change the skin and soft tissues of the face. Fine lines, pigmentation changes, textural irregularities, and subtle volume loss can alter your appearance over time.
Not everyone needs — or wants — surgery to address these concerns. Non-surgical aesthetic treatments offer a refined, lower-downtime option to soften early signs of aging, improve skin quality, and restore facial balance without fundamentally changing your features.
At our San Francisco practice, the goal of non-surgical rejuvenation is always subtlety. The most beautiful results look natural and effortless. You should appear rested and confident — never frozen, overfilled, or overtreated.
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All treatments are performed under the direction of Board-Certified Plastic Surgeon Dr. Karen Horton. Our Nurse Practitioners, Emily Sespaniak, NP, and Agnes Wong, MSN, NP-BC, are extensively trained in advanced injection and laser techniques and share a commitment to balanced, individualized results. Many surgical patients also incorporate non-surgical treatments to maintain or refine their results over time.
Dynamic wrinkles — including frown lines, forehead creases, and crow’s feet — develop from repeated muscle movement and natural collagen changes. Neuromodulators such as BOTOX and Dysport temporarily relax targeted muscles to soften these lines while preserving natural expression. Treatments are precise and conservative, designed to refresh your appearance without altering your character. Results typically develop within several days and last approximately 3–4 months.
Learn more about neuromodulators here.
Gradual volume loss can contribute to hollowing in the cheeks, under-eyes, temples, and deeper folds around the mouth. Hyaluronic acid dermal fillers restore structure and contour when placed thoughtfully and conservatively. In our practice, filler is used artistically to enhance balance and proportion — never to overfill or distort natural anatomy. We offer advanced filler options including Juvéderm®, Restylane®, and Voluma®, selected based on your anatomy and aesthetic goals.
Learn more about Injectable Fillers here.
Lip enhancement focuses on proportion, definition, and balance — not simply volume. Using hyaluronic acid fillers, treatments are customized to complement your facial structure while maintaining softness and natural movement.
Learn more about Lip Fillers here.
Intense Pulsed Light (IPL) therapy addresses sun damage, redness, and pigmentation irregularities.
IPL is commonly used for photorejuvenation of the face, neck, and chest and may also be incorporated into scar management protocols to improve discoloration.
Clear + Brilliant is a gentle fractional laser treatment designed to improve skin texture and early signs of aging. This treatment supports smoother, more even-toned skin and is often selected by patients seeking subtle, progressive refinement with minimal downtime.
Learn more about Clear + Brilliant here.
Healthy skin is the foundation of both surgical and non-surgical results. Medical Grade Skin Care products contain higher concentrations of active ingredients and are formulated to improve tone, texture, and overall skin health. Customized regimens support treatment preparation, recovery, and long-term maintenance.
Learn more about Medical-Grade Skin Care here.
Microneedling stimulates collagen production by creating controlled micro-injuries in the skin. This treatment may improve fine lines, acne scars, enlarged pores, and overall skin texture. It can be performed as a standalone treatment or incorporated into a comprehensive skin rejuvenation plan.
Learn more about Microneedling here.
LATISSE® is an FDA-approved prescription treatment designed to grow eyelashes longer, fuller, and darker over time. Applied nightly along the lash line, it enhances the eyes in a subtle and natural way.
Learn more about Latisse® here.
A BOTOX Lip Flip subtly relaxes the muscles around the upper lip, allowing it to gently roll outward and appear slightly fuller without adding volume. This treatment is ideal for patients seeking a refined enhancement with minimal intervention and can be performed alone or alongside lip filler.
Learn more about BOTOX Lip Flip here.
BOTOX may be used to temporarily reduce excessive underarm sweating by blocking the nerve signals that stimulate sweat glands. This treatment can provide meaningful improvement for patients who struggle with hyperhidrosis and wish to avoid more invasive options.
Learn more about BOTOX for Hyperhidrosis here.
Bruxism — or chronic teeth grinding and jaw clenching — can contribute to jaw tension, headaches, and facial discomfort. Strategically placed BOTOX injections may help relax the masseter muscles, reducing tension and softening the lower face when appropriate.
Learn more about BOTOX for Bruxism here.
Scar formation is a normal part of healing after surgery, but its appearance can often be improved with proactive management. Our scar therapy protocols may include topical treatments, massage techniques, and laser-based therapies to support optimal healing and minimize long-term visibility.
Learn more about Scar Therapy here.
From time to time, our practice offers thoughtfully curated specials on select non-surgical treatments. These limited offerings are designed to provide added value while maintaining the same level of expertise, safety, and individualized care you expect from our team.
We invite you to explore our current specials to learn more about available treatment opportunities.
If you are considering non-surgical rejuvenation, we invite you to schedule a consultation at our San Francisco practice.
Our team will evaluate your concerns, review your medical history, and develop a personalized treatment plan designed to enhance your natural features while maintaining balance and proportion.
Whether you are new to aesthetic treatments or seeking to refine existing results, we are committed to thoughtful, individualized care in a discreet and professional setting.
Contact Us
Our Aesthetic Nurse Practitioners, Emily Sespaniak and Agnes Wong.Dr. Karen Horton has either authored or reviewed and approved this content.
Give us a call or fill out form below to schedule online.
Monday-Friday: 9am - 5pm
Saturday-Sunday: Closed
Monday:
9 AM to 5 PM
Tuesday:
9 AM to 5 PM
Wednesday:
9 AM to 5 PM
Thursday:
9 AM to 5 PM
Friday:
9 AM to 5 PM
Saturday:
Closed
Sunday:
Closed
Dr. Karen M. Horton
2100 Webster St., Suite 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the
Pacific Heights District
in the Pacific Professional Building.
*Please note: Our office is no longer a Participating Provider for insurance. We can provide a financial quote for what anticipated surgical fees will be after your consultation.