After doing a little bit of this and that, I received everything. There was no recommendation from the director at all, I just asked for it first because I wanted it, and the director actually tried to discourage me by saying it wouldn't be effective. In conclusion, there are no dramatic changes in any of the three, but as someone who has been to many places, I know that dramatic changes are honestly impossible, so I recommend them because I think they are good dermatologists who can take care of them with peace of mind.