BioIdentical Hormone Replacement
What is a bioidentical hormone?
A bio-identical hormone is exactly the same, atom for atom and molecule for molecule, as the hormone your own body makes. They are produced from plants to create hormones that are exact replicas of human hormones. Patients who use them generally feel much better than when they are on the synthetic hormones. Synthetic hormones are often created in a lab or extracted from the urine of pregnant horses. Synthetic hormones are not identical to human hormone molecules. Why are bioidentical hormones better than synthetic hormones? Unlike synthetic hormones manufactured by big pharmaceutical companies, bioidentical hormones are created just for you with the exact dose that your doctor recommends to meet your individual needs. And unlike synthetic hormones, bioidentical hormones are made at the time they are prescribed right in a compounding lab. There is no need to include unnecessary additives or preservatives.
How do I know if I need BHRT (BioIdentical Hormone Replacement Therapy)?
Do you experience any of the following: Mood swings, insomnia, anxiety, weight gain, hot flashes, anxiety, low libido, fatigue, depression, PMS? If any of these symptoms are effecting your ability to be happy and function normally through life, then you might want to consider bioidentical hormone replacement therapy.
How do you test my hormone level?
We perform a comprehensive blood panel designed to measure the inactive and active forms of hormones in your body. This testing is much more involved than your usual primary care annual blood testing. After beginning the therapy, we retest your hormone levels to ensure safe and optimal levels are obtained. Testing will continue at specific intervals and adjustments to your program will be made to assure levels remain optimized.
Is Bioidentical Hormone Replacement Therapy the only thing I should do to improve my symptoms?
No- getting regular exercise, reducing carbohydrate intake, increasing vegetables in your diet, limiting red meat, moderating use of alcohol, quitting smoking and taking needed supplements all play a role.
How would I take bioidentical hormone therapy?
There are a variety of options. These include creams, gels, oral medications, lozenges, injectables, or implantable pellets. Your provider will explain the different types of hormone delivery and determine which is best for you.
Are bioidentical hormones safe?
There is a body of research that shows that bioidentical hormones are not the same as synthetic hormones. Bioidentical hormone replacement therapy is an increasingly popular alternative to traditional (synthetic) hormone replacement therapy. Many doctors and others have turned away from providing hormone replacement to women as a result of the U.S. government-sponsored Women’s Health Initiative study in 2002. The study showed that traditional, synthetic hormone therapy increases a women’s risk of breast cancer, heart attack, blood clots and stroke. This is not the case for bioidentical hormones. When it comes to bioidentical hormones, there is a large body of evidence that supports the safety of natural bioidentical hormones. They have been linked with lowering a patient’s baseline risks for breast cancer, cardiovascular disease and osteoporosis. There is other research that has found that bioidentical hormones have favorable action on blood vessels and are associated with a decreasing risk of dementia. Studies of both bioidentical estrogens and progesterone show that they are not associated with an increased risk of blood clots.
Does Testosterone Therapy increase risk of heart disease?
In early 2014 the media cited a flawed study that was retrospective, poorly designed, and implied that testosterone therapy had negative cardiovascular effects. Numerous physicians including leading urologists have criticized these studies, and they point out that there are many, many studies documenting the beneficial cardiovascular effects from testosterone optimization.
Does Testosterone Therapy increase risk of prostate cancer?
There have been numerous studies documenting no increased risk of prostate cancer with testosterone therapy. Dr. Abraham Morgentaler is a well known and respected Harvard urologist who has devoted a much of his career to studying this issue. He has written extensively on the safety of testosterone replacement therapy. He has shown that testosterone replacement is safe to give even in patients who have a history of having had prostate cancer in the past.
Is pellet therapy safe?
Yes, the minimally invasive procedure to implant the pellets is carried out through a very small incision in the buttocks area. Most patients state that the area is mildly sore for several days following implantation. You will enjoy the benefit of a steady reliable release of hormones to achieve optimal blood levels 24 hours a day.
What do patients experience after starting bioidentical hormone therapy?
Most patients experience an increase in energy, improved libido and a greater sense of well-being soon after beginning their BHRT regimen.
How much does Male HRT cost?
The Low Testosterone hormone replacement therapy costs $700. This covers the cost of the treatment whether you choose weekly shots or pellets, lab work, insertion, and provider visit.
Can I work out after getting pellets?
No. Light walking is encouraged but vigorous exercise should be avoided for one week.
Does insurance cover this?
Unfortunately most insurance companies do not cover this but we can create a “Superbill” that you could submit for potential reimbursement.
How often would I need pellets?
Every 3-4 months
Why pellets instead of gels or shots?
There is a more even release of testosterone into the bloodstream with pellets.
How do I know if I am a candidate?
At Rejuvenate we offer a free complimentary blood test for free and total testosterone level to see if you are a candidate.
How do I get my test results?
Your first complimentary blood test is followed up with a phone call advising you of your results and if you are be a potential candidate.
What happens if I am a candidate?
You would come in for a free consultation to talk about your symptoms, how HRT could help, the different delivery methods and pricing. Should you decide to proceed we then would draw the additional labs that we need and schedule you to see one of our Medical Providers.
What are symptoms of Low T?
Fatigue, muscle weakness, decreased erections, decreased libido and decrease body hair, to name a few.
How can I get started on weight loss?
We offer free consultations Monday through Friday to discuss the weight loss options available for you.
Do you only work with obese patients?
No. We offer a variety of weight loss plans that can be customized to lose 5 pounds or 100+ pounds, depending on the goals of the individual.
Will I get prescribed appetite suppressants?
The medical provider will determine during your visit if appetite suppressants are right for you.
What lab work do you check?
Complete Blood Count, Complete Metabolic Panel, Hemoglobin A1C, Thyroid Panel, Lipid Panel and Vitamin D
How much are your weight loss plans?
We offer 4 different weight loss plans ranging from 189 to 499 per month
I have recent lab work from my physical do I have to get them again?
We do very specific lab work that most physicals don’t cover. Bring in your labs to determine if you need to get additional testing.
How long do the free consults take?
Usually 30 minutes is adequate time to review of 4 plans and answer any questions but if more time is needed we can make that happen.
Can I drink alcohol?
We want to create the very best experience and results for your weight loss journey. Alcohol consumption can slow down the weight loss process and keep you from reaching that desired goal. With that in mind the choice is ultimately yours!
What type of foods do you eat on the keto plan?
When on the keto plan, high volumes of unsaturated fat are consumed as well as moderate portions of protein and low-no carbs. This plan keeps our clients feeling full while helping them to reach their weight loss goals.
Do I have to exercise in order to lose weight on my medically supervised weight loss plan?
In weight loss, 90% of results come from diet and about 10% come from exercise. This does not mean we do not encourage cardio and resistance training during each of our 4 plans but believe that nutrition is key!
Can I start on a medically supervised weight loss program if I am a diabetic?
There are weight loss options available for diabetics. The provider will review your lab results and determine which plan is best for you.
How often can I get a lipo shot?
You can come in once a week or every 5 days!
Will these shots make me lose weight?
No. These shots will not make you lose weight. However, they do add in your weight loss efforts to help the body speed up the breakdown of fat. On average, our patients who do our weight loss plans with shots lose 11.2 lbs more than those who do not.
Why am I not losing weight on these shots?
These shots do not make you lose weight. If you haven’t changed anything with your lifestyle these shots can make you feel more energized. Weight loss at it’s core is calories in and calories out. While the shots allow your body to break down fat faster if you are taking in more calories than you are expending you will not lose weight.
Is my shot going to hurt?
The shots are very quick and easy. You feel a small prick as the needle goes in and a slight burn of the solution but it subsides quickly.
What is the difference between B12 and Lipo?
B12 shots are primarily used to increase vitamin B deficiency, resulting in a boost of energy. The lipotropic injections have multiple benefits including both fat burning and energy boosting.
How do the lipotropic injections help with fat burning?
These injections are made up of three amino acids, Methionine, Inositol and Choline. They work as catalyst to speed up the fat burning process and aid in weight loss.
Where does the shot go?
B12 shots are in the arm. Lipotrophic shots are in the posterior hip.
Will I be bruised?
Typically, those who bruise are known easy bruisers. Most patients do not bruise.
Can I purchase these shots and administer them myself at home?
No. You must receive these shots in office. What is the difference between taking a multivitamin and getting a B12 shot?
What is the difference between taking a multivitamin and getting a B12 shot?
Multivitamin has multiple vitamins. B12 shot has just B12 in it.
Are my lipo shots still working? I don’t feel a difference anymore
Yes. You noticed such a remarkable difference beforehand because you were at such a deficit. Now that your levels are more normalized, you are maintaining the results. If you went a while without a shot you would notice you start to feel sluggish again; not that it’s something I recommend!
What is a Coolsculpting Certified Practice?
Our staff members at Rejuvenate MD are fully trained to perform CoolSculpting treatments and assesments. In order to be a certified practice, more than 2 of our staff members have recieved coolsculpting themselves, which allows us to have the best inside view for our patients. In addition, over 3 of our staff members have attended Coolsculpting University which is the highest ranked training you can recieve.
How long does it take to see results with CoolSculpting?
You’ll see your best results at 3 months but sometimes patients see it as soon as 30 days. It depends on the person and the treatment area.
Does it hurt?
Not much. Some patients experience slight discomfort as the area is getting cold, but once numb you don’t feel it! Although, we do notice a bit more discomfort in our more petite patients.
Can I work out afterwards?
Absolutely. With CoolSculpting, there is no downtime and you are able to return to your everyday activity directly afterwards.
Will I lose weight with CoolSculpting?
No. CoolSculpting is for fat reduction, not for weight loss. If you are trying to get to a healthier weight you should a complimentary consult with one of our wellness consultants discover what plan is best for you.
How long are the treatments?
Most are 35 minutes
Can you coolsculpt calves?
No, this area is not approved
Will the coldness hurt my skin?
No, there is a protective gel barrier pad that is applied with each treatment
Should I eat or drink before coming in for treatment?
Yes, we encourage each person to eat a normal meal prior to coming in.
How many treatments will I need?
We offer free consultations for that very reason. We want to understand and evaluate the areas that bother you the most and during that time is when we make our very best recommendation for the number of treatments/cycles.
What is Xeomin?
It is a more purified form of Botox. They work pretty much the same way, and they are the same price. Dr. Green is excellent at deciding which neurotoxin works best for you.
Will I become addicted to Botox / Xeomin?
No, you will not become “addicted”. You may really love your appearance after the treatments and may wish to continue- but this is not an “addiction”
If I have Botox or Xeomin and later on I stop, will I look worse?
Absolutely not! In fact you will have delayed some of the aging effects of time
I need Botox in my smile lines. Can you do that?
No. You don’t need botox in your smile lines, you need filler. Schedule a consultation with your injector to find the best product to fit your needs.
How long does Botox last?
Botox and Xeomin typically last 3-4 months. Usually 3 months as you first start and eventually, lasting longer.
When will I notice my results?
Botox and Xeomin will start to take effect 3 days after treatment, with optimal results seen at 2 weeks
Does Botox hurt?
No. The needle is very small and goes in at a superficial level
Can I go back to work after Botox?
Yes. Immediately post treatment you will have some welts at the injection site but they typically subside in thirty minutes.
How big is the needle?
A very thin 30G needle is used for Botox/Xeomin injections
How does Botox/Xeomin work?
Botox/Xeomin works by disrupting the communication between muscles to cause temporary paralysis.
How long does filler last?
Like most things, this varies. Where your filler is placed, what product is used, how severe the correction is, all effect how long the filler will last. Typically, most fillers last between 9-12 months.
How many syringes do I need?
You need to meet with your injector to discuss what your cosmetic goals are and what it will take to achieve that. Many factors, including the patients facial structure and volume loss will impact the syringes needed.
Can I use the same syringe to treat everywhere?
Probably not. Unless the areas of improvement are very minor one syringe is not enough product to spread to multiple treatment areas.
What filler is the best?
The best filler is the one that is appropriate for the area. The filler that’s best for the undereye hollows is not the same as the filler used to build volume in the cheeks.
What is the cannula technique?
The cannula is a blunt needle that is used to help minimize bruising.
What is the difference between filler and botox?
Filler is used for filling in areas of depleted volume and etched in static lines. Botox is used for dynamic action lines.
Is there any down time after getting a filler procedure?
It’s recommended to have a 2 week window after filler and before any major social events. Potential downtime would consist of bruising and swelling.
What if I don’t like the results?
Filler is not permanent. You and your injector will have a discussion before the procedure to ensure you are both on the same page. If you are unsure of your results you can come back in for an adjustment or even have it dissolved if that’s necessary.
Will I look like I’ve had something done?
Our motto at Rejuvenate MD is, “The best injectable is undetectable.”
Can I have my teeth whitened after having lip filler?
Crest White Strips are fine but anything that uses a tray or an in-office treatment you will need to wait 2 weeks. Waiting 2 weeks allows your filler to settle and not be moved to improper placement.
What is BBL?
BBL, which stands for Broad Band Light, is a form of treatment known as IPL- Intense Pulsed Light. Short bursts of light energy of many wavelengths are pulsed into the skin. It helps to reduce or eliminate brown pigments (“age spots”), reds in the skin (capillaries) and stimulate collagen synthesis.
Does BBL hurt?
There are very short little bursts of energy onto the skin. Many describe it like a mild snap of a warm rubber band. In general it is comfortable and very well tolerated.
What is the downtime from having a BBL?
There is typically no downtime. The facial skin may be a little red for 30-60 minutes. Some clients do have some swelling- but most do not. Once in a while we see a patient who has a large amount of swelling- that is always possible- but it is not at all common.
Will SkinTyte help my sagging skin?
Perhaps. SkinTyte is best for crepey, loose skin. Severe hanging skin typically needs surgery. It’s best to meet with one of our estheticians for an evaluation.
How long does a BBL Forever Young photofacial last?
Plan on your first visit being an hour. After that, most patients take 35-45 minutes for a treatment.
Can I do just one BBL treatment?
It is recommended to do a series of treatments to address the pigment. Most people require 3-5 treatments, depending on the level of damage.
How many treatments do I need to manage my Rosacea?
There is no known cause or cure for Rosacea. We do know that BBL does help to improve and treat Rosacea. Typically, after your series of treatments has been completed you will need to do maintenance treatments every 4-6 months.
Are BBL and IPL the same?
BBL is Broad Band Light. It is a newer, safer form of IPL or Intense Pulse Light. The mechanism of treatment is the same, how the energy is delivered is what is different.
Can I do BBL any time of the year?
Yes. Patients can do BBL year-round as long as they commit to taking proper precautions with their sun exposure.
Will I peel after a chemical peel?
It depends on the peel. We have several different chemicals peel- ranging from superficial which has no downtime or peeling like our stimulator peel, and deeper peels where you can experience some peeling.
Is a chemical peel painful?
Most of the peels we use at Rejuvenate MD you will experience some slight tingling and stinging but this is mild. We do offer deeper, more intense peels that will cause more temporary discomfort if that is indicated for your skin type.
How many peels will I need?
The amount of peels needed is dependent on the condition of your skin. Speak with your esthetician to get a treatment plan.
Can I do peels as well as lasers?
Yes. Typically, peels and laser treatments are spaced out 2 weeks between services.
How often should I do a peel?
Frequency of peels is determined by depth. Some peels can be performed weekly, others require 6 weeks between.
Can I go back to work after a peel?
Yes. Discuss with your esthetician your social calendar and the proper peel, with the correct amount of down time will be chosen.
When I will start peeling?
Typically, you peel 2-3 days after the treatment; this flaking and peeling can last up to one week
My child is having acne, do you treat minors?
We do treat minors on a case by case basis. Please schedule a complimentary consultation to determine what treatment is right for your child.
What are my options for laser hair removal?
We treat the lips, chin, face, arms, underarms, legs, bikini area and backs
Can I use self tanner before my treatment?
No. The laser only sees a tan, it can’t differentiate between a real tan and a fake one. It’s best to wait until you’ve completed your series before using self tanner.
Will I be numbed for my treatment?
Numbing depends on what laser treatment is being performed. Typically, all Halo patients are numbed. Laser peel patients are numbed if the depth of the treatment is greater than 10 microns
Do I need to grow my hair out for laser hair removal?
No. You can shave as often as you like while getting laser hair removal treatments; and it is best to come clean shaven to all your appointments.
How long until I see results with laser hair removal?
Typically, after 10 days you will notice some stubble falling out and have a week of no hair growth. To have lasting, dramatic results it will not be until your series of treatments is completed.
What is a halo treatment?
Halo is a resurfacing laser treatment. Two laser beams work simultaneously to polish the surface of the skin and also deeply penetrate to encourage collagen growth.
What is a fractional laser?
Fractional lasers laser a fraction of the skin. This means faster healing time and still big results.
Should I take the day off from work for my Halo appointment?
Yes. You will be red day of treatment and warm. It’s best to go home and relax.
Do laser treatments help with acne scars?
Yes. Laser treatments can help with acne scars but they are not the only option. Schedule a consult to determine what the best treatment is for your skin.
What is a hybrid laser?
A hybrid laser uses two different lasers to treat the skin.
Is dermaplaning the same as microdermabrasion?
They are both exfoliating treatments using different methods. Dermaplaning uses a sterile blade to exfoliate the surface of the skin, microdermabrasion uses a wand with a diamond tip and vacuum to gently remove dead skin.
What treatment would you recommend for me?
Your esthetician will decide on the best treatment for you depending on your skin concerns and goals.
Will I be red after a facial?
You may be slightly pink due to increased circulation but in general you should leave with a healthy glow.
Will the peel burn my skin?
Depending on the depth of the peel it can range from a mild tingling to a more intense stinging/itchy feeling. The better health your skin is in the better results you will achieve
What can I do about dark spots?
UV exposure is one of the main causes of irregular pigmentation on the skin. Wearing spf and avoiding the sun can prevent new spots from forming. Exfoliating regularly can help lighten existing spots. Our BBL treatment is excellent at lightening or removing dark spots on the skin
What are extractions?
Extractions are performed by your esthetician to help reduce the congestion and clogged pores in your skin.
My skin is oily, do I still need to wear moisturizer?
Yes even oily skin still needs hydration. If you skip this step your skin will over compensate and become oilier in the long run. Look for a lightweight oil free hydrator- ZO daily power defense or Skinceuticals Daily moisture are great for oilier skin types.