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Q: What are natural hormones?
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A: From a physiological perspective, bioidentical hormones derive from natural plant sources are identical to those that the body produces for itself, in physiological proportions. When we are "replacing" the body’s hormones, we feel it makes more sense to use entities which the body recognizes as its own, rather than hormones from horses, imbalanced versions or overly potent synthetic versions. The hormones we use are mainly Estradiol, Estriol, progesterone, testosterone, and DHEA.
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Q: How can I get natural, bioidentical hormones?
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A: Natural, bioidentical hormone therapy is generally obtained through a physician’s prescription. Bioidentical hormone treatments are provided at Bienvenu Aesthetics.
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Q: Once my doctor has prescribed Natural Hormones, why can’t I just get them at any pharmacy?
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A: Because the ingredients used for bioidentical hormone therapy are naturally derived, it is impossible for a manufacturer to obtain a patent on these substances. Without a patent, it is unlikely that any drug manufacturer will go to the expense of pursuing these products for marketing and sales. Consequently, these bioidentical hormones must be prepared for the patient from pure, plant derived chemicals by a pharmacist at a compounding pharmacy.
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Q: What is a compounding pharmacy?
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A: Actually, it's the oldest type of pharmacy in the world: an apothecary with a pharmacist trained in formulating prescriptions and who prepares them from pure ingredients on the order of a physician. A caring and competent pharmacist works closely with the prescribing physician to create just the right dosage form and strength for you, the patient.
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Q: What dosage forms are available?
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A: Bioidentical hormone dosage forms are numerous and variable in nature. Each method has its advantages for use. Usage of specific dosage forms depend on patient compliance, type of response desired and medications involved. Oral capsules, vaginal suppositories, transdermal creams, gels and troches (a lozenge that dissolves between the gum and tongue) are types of dosage forms available to be compounded, each patient’s medications must be tailored to their individual needs for treatment.
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Q: Where do the actual bioidentical hormones come from?
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A: Natural plant sterols are extracted from soybeans and/or Mexican yams. These are taken to a laboratory where they are converted chemically, or semi-synthesized to hormones that are identical and indistinguishable from the body’s own.
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Q: If they are synthesized in a lab, doesn't that make them "synthetic"?
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A: Although these hormones are derived from substances in soybeans and yams (diadzein and genistein), they are natural in the sense that they are biologically identical in structure and function to hormones produced in the body. For that reason, we prefer to call these hormones "Bioidentical, plant derived". We use the term "synthetic" to describe those entities chemically altered to be many times more potent than the "naturals".
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Q: Will my insurance company cover these bioidentical hormone treatments?
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A: Although compounds such as these cannot be processed at the pharmacy like mass produced medications, most insurance companies will reimburse a percentage of the cost to the patient. Look closely at your benefit package. If you have a flexible spending account or HSA (Health Savings Account) you may use your account to pay for you consult and/or hormone prescription(s).
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Q: Are these medications FDA approved?
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A: The Food & Drug Act of 1938 contains specific exemptions to the approval process, with the specific intention of NOT interfering with a doctor’s ability to treat his patient. "The FDA cannot approve or disapprove of how a legally marketed drug is used by a physician in practice. The agency approves of what the manufacturer may recommend about uses in its labeling (package insert) and advertising." (Editorial, JAMA 1984; 252:1054-5)
In other words, the physician has the ultimate responsibility for judging the suitability of a medication for his or her patient regardless of whether it is patented or whether the use is listed on the label. Bienvenu Aesthetics is one of the leading physicians providing bioidentical hormone therapy, helping to maximize your benefit and results.
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Q: How will the doctor know what dose is right for me?
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A: EVERY PATIENT IS DIFFERENT! The prescriber will take many issues into account when dosing replacement therapy: Age, weight, symptoms, gynecological history and prescriber experience will all affect the choice of dose and dosage form. Saliva or blood spot testing to identify specific imbalances of one or more hormones eliminates physician guesswork when prescribing and regular monitoring with use allows adjustment of dose as needed.
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Q: What is Botox?
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A: Botox is a commercially prepared and purified form of Botulinum toxin A. Medical use of this toxin to temporarily relax muscles was first reported in 1973. Work on its use in cosmetic situations was begun in 1986 and continues to the present.
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Q: What does Botox do?
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A: Botox is an injectable substance that can produce a temporary paralysis of a muscle after being injected into it. When injected to overactive facial muscles that are causing facial lines and wrinkles, the resulting temporary paralysis of those muscles allows the skin to relax and the lines and wrinkles to soften and smooth out.
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Q: Can any facial lines or wrinkles be treated?
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A: At present the best results are achieved when treating frown lines between the eyebrows,forehead lines and “crows feet”. Treatment of other areas has been shown to be sometimes effective but the best results are when it is used in the upper third of the face.
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Q: How are the treatments done?
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A: Tiny amounts of Botox are injected into the overactive muscles responsible for the facial lines of concern using a small syringe and extremely fine needle. This is easily done at the time of an office visit. Any discomfort is usually minimal and passes quickly. No anesthesia is needed.
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Q: Will I see the results right away?
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A: No. Botox must be taken into the muscle and the nerve tissues to be effective. This takes time. Most people will begin to see an effect within 48-72 hours. The maximum effect may not be present for 7-14 days.
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Q: How long do the effects last?
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A: On average you can expect the results to last 3-6 months, though this will vary from person to person. The effect does not wear off all at once but will be a gradual return.
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Q: When can I get another treatment?
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A: Repeat treatments can be done as soon as you feel enough of the lines or wrinkles have re-developed to be worth addressing. You will be the best judge.
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Q: Can there be problems If I keep getting treatments over a long period of time?
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A: Studies have shown no long term or permanent effects on injected muscles, even after many treatments.
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Q: Are there any special instructions or restrictions after a treatment?
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A: Yes, in order to speed the uptake of Botox into the muscles; I recommend that you use those muscles as much as you can in the fIrst 4-6 hours after your treatment. This means intentionally wrinkling your forehead and brows as well as forcefully squinting your eyelids. To minimize the chance of spreading the effect of Botox to nearby muscles, I recommend that you DO NOT rub or otherwise manipulate the treated areas and that you DO keep your head elevated for the next 4-6 hours as well.
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Q: Are there any side effects or complications?
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A: There have been a few reported cases of a rash developing after a treatment. Temporary localized swelling has also been reported. The relaxation of nearby muscles can result in temporary drooping at the eyebrow or eyelid, usually resolving in 2-4 weeks. In patients with already loose skin, relaxation of the underlying muscles may appear to accentuate that skin excess temporarily.
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Q: Are there any medications I should avoid before the treatment or any medical conditions that would keep me from getting Botox?
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A: Yes. Certain antibiotics and other medications can accentuate the effect of Botox. Also, patients with certain nerve disorders should not gef Botox without consulting your Neurologist or Family Doctor. For your safety, please be sure to inform me of ANY and ALL medications you are taking and ANY or ALL medical conditions you may already have.
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Q: What does this surgery help?
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A: Brow lift surgery raises the eyebrows, smoothes the forehead and the skin between the eyebrows and can reduce the heavy look of the upper lids in many patients. These things contribute to a more open, rested and less worried look to the forehead, eyes and face overall.
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Q: I just thought I needed my upper eyelids helped. Do I have to have a brow lift?
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A: Many patients do quite well with eyelid surgery alone. But I have found that it is common to see patients who ask about their heavy looking upper lids and what seems like a lot of extra eyelid skin whose eyelids are actually much improved, if not corrected, by raising the brows a small distance. Each surgery alone is good for a part of the overall problem. Both together are sometimes the best solution.
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Q: How Is this surgery done?
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A: An incision is made either at or behind the hairline, then the skin of the forehead is raised and tightened with a gentle upward pull. During the surgery, the muscles that produce the frown lines are also weakened to further smooth the face and lessen the chances of re-development of those lines.
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Q: Do you shave my hair?
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A: This is not required for brow lift surgery.
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Q: Where is this surgery done?
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A: For maximum safety and comfort for my patients, this is done in an operating room setting.
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Q: Will I be awake?
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A: Brow lift surgery can be done with heavy sedation and local anesthesia or under a general anesthetic.
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Q: Does the surgery leave scars?
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A: All surgical incisions leave scars. The brochure provided to you shows the approximate location of the scars from brow lift surgery. These are usually well camouflaged in the hairline and acceptable.
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Q: I’m a man with little or no hair to hide a scar. What about me?
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A: Alternate approaches exist far these situations. These can be discussed at the time of your consultation.
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Q: Do I have to stay at the hospital after surgery?
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A: No. The vast majority at patients are able to go home after this surgery.
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Q: Will I have dressings?
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A: Yes. A bulky soft dressing is applied to the forehead and scalp. This is removed at your first office visit. You will be able to wash your hair after that.
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Q: What does this surgery help?
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A: Surgery of the eyelids (blepharoplosty) is aesigned to remove excess, loose and wrinkled skin from the lids and to reduce the “bags” or bulges from fat behind the lids.
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Q: I want my upper eyelids helped. Will eyelid surgery alone dolt all?
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A: Many patients do quite well with eyelid surgery alone. But I have found that it is common to see patients who ask about their heavy looking upper lids and what seems like a lot of extra eyelid skin whose eyelids are actually much improved, if not corrected, by raising the brows a small distance also. This is called a brow lift. Each surgery alone is good for a part of the overall problem. Both together are sometimes the best solution.
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Q: How is this surgery done?
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A: For the upper lids; an incision is made in an existing crease line and the excess skin is removed. Excess, bulging fat is then removed and the incisions closed. For the lower lids, usually the incision con be hidden inside the lid and the bulging fat can be removed from that direction. The skin of the lid is then sometimes tightened using a laser or chemical peel technique.
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Q: Where is this surgery done?
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A: For maximum safety and comfort for my patients, this is done in an operating room setting.
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Q: Will I be awake?
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A: Eyelid surgery can be done with heavy sedation and local anesthesia or under a general anesthetic.
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Q: Does the surgery leave scars?
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A: All surgical incisions leave scars. The brochure provided to you shows the approximate location of the scars from eyelid surgery. These are usually well camouflaged and acceptable.
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Q: Do I have to stay at the hospital after surgery?
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A: No. This is an outpatient surgery.
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Q: Will there be bruising or swelling?
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A: Yes. The worst of the swelling should begin to pass within the first few days, but some swelling may persist for 2-4 weeks or more depending on your body’s healing response. If laser resurfacing or a chemical peel is used to tighten the eyelid skin, it will take about a week to heal before you will be able to wear covering makeup. Some redness in this area may persist tor several weeks.
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Q: Can there be complications to this surgery?
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A: As with any surgery there are known risks and potential complications to eyelid surgery. You will be given information abaut these at the time of your consultation.
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Q: How is the fat removed?
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A: Small incisions are made in the skin through which hollow metal tubes, or cannulas. are pushed into the fat. These are attached to a vacuum device at the other end allowing the fat to be removed by suction as the cannula is moved.
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Q: What is tumescent liposuction?
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A: In order to prepare the fat for removal and to reduce postoperative bruising and possibly discomfort, many physicians will inject solutions of fluids and medications into the fat before suctioning. This has been done for a number of years and "tumescent liposuction" is one of the names given to a version of this technique.
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Q: How much fat do you take out?
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A: This varies from patient to patient and body site to body site. There is not set amount that is removed every time.
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Q: Will I lose much weight?
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A: Liposuction is not a weight reduction technique. It is intended to produce reduction in contours if those bulges are from localized fatty deposits. Even the removal of a relatively large volume of fat will not change one’s weight significantly. Diet and exercise are still the best answers for weight loss.
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Q: Will liposuction help cellulite?
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A: No. Skin irregularities present before liposuction will remain.
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Q: Who is a good candidate for this surgery?
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A: The best candidates for liposuction have well localized deposits and skin with good tone.
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Q: Where is this surgery done?
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A: Liposuction is done in an operating room setting as an outpatient.
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Q: Will I be awake?
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A: The majority of liposuction cases require a general anesthetic. If a very small area is to be treated it is sometimes possible to use local anesthesia with light sedation.
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Q: How long will recovery take?
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A: This will depend on the number and location of the areas treated, but in general; most people are able to be back to normal day to day activities within 5-10 days. Compression garments are worn over the treated areas for an average of 4 weeks though this may vary by location and amount of fat removed.
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Q: Are there any complications to liposuction surgery?
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A: As with any surgical procedure there are known risks, complications and trade-offs. You will be given intormation about these at the time of your consultation.
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Q: How much does this surgery cost?
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A: This will depend on the number and location of the areas treated.
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