Body Sculpting

Things Women Should Know About the Black Box Lift on Hormone Replacement Therapy by the FDA

Wed, 18 Feb 2026 14:28:44 GMT

Recently (Nov ’25) the FDA decided to lift/remove the “black Box” warning on hormone replacement therapy (HRT) for women. The FDA's black box warning on HRT was first introduced in 2002, following the Women's Health Initiative (WHI) study, which raised concerns about the risks associated with hormone therapy. The WHI study suggested the risks of HRT (increased incidence of breast cancer and heart disease) outweighed any benefits especially in certain age groups of women. For many women, this warning was enough to deter them from considering HRT, despite the severe symptoms of menopause. The rate of women over age 50 who were utilizing HRT went from 25% in 2000 to current levels near 4-5%.

However, recent studies and expert opinions have led to a reevaluation of these risks. According to a 2020 study published in The Lancet, the risks may not be as significant as previously thought, especially for younger women or those within 10 years of menopause onset.

This change in mind set has led to current FDA commissioner Dr. Marty Makary to recommend the removal of the warning and the advocation of HRT in peri and post-menopausal women. He has written that the current evidence suggests that hormone therapy initiated within a decade of the onset of perimenopause has been associated with numerous long-term health benefits, including reduced vasomotor symptoms, without significantly affecting atherosclerotic cardiovascular disease among younger postmenopausal women aged 50 to 59 years. By removing the black box warning, the FDA hopes to alleviate unnecessary fears and enable more women to consider HRT as a viable option. It's a decision that aligns with current medical thinking, emphasizing the importance of individualized care.

HRT is primarily recognized for its effectiveness in alleviating common menopausal symptoms like hot flashes, night sweats, and mood swings. For many women, these symptoms can be severe and debilitating, impacting their quality of life. But the vast benefits of HRT should also be evaluated and considered when deciding on the right dose/type of HRT intervention.

Hormone therapy has been associated with a 25% to 50% reduction in fatal cardiovascular events (the leading cause of death in women), a 50% to 60% reduction in bone fractures, a 64% reduction in cognitive decline, and a 35% decreased risk of Alzheimer disease.

A study in the Journal of the American Medical Association highlights that women using HRT report significant improvements in sleep quality and overall well-being. This reinforces the notion that HRT can be a powerful tool in enhancing daily life during menopause. While it's not a one-size-fits-all solution, its potential benefits are undeniable when appropriately prescribed. By considering HRT, you might find a path to easier days and more restful nights during menopause.

Dr. Makary has been quoted as saying “with the exception of antibiotics and vaccines, there may be no medication in the modern world that can improve the health outcomes of older women on a population level more than hormone therapy.

The lifting of the black box warning will likely result in a flood of individuals searching for information which should stress the importance of personalized care in managing menopause and it’s symptoms.

All women are not equal, and their responses to HRT can be variable. Personalized care means tailoring HRT to your specific symptoms, risks, and health goals. It's an approach that respects your individuality and aims to provide the best outcomes. This involves initial consultation and regular check-ins with your healthcare provider to assess how well HRT is working for you. It allows for adjustments in treatment as needed, ensuring that your therapy remains effective and safe. By prioritizing personalized care, you engage in a proactive, informed approach to managing menopause.

Additionally, lifestyle changes can play a significant role in managing menopausal symptoms, either alongside HRT or independently. Diet, exercise, and stress management can all contribute to your overall well-being during menopause. Incorporating simple changes like regular physical activity or a balanced diet rich in calcium and vitamin D can also make a difference. Stress-reduction practices such as yoga or meditation can also help manage symptoms like mood swings and anxiety. By focusing on wellness, you can approach menopause with a well-rounded strategy. It's a reminder that small, consistent efforts in self-care can lead to significant improvements in how you feel.

Weight Loss Strategies

Mon, 16 Feb 2026 18:05:48 GMT

Avoiding weight loss pitfalls

I once had a patient tell me that they had lost over 500 lbs. Prior to my congratulations she did admit laughingly that it was the same 25-50 lbs. lost repeatedly over the last few decades. While her sense of humor is refreshing the comment brings up several important questions.

Why is it so difficult to lose weight and then subsequently keep it off?

Why do we seem to be able to lose weight but ultimately, we begin to plateau making further weight loss difficult if not near impossible?

Why do some people lose weight faster than others, and is there an optimum speed for weight loss?

Why do so many of us lose a few pounds only to regain the weight shortly after returning to regular eating patterns and end up heavier than when we started?

Are there safe and effective medications that assis t with weight loss?

I get asked these questions frequently and clients are sometimes surprised to hear that the answers are relatively simple. Once a basic understanding of the concepts of metabolism, calories per meal, calories to protein ratios and optimizing of individual protein to carbohydrate ratios are achieved then a lot of the usual pitfalls to weight loss can be avoided. These strategies can be used by a supervising healthcare professional or by an educated individual to assist with their durable total body weight loss.

Why calorie restriction alone doesn’t work for most people

During periods of calorie restriction, the human body will struggle to maintain its current resting metabolic rate by utilizing stored energy previously stockpiled for just this reason. Most of us would prefer that the body utilize the warehoused adipose tissue (excess fat) that we desire to be rid of but regretfully several variables need to be in place for the body to use (burn) these fat stores. It may surprise most of you that the body’s first inclination is to burn stored energy in the liver (called glycogen stores) during periods of starvation. Once these glycogen deposits are depleted the resting metabolic rate (RMR) is reset at a lower level. This lowering of RMR then causes decreases in energy levels and increases in appetite resulting in calorie intake (binge eating behavior) exceeding the requirements needed and resulting in addition of more adipose tissue or larger hips and thighs in some cases. This type of interval starvation dieting results in unsustainable weight loss measured by stool evacuation, and water loss. In my experience skipping meals and “starvation” dieting is the most frequent short-term weight loss strategy attempted by most of my patients. While gaining in popularity on social media interval starvation dieting is frequently unsuccessful in most of the patients I talk with and can lead to low metabolism followed by binge eating behavior and subsequent weight regain.

With prolonged calorie reduction (over 48 hours of severe caloric reduction) the glycogen stores (Liver) become depleted and the body will attempt to utilize the catabolism (breakdown of body tissue) processes available to maintain normal body function. Unless certain parameters are readily available, the body will find it easier to breakdown muscle tissue to use as a calorie source while at the same time reducing the RMR again resulting in more fatigue, muscle wasting and a smaller calorie requirement. Very frustrating!

It appears that the adipocyte (body fat cell) has plenty of energy inside (stored as lipids) and would be a better catabolism source but this cell has what appears to be a “locking” mechanism restricting the primary use of this stored fuel. Unless we can find the “key” to unlock the fat cell’s potential energy, the primary weight loss seen by most individuals using calorie restriction alone is muscle wasting. This is seen with rapid weight loss (think 30 lbs. in 30 days promotions), but regretfully rapid weight re-gains. Once a person resumes their usual caloric intake and eating behaviors the muscle is replenished and since very little fat stores were “burned” the resulting body weight is equal or slightly higher than before they started this process. This yo-yo effect of weight loss and re-gain is frustrating as well as unhealthy.

Strategies to break the YO-YO weight loss cycle

We all have misconceptions we have learned from various sources. Prior experience, our friends, television, NEWs ads, the internet and or school curriculum that was inaccurate, misunderstood, or incomplete. Sometimes we will attempt to modify other weight loss programs that don’t appear to be working or are too expensive for our current budget. Occasionally we will make erroneous assumptions like “if a little amount works… than more will work better.” When I ask my patients questions, I find that many or all the above items will factor into their misunderstandings regarding safe and long-term body fat reduction.

Re-education is sometimes the hardest part of successful weight loss. For example, an obese patient presented to my office and claimed that she had been on an 800 calorie/day diet for weeks and had not lost any body weight after the first few days (not an unusual complaint). She was complaining of fatigue, decreased energy, and a massive appetite. She desired that I provide a strong appetite suppressant to allow her to reduce her caloric intake even further. After a thorough history and exam, I began to explain the concepts of safe body fat reduction and metabolism. At some point during the discussion she interrupted me and asked if my advice was that she should eat more calories per day in order to lose weight? When I replied positively, she was doubtful because she could not allow herself the realization that an increase in calories would result in weight reduction. She stated that all her life she could achieve weight loss by skipping meals, eating low fat foods, avoiding “sweets”, avoiding high calorie drinks, and utilizing certain appetite suppressant medications prescribed by her provider. She admitted that her weight loss was usually short term and seemed to reappear after the appetite suppressants were stopped and she resumed normal eating patterns.

The above example is a common misconception to weight loss. By starvation methods (skipping meals, severe calorie restriction/day) we become more prone to binge eating behaviors, late evening and night eating, and poor food selection. This will ultimately lower our resting metabolic rate (RMR) and make it difficult for us to lose excess body fat.

In order to break this “Yo-Yo” weight loss cycle and to help prevent weight loss plateaus we need to re-train our bodies by utilizing mechanisms to increase our metabolism (RMR).

Calorie Counting (Count cal/meal vs cal/day)

The first hurdle is to avoid is daily calorie counting. This may sound like heresy to most but the concept of calories per day measurement is a poor weight loss technique. Our body finds it difficult to utilize more than 500-700 calories at one time and tends to place any unneeded calories into fat reserves immediately. A better strategy would be to limit our calories per meal and to eat 3 meals daily rather than the standard 1-2 meals most Americans admit to. Many of my patients tell me of being placed on 800-1200 calorie diets only to complain of severe appetite issues and minimal long-term body fat reduction. One of the most common mistakes of many weight loss attempts is the avoidance of meals like breakfast in order to reduce calorie intake. This will usually result in a lower metabolism and inhibit successful body fat reduction. Limiting portion sizes per meal by creating a meal calorie goal is an essential first step to controlling the protein to calorie ratio and increasing your metabolism.

Deficiencies

Another strategy is avoiding nutritional deficiencies. This is paramount to reducing barriers to reducing body fat and increasing metabolism. Deficiencies in Iron, Vitamin D, B complexes, certain hormones and proteins can contribute to an inability of the body to raise the resting metabolism and eliminate body fat. Checking for these deficiencies with simple blood tests is important to identify and remove the potential barrier.

Protein

A third strategy is protein supplementation. Let’s face it, we do not get the proper protein to calorie ratio in our usual diet. Concentrating on protein to carbohydrate ratios like the “Keto” or Atkins” diets can help but these diets are not selective enough to individual needs, concentrate too much on protein to carbohydrate ratios exclusively, and are difficult to maintain without significant cravings. Determining the proper protein to calorie ratio is usually best achieved by trial and error. If attempting to calculate this mathematical challenge per meal is attempted the process can be quite time consuming, frustrating and involves a lot of math. An easier plan is to initiate protein supplements at specific times of the day to assist with appetite control and raising your overall resting metabolism. This enables a better diet structure and allows you to find the right protein ratio to optimize your metabolism. This is an important aspect of the right dietary plan and can be tailored to serve as weight loss or weight maintenance strategies. In other words… qualifying protein supplements taken between meals will have less competition for absorption and will result in a better Protein : Carbohydrate ratio.

Exercise

For many decades health care providers have been recommending diet and exercise in combination to help reduce body fat. The question is what is the minimum amount of exercise and how does it effect weight loss? Most of my patients believe calories expended is the main goal of their exercise routine. Surprisingly calorie expenditure has little to do with the immediate reduction in body fat. The adrenaline released during the activity and the degree of muscle breakdown contribute to increasing an individual's metabolism and the bodies ability to utilize the fat cell for needed energy as opposed to the body’s glycogen or protein stores (muscle mass). This can get confusing and the information available can be contradictory at best. In order to simplify, l encourage my patients to achieve their target heart rate at least once daily through any activity (this will confirm adrenaline release) and to structure a 15-20 minute exercise program 2-3 times per week (muscle fatigue which helps to raise metabolism) for best results. This is the most individualized aspect of anyone’s weight loss programs and will need adjustments frequently, so best to work with a trained provider regarding your goals (weight loss vs strength building vs increasing endurance vs muscle building) as it relates to exercise and resistance training. Remember that without adrenaline the adipocyte (fat cells) will retain a locking mechanism and any weight loss via calorie restriction with be mainly muscle wasting. Getting an adrenaline dose daily will allow this hormone to bind with receptors on the fat cells to allow these to be "unlocked" and utilized for energy needs.

Medications

The utilization of medications can be used to assist with appetite control during caloric restriction and can also be beneficial to altering certain mal-adaptive eating behaviors. The use of these medications is voluntary and not without some risks. These medications should only be used by licensed providers with experience in their use, but they can help many of us to control our food portions, avoid problem foods, reduce "binging" activity, and maintain certain calorie intake goals. The risks and benefits of medications for eating behavior or appetite control should be properly explained before using them. Warnings should be discussed prior to initiation, and medications stopped or changed if adverse effects are suspected.

In recent years a multitude of prescription medications have been developed to assist with appetite suppression and enabling better compliance with the designed weight loss program. Stimulants like phentermine (Adipex, Qsymia, Bontril, Tenuate) are available but since these are a controlled substance then frequent monitoring is required by a provider. Bupropion/Naltrexone (Contrave) products are slightly less effective appetite controllers but are very good eating behavior modifiers. In 2005 GLP-1 products were developed and introduced by 2009 (Byetta, Victoza, Ozympic, Wegovy, Zepbound) in a subcutaneous shot delivery. These were found to quite effective in appetite control which led to the rising cost due to popularity and demand. In January of 2026 Oral Wegovy became the first oral semaglutide FDA approved for weight loss indications, this is a daily pill that has proprietary engineering to allow better absorption (these are usually not found in generic oral semaglutide ODT products. Because these are prescriptions medications, great care should be taken to acquiring these medications from a licensed provider and via a face to face encounter. I also advise care to avoid the many fraudulent products that are easily acquired from online sources, etc. Remember that these medications are tools and may not work for everyone, when a tool becomes non-functional or is associated with adverse events then consideration of a new tool should be offered.

These are just some of the strategies anyone can use to assist in long term, durable reduction of their total body fat and subsequent total body weight. Individualized modifications are important to maintaining success and avoiding weight loss plateaus that seem to afflict many of us when trying to lose weight. Remembering to keep weight loss goals realistic and utilizing appropriate supervision and maintenance is instrumental in long term success.

If you are interested in starting an individualized supervised weight loss program then please call 501-781-0772 in the Hot Springs, AR area for more info or to schedule a consultation. For more information on our approach to supervised medical weight loss clink the appropriate button below.

Virtue RF Micro-Needling

rsg63@me.com (Russell Gornichec) — Mon, 11 Jul 2022 16:37:38 GMT

RF Micro-needling:Newest non-surgical modality for skin tightening

The Pros and Cons of

Radio Frequency (RF) Micro-needling Treatments

Most people are bothered by signs of aging, like wrinkles and sagging skin. Even small issues can prevent you from feeling confident about your appearance. Radiofrequency (RF) micro-needling treatment is a fast and noninvasive way to treat these issues without going under the knife.

So, what is micro-needling, and how does radiofrequency energy complement micro-needling to change your complexion? Our trained provider reviews the pros and cons of RF micro-needling treatment below.

What is micro-needling?

Micro-needling is a treatment modality that uses a device containing medical-grade needles. These needles exfoliate dead skin layers and create tiny skin channels that prompt your body’s natural healing response. Additional application of healing nutrients can be applied to the treated skin to accelerate this process (for example, using your own blood products this is sometimes referred to as a “Vampire” facial). This process can provide an increase in collagen and elastin deposition. The overall effect can lead to a smoother complexion and healthier skin with decreased laxity and wrinkles.

Radiofrequency treatment explained

Loose or sagging skin is a common problem that stems from genetics, age, and sun damage. Radiofrequency devices can induce energy gently into the outer layer of your skin, leaving the surrounding tissue undamaged. The energy causes tissue damage underneath the outer skin layer which can result in new collagen production. After the treatment and for several weeks after a procedure, this increase in collagen production can lead to tighter skin with less wrinkles. Radiofrequency devices come in all shapes and sizes (even some home units are available). Some are technician directed, some are hands free. Most are painless and effective to some degree. A few years ago, the combination of micro-needling and RF therapy were combined with better immediate and longer lasting results.

Advantages of RF micro-needling

This modality offers a wide variety of treatment options.

While loose skin is the most popular intervention (think non-surgical face lifts), treatments can address concerns like textured skin due to acne scars, stretch marks and hyperpigmentation.

Since most RF Micro-needling machines can be used on all skin types the provider or technician can customize and address your specific concerns and needs.

RF micro-needling can also be used in any area of the body, so face and neck skin laxity are not the only areas that can be treated.

While it is true that certain RF machines can be painful, the newest modalities and versatility of the latest generations in RF micro-needling technology can be tolerated without the need for sedation or invasive anesthesia greatly reducing the cost of treatment. Topical anesthesia application is usually the only requirement for a comfortable treatment session with the newer generation of RF micro-needling machines.

Disadvantages of RF micro-needling

Down-time: This includes some temporary redness, possible bruising or needle marks (typically lasting 24-72 hours) but utilization of medicated mask applications post treatment can significantly reduce this issue. Prior adverse events to RF or micro-needling should be a warning to avoid this combined modality.

Treatment discomfort: Use of topical anesthetic and utilizing a machine with adjustable frequencies, energy levels and needle depth can make this a “pain free procedure.” It is important to realize that decreasing energy and using a higher frequency will be more tolerable but may reduce some of the immediate and long-term benefits. Residual discomfort (after the procedure) typically lasts about 2-8 hours and is best treated with mild opioids, NSAID’s or Tylenol products. Again, medicated mask therapy post treatment will significantly reduce this issue.

Realistic expectations: Individuals looking for an immediate “facelift” effect will be disappointed. This less invasive approach is safer, less expensive, with significantly less downtime, and this treatment does produce noticeable results, although they may not be as dramatic as plastic surgery.

Cost: RF Micro-needling ranges from $250-$2000 per session depending on the size and region of the skin being treated. The recommendation is to schedule sessions about 4 weeks apart and count on 2-3 sessions for best results. Typical face treatments range from $500-$900 per session and savings can be acquired by packaging together different regions to be performed at the same time (i.e., Face and Neck; Face, Neck, and Decolletage).

Summary:

If you have loose skin, poor skin texture, and fine lines, it’s time to do something about these concerns. Combining micro-needling and radiofrequency energy is one of the best ways to treat signs of aging and feel more confident. Learn about RF micro-needling side effects and more by scheduling a free consultation appointment at Laser Solutions Medical Spa and Weight Loss in Hot Springs, Arkansas. 501-781-0772. Visit our website for more information: www.LaserSolutionsMedSpa.com

Differences in Various Skin Resurfacing (Facials) Therapies

Thu, 05 Dec 2019 23:34:45 GMT

Considering getting a facial or wondering what other options are available? Read this Blog to get more information on the various techniques and what they do best.

Chemical facial, micro-needling or Laser resurfacing: When it comes to treating facial blemishes which therapies are best?

What options are currently available for skin resurfacing? A simple google search regarding facials and skin resurfacing will list countless products and therapies currently available that promise younger, healthier appearing skin.

For the last several decades men and women have been pursuing flawless skin. Recent advancements in technology and techniques have created some confusion on how to achieve the best skin re-surfacing for the money. How do the various techniques work to provide a younger healthier appearance and are the newer non-invasive anti-aging modalities better and are they safe?

Below I compare the most common facial (chemical peel) with the newest and hottest skin resurfacing modalities currently now available (Laser skin resurfacing and micro-needling). Understanding the benefits and limitations can assist individuals in deciding on which therapy if any is the best option for their search for younger and healthier appearing skin.

Chemical peels (cost range $150-$1500, frequency recommendations 4-6 weeks)

This type of facial, utilizing different types of acidic materials and has been around for over 100 years. During the peel process, the chemicals cause a reaction with the skin and dissolve the outer layers of dead skin to help even the skin tone and texture and promote the building of collagen. The more concentrated acidic materials break down more skin layers and promote more collagen growth depending on concentrations and length of time utilized.

Home peel kits can be effective for removing dead skin layers and treating uneven skin tone but since the strength of the acidic material is minimal, it is like using an exfoliant or facial scrub. This treatment is not considered painful and without any significant downtime.

Superficial Peels are the most common peel (utilized at most spas) which are quick and mild leaving the recipient with some redness lasting about 20-30 minutes. Superficial skin layers then dry and flake off over the next few days leaving less visible fine lines, large pores and some removal of light pigmentations.

Medium Peels are not commonly painful and use a higher concentration of acid that isn’t neutralized. These concentrations of 35 percent or less are usually available only at dermatologists or plastic surgical offices. At medium depth we can start to see additional treatment of sunspots, mild ACNE scars, and improved skin tightening. The trade-off is down time which averages 5-7 days of raw appearing skin that needs constant topical salve coverage. This can be labor intensive, and most individuals will not venture out into public until resolution.

Deep Chemical Peels also uses trichloroacetic acid, though at concentrations starting at 50% to 70% or phenol acid. At this depth we start to address more serious skin issues such as severe acne scars, excessive sun damage or looseness of the skin. At these concentrations we might begin to lighten natural skin tones so darker skinned individuals should use caution as the results may not be uniform. Considered painful by many individuals often requiring some anesthetic utilization and significant downtime.

Micro-needling (Cost range $200-$700; Vampire facials range $700-$2000: frequency recommendations every 3 months)

Micro-needling is the process of using a pen like device that rapidly punctures the skin over a small area. The pen is then directed over the entire area to be treated. The procedure is described as mildly uncomfortable by most. The natural healing potential promotes new growth and can improve significant skin issues such as fine to mild lines and wrinkles, large pores, acne scarring, etc. but is not selective to any specific problem. The result is usually a bright, smooth and tighter skin surface.

The process of bathing the damaged area in the patients previously drawn serum (platelet rich plasma-PRP) is called a Vampire facial by most salons. Theoretically this addition will help promote faster recovery and add certain growth and healing agents to the damaged area. This may allow longer duration of improvement from 3-9 months.

Pros of micro-needling include a relatively quick recovery time (about a 1-5 days of a light sunburn appearance) and less potential side effects. It’s also safe to use on all skin types. The cons of micro-needling are it can take numerous sessions to achieve the results desired. The sessions last about 45-60 minutes depending on the experience of your provider and the size of the area in question.

Laser Skin Resurfacing-Facials (Cost range $150-$1000: frequency recommendations every 8-12 weeks)

Both IPL, and Diode laser light energies have been utilized in skin resurfacing (facials) to damage the deeper levels of skin and provide the surface skin rejuvenation. The procedures are quick and usually painless depending on the energy levels, desired effect and filters used. This type of facial is rapidly becoming the more preferred method of facial skin rejuvenation (according to recent reviews comparing the other modalities) due to the quick procedure time, decreased costs and pain free application. Light energy facials are considered more specific to various skin conditions such as micro-vascularization (i.e. rosacea), skin tightening, unwanted pigmentations as well as providing the brighter, smoother, tighter skin of other facial modalities.

The trade-off can be unwanted side-effects like temporary skin darkening, sunburn effect lasting 2-3 days, rare skin burns, bruising, swelling, aggravation of some types of skin conditions like melasma, etc. It is important that the correct skin type energy levels be selected and that a sample area of skin be treated in a less visible location before proceeding with a facial treatment (something I recommend prior to any of the treatment options I’ve discussed so far)

Radiofrequency Skin resurfacing – New modality.

Sometimes called fractional skin resurfacing or Fraxel Lasers. This is a newer non-surgical skin resurfacing treatment that allows more aggressive skin damage using radiofrequency energy (RF) so this modlity can be painful and have a few days downtime like the aggressive micro-needling, deeper dermal abrasions and chemical peels.

RF energy has been used for many things over the last 5-6 decades and has a firm basis is cosmetic care. RF energy can be directed below the superficial skin to the dermal layer to improve collagen production and tighten skin, reduce scarring, and eliminate fat tissue to mention just a few of the effects seen in the aesthetic world.

Summary

As we age our skin loses many of the aspects of youth that can lead to wrinkles, large pores, visible small vessel production, pigmentations, etc. Skin resurfacing can be repeatedly utilized to address minor and sometimes moderate skin blemishes and fine wrinkles. Please don't confuse the above modalities as alternatives for surgical skin tightening procedures. Don't get me wrong, there are good alternatives to surgical skin tightening but that is another blog.

Chemical peels at various depths and costs can give someone a temporary smoother and brighter look but to address more specific concerns I would recommend micro-needling or laser/IPL facials. These techniques create more restructuring to superficial and deeper skin layers and this can result in better collagen formation and longer duration of effects.

Anyone interested in getting skin resurfacing should research any skin treatment modality and if possible, ask for a sample skin area treatment prior to a full session to see if they are an adequate candidate. Many of these options can be used together and this combined approach can lead to better outcomes. The best candidate should comply with pre-procedural and recovery protocols. They need to be free of active infections, or inflammation in the treatment area, avoid sun damage both before and after procedures and ask a lot of questions.

Excessive Sweating

Fri, 16 Aug 2019 18:08:27 GMT

It is important to understand the reasons for excessive sweating before requesting therapies that may be expensive or have significant side effects. Consultation with an experienced provider is key to discussing your options. If you desire free consultation for excessive sweating and would like to discuss therapeutic options then call Laser Solutions Medical Spa in the Hot Springs, AR area at 501-781-0772 to schedule an appointment.

Hyperhidrosis (Excessive Sweating)

I frequently get asked by my patients and clients regarding therapeutic option to address excessive sweating. Because these questions are becoming more common, I decided to write this blog regarding a less common issue called primary hyperhidrosis.

If you experience clammy or wet palms of the hands or feet, frequent excessive sweating episodes in any body region, noticeable sweating that soaks through clothing, irritating and painful skin problems brought on by sweating such as fungal or bacterial infections, if you spend a large amount of time each day dealing with sweating issues; such as changing clothes, wiping, placing napkins or pads under the arms, washing, wearing bulky, or dark clothes, worry more than other people about body odor, and you stop sweating when you're sleeping (for unclear reasons excessive sweating during sleep is not common for people with primary hyperhidrosis) then you may have primary hyperhidrosis. A disease that is estimated to affect 2-3% of the population (approximately 7-8 million Americans) according to the International Hyperhidrosis Association and can lead to social stigma, psychological issues and embarrassment for anyone suffering from this ailment no matter what age.

The good news is that there are treatment options that may help reduce or eliminate this problem.

The first step is diagnosis and usually starts with an examination and possibly some simple blood test to rule out secondary causes (the person sweats too much because of certain medications or underlying health condition, (i.e. obesity, gout, menopause, certain tumors, chemical toxicity, diabetes , or hyperthyroidism (overactive thyroid gland).

On initial evaluation your provider may ask you specific questions or to fill out a short questionnaire to determine the extent and severity of the sweating episodes. Questions like:

Do you carry anything around to deal with episodes of excessive sweating, such as napkins, antiperspirants, towels, or pads?

Does hyperhidrosis affect your behavior or mental state when you are in public?

Has hyperhidrosis had any effect on your employment?

Have you ever lost a friend due to hyperhidrosis?

How often do you change your clothing?

How often do you wash or have a shower/bath?

How often do you think about excessive sweating?

If you meet at least two of the above criteria, chances are you have primary focal hyperhidrosis, and you should make an appointment with a knowledgeable provider with treatment options for people with hyperhidrosis.

Common testing may be performed: several tests are available to pinpoint the areas of sweating and estimate the severity of your condition, including an iodine-starch test, skin conductance and a thermoregulatory sweat test.

Identifying a cause:

Sweating is a natural response to warm weather, intense physical activity, stress, and feelings of fear or anger. With hyperhidrosis, you sweat more than usual without a reason. The underlying cause depends on which type of hyperhidrosis you have.

There are two types of hyperhidrosis.

Primary focal hyperhidrosis

Sweating mainly occurs on your feet, hands, face, head, and underarms. It usually starts in childhood or adolescence and can be associated with a family history in some cases. Not usually seen while sleeping.

Secondary generalized hyperhidrosis

Secondary generalized hyperhidrosis is sweating caused by medication or health issue. Secondary hyperhidrosis generally starts in adulthood. With this type, you might sweat all over your body, or in just one area. You might also sweat while you’re sleeping.

Link to medications and health issues that can cause secondary hyperhidrosis

https://www.sweathelp.org/pdf/drugs_2009.pdf

https://www.sweathelp.org/pdf/Diseases_2009.pdf

Whether you have primary or secondary hyperhidrosis can be determined by asking yourself a few questions as outlined by and published in the Journal of the American Academy of Dermatology, (2004, Vol. 51, P. 274-86). This link has a great deal of helpful information.

Once primary hyperhidrosis is diagnosed, and you desire seek treatment then options should be discussed and understood before proceeding.

Treatments Options

Any discussion regarding treatment options should include some natural remedies. These include

• alterations in lifestyle and activities to improve symptoms, behavior therapies by trained professionals

• clothing choices (Loose clothing is better).

o Shoe wear - synthetic materials are more likely to worsen symptoms.

o Natural materials, such as leather, are recommended. Synthetic material like nylon may worsen symptoms

o Socks - some socks are better at absorbing moisture, such as thick, soft ones made of natural fibers like cotton.

• Use of Antiperspirants - deodorants do not stop sweating, but antiperspirants do. Non-prescription formulas containing aluminum are recommended and if ineffective prescription antiperspirants can be employed (more below).

• Armpit shields - pads worn in the armpit to protect a garment from perspiration.

If these measures are not effective, medical treatment may help.

The usual approach to treating excessive sweating generally proceeds as follows:

• Antiperspirants

Over-the-counter antiperspirants containing a low dose of metal salt (usually aluminum) are usually tried first because they are widely available. Antiperspirants containing aluminum chloride may be more effective when other antiperspirants have failed.

Aluminum Chloride Hexahydrate and Excessive Sweating

When regular antiperspirants fail to treat excessive sweating, many providers start by recommending aluminum chloride hexahydrate (Drysol), a prescription-strength version of aluminum chloride. It is applied before bedtime 2 to 3 nights in a row, then roughly once a week thereafter to maintain improvement. This treatment works reasonably well for many patients whose problem is excessive underarm sweating, but it is less desirable for most of those with palm and sole sweating.

The main side effect of Drysol is irritation, usually remedied by decreasing the frequency of use, allowing to completely dry or applying steroid cream to the area in question.

• Iontophoresis : a device which passes ionized tap water through the skin using direct electricity.

Iontophoresis was introduced over 5 decades ago and its mechanism is still unclear. Some think that it blocks the sweat glands temporarily. The process uses water and electric current over the skin a few times each week. This usually takes 10-20 minutes daily followed by a maintenance treatment every 1-3 weeks depending on each person’s results.

The devices are sold commercially with prescription for $250-$300.

• Oral Medications : Certain medications can reduce sweating.

Anticholinergics. Some oral medications block the chemicals that permit certain nerves to communicate with each other. This can reduce sweating in some people. Possible side effects include dry mouth, blurred vision and bladder problems. Oral anticholinergic drugs such as glycopyrrolate (Robinul) are not commonly used for excessive sweating, because in order to work they often produce side effects like dry mouth, blurred vison, and urinary retention. Oral medication is typically reserved for people who have tried first-line treatments without success.

Antidepressants. Some medications used for mood disorders can also decrease sweating. In addition, they may help decrease the anxiety that worsens the hyperhidrosis.

• Botox (neuromodulators) and Excessive Sweating

Botulinum toxin A (Botox), and other neuromodulators (Xeomin, Dyspot) are nerve toxins that can temporarily paralyze muscle and are often used as a cosmetic treatment for fine lines and wrinkles. They can also be utilized in many areas of medicine, such as in the treatment of certain muscle spasms and migraine headaches. Their latest medical intervention is the treatment of excessive sweating and have received FDA approval recently for hyperhidrosis in certain body regions.

A small amount of toxin is injected with a very fine needle into roughly 25 to 20 spots in each underarm. This may produce 6-12 months of complete relief from sweating. This is usually painless and does not require local anesthetic although topical pain-relieving ointment is sometimes requested and used.

Currently, the FDA has not approved Botox for sweating of the palms and soles of the feet, though some physicians are administering it as an off-label use, reportedly with success. Palm injections cause more pain, requiring more aggressive means to numb the hands in order to make the injections comfortable. Skilled practitioners have also used Botox for the head and face, as well.

• Microwave therapies : Mira Dry@ is a treatment which uses microwave energy to permanently kill sweat glands. It was FDA approved in 2011 for the treatment of excessive underarm sweating. It is a noninvasive treatment using electromagnetic energy that targets heat on sweat glands, destroying them. Local anesthesia is used, and the skin is cooled during this hour-long procedure. It can be repeated 2-3 times for optimal effect.

Possible side effects are a change in skin sensation and some discomfort. This therapy may be expensive and not widely available.

• Lasers : Lasers can target and kill the underarm sweat glands.

Lasers can focus heat a narrow beam of heat to destroy underarm sweat glands and can be done faster with a faster recovery.

• Surgery (may be considered after primary treatment failure)

Thoracic sympathectomy

This is a type of nerve surgery (sympathectomy). During this procedure, the surgeon cuts, burns or clamps the spinal nerves that control sweating in your hands. In some cases, this procedure triggers excessive sweating in other areas of your body (compensatory sweating).

Surgery is generally not an option for isolated head and neck sweating

Sweat gland removal .

If excessive sweating occurs just in your armpits, removing the sweat glands there may help. A minimally invasive technique called suction curettage may be an option as well if you aren't responding to other treatments.

It is important to understand the reasons for excessive sweating before requesting therapies that may be expensive or have significant side effects. Consultation with an experienced provider is key to discussing your options. If you desire free consultation for excessive sweating and would like to discuss therapeutic options then call Laser Solutions Medical Spa in the Hot Springs, AR area at 501-781-0772 to schedule an appointment. Even if we do not offer the best treatment offer for you at our locations, we may be able to direct you to the right specialist to discuss other alternatives to consider. The bottom line is there are more therapeutic interventions that were not available a decade ago that may help to alleviate or even eliminate this issue in your life.

Comparisons of common hair removal Techniques

rsg63@me.com (Russell Gornichec) — Mon, 01 Jul 2019 19:28:29 GMT

Options and Comparisons of Various Hair Removal Techniques

Types of hair removal (not all-inclusive list)

Shaving : (cheap, easy, quick, duration 1-3 days)

Cutting the hair shaft at skin level with a sharp razor. The easiest method we rely on, and one of the cheapest, is also one that can leave our skin bumpy, stubbly and even bloody. When hair is cut at an angle it may tend to grow inward and cause “ingrown hairs” especially if curly in nature. This may cause inflamed and bumpy skin (infection) that may not resolve until hair is removed.

Depilatory creams : (more expensive than shaving, easy, quick, 1-2 weeks duration) This technique uses chemicals that dissolve the hair shaft to skin level or a little below. Less likely to get ingrown hairs.

Just make sure to read labels and follow instructions very carefully, and to test the cream on a small patch of skin on your arm or leg to check if you’re allergic and before trying it on more sensitive areas. Depilatory creams dissolve hair in minutes, but they tend to smell like wet dog mixed with gasoline.

Waxing : ($, painful, duration is like depilatory creams) Waxing involves applying hot or cold wax to an area and removing the wax, together with the body hair, with a strip of cloth. This breaks the hair shaft at skin level or below. You can do it on your legs, underarms, bikini area, eyebrows, and upper lip – but it’s best left to the professionals. If you’re a seasoned “waxer” and know what to expect in terms of pain and aftercare, ready-to-use wax strips can be locally purchased and utilized as DIY.

Sugaring : ($, can be DIY, similar duration to waxing) Sugaring is like waxing, but the method uses sugar mixed with a paste or gel instead of wax. It’s a traditional hair-removal method popular in the Middle East. Recommend having it professionally done if it’s your first time to try it out. Reportedly less painful.

Threading: (cheap, quick, painful, longer duration than shaving) Threading involves twisting a piece of thread together (hence, the name) to trap hair in the area where the thread intersects. By doing this, each hair is pulled out from the root, like tweezing or waxing. Small areas of the body are best for threading, like your eyebrows or upper lip. Results like waxing but for areas sensitive to waxing or creams. Threading is best done by a professional, especially if you’re getting it done on your eyebrows for quality shaping. Usually a cooling gel is applied afterwards to reduce redness and swelling.

Tweezing : (cheap, easy, quick, painful, similar duration to waxing) Plucking hair with tweezers causes hair shaft breakage and is usually used in fine sensitive areas, DIY or professionally performed. Because tweezing involves removing hair one by one, this won’t work so well on large areas. Tweezing would be best for removing strays post-shave or wax. Attempt to tweeze in the direction of the hair growth.

Epilation : (special equipment, painful, similar duration to waxing) Epilation is like high-tech tweezing. An epilator has a series of small tweezer heads on a spinning wheel and plucks out your hair from the root as you roll it over your skin. If this sounds painful its because it usually is.

Eflornithine hydrochloride cream (Vaniqa) : ($$, possible side effect, long duration hair follicle growth deterent) Not an exfoliant that dissolves the hair shaft but reduces hair growth by enzymatic blockage. Women who feel they have been plagued by little chin hairs or thick facial hair can now benefit from this effective, but costly, prescription product. After approximately two months of twice daily use, the cream slows down hair growth.

Electrolysis : ($$, time consuming, less painful, permanent hair follicle eradication) Usually performed by a professional who places a tiny needle with an electric current in the hair follicle. There are two primary hair removal methods with electrolysis: galvanic and thermolytic.

-Galvanic hair removal chemically destroys the hair follicle.

-Thermolytic removal uses heat to destroy the follicle.

In either case be sure to find a professional who is highly trained and knowledgeable. You can get electrolysis on any part of the body. Electrolysis is a permanent way to remove hair. That said it is possible to see hair growth in a region previously treated. The secondary growth you see will not be the same hair that has been treated. It takes anywhere from three to ten weeks for some hair to grow, and a percentage of hairs in a given area can lay dormant under the skin.

Important Note: Permanent hair removal applies to follicle damage of active growth hair unit. Because hair can be in one of four growth stages only about 25-30% of any given hair shaft seen at skin surface is amenable to follicular damage. After spending the time and energy of electrolysis on a given area it is sometimes frustrating to find hair growth returning weeks or months later. These represent hair shaft/follicles that were not seen or were missed by prior treatments.

Between starting to grow and falling out years later, each hair passes through four stages: anagen, catagen, telogen and exogen. Every hair can be at a different stage of the growth cycle at any given time.

Anagen (Growing Phase): The growing phase lasts 2-7 years and determines the length of our hair. Only phase amenable to hair follicle eradication.

Follicles in the stages below are not believed to be amenable to eradication with any techniques

Catagen (Transition Phase): This is the transitional stage that lasts about 10 days. The hair follicle shrinks and detaches from the dermal papilla.

Telogen (Resting Phase): This is the resting phase which lasts around three months. Around 10-15 percent of hairs are in this phase. While the old hair is resting, a new hair begins the growth phase.

Exogen (New Hair Phase): This is part of the resting phase where the old hair sheds and a new hair continues to grow. Approximately 50 to 150 hairs can fall out daily, this is normal hair shedding.

Laser Hair-removal : ($$$, certain types are painless , long term hair growth eradication) Laser/IPL hair-removal destroys the hair follicle using light energy. Heat from the laser/IPL source is absorbed by the hair’s dark pigment, this energy then kills the follicle cells permanently and this technique can be used on any part of the body.

This is best used for anyone who’s sick of the maintenance, time or pain tolerance the hair-removal methods above require. It’s not cheap, nor is it quick. Due to the growth phases discussed above only a certain percentage of the hair complexes are amenable to destruction at a given time, so several sessions over 3-6 months are recommended for better results.

This hair removal option damages the hair follicle to minimize future hair growth. The light energy heats the pigment (melanin) in the hair follicle and this thermal energy can damage the follicle to the point of eradication. The pigment is also present in the hair shaft. This means that if a hair shaft is present (not shaven prior to treatment) then this hair shaft can heat up at time of treatment and this can cause skin irritation or burning. This means that pre-treatment shaving is important.

- Pain free Procedure : This mechanism is dependent on the energy setting and light pulse duration (IPL) so pre-testing is a must. If the energy setting is too low, then the energy only damages the follicle but does not eradicate. Energy setting too high will cause pain and skin damage to surface skin in the form of a burn than can blister. The “snapping” pain associated with older laser techniques and devices using the wrong wave lengths for the determined skin type is no longer a common issue. Even darker skin can now undergo this therapy, but specific filters for darker skin and lower energy levels are used. Several product manufacturers (Viora IPL device) now have light filters and settings for the darker skin seen in middle eastern and African American skin types (Fitzpatrick score type VI). In addition, most devices have a cooling mechanism built into the hand piece itself to minimize thermal sensation and damage to surface skin and make the procedure comfortably pain free .

- Quicker Sessions : Laser/IPL devices today usually have larger lenses so then can cover a larger area for quicker sessions. Even a larger area can be performed in less than 20 minutes time.

What are the cons?

- It’s a longer process . A session of laser hair removal on the underarms can take less than a minute, but it takes multiple sessions to see real results (anywhere between three and eight depending on the size of the area, hair type and thickness), and you generally have to wait 4-6 weeks between treatments to allow the other follicles to enter amenable growth stage.

- It can be expensive . Some centers charge $200-$400 pers session. Other clinics will have package options for all 6 sessions up front to reduce the treatments total cost dramatically. Shopping around is key to finding the best deal and the best device for your needs. If you add up how much you spend on razors or bikini wax sessions in your lifetime, it might be worth the price tag. You can think of laser hair removal as a beauty investment.

- Not effective in non-pigmented hair : Blonde hair is amenable to this mechanism but requires a higher energy level and possibly more treatment sessions. However, this therapy is not effective in hair that is not pigmented. If your hair is white or grey than don’t expect this technique to provide effective results despite the energy level used. If your considering laser/IPL hair removal, then start this process before your hair begins to turn grey. (Using dye for your hair color does not change the fact that the follicle itself does not have pigment, remember that hair dye is only at the skin level and the energy utilized needs pigment inside the follicle which is below the skin surface).

- Skin protection or preparation may be required : Skin pigment will redirect the energy from the hair follicle towards the skin surface so beauty marks, tattoos, and permanent make up should be covered thoroughly or can be subject to significant fading by this process. This also applies to skin tanning (using UV light), spray tans and topical make up (which requires removal prior to session).

- Possible Hair regrowth : Like electrolysis hair follicles in a specific region that were dormant during the session can re-initiate growth 6 months - 2 years later. Sometimes the energy levels used with Laser/IPL techniques were insufficient to damage the follicle completely. This can lead to frustration if someone was told that these techniques guaranteed permanent hair loss. Most clinics will suggest maintenance sessions in 6-12 months as needed to address any stubborn residual hair growth.

Remember hair removal is a choice and the type of intervention you decide on should be carefully thought out and planned. When using more expensive or topical techniques it is suggested to undergo a test area to check for skin reactions. Beware the clinic or clinician that signs you up for something without proper discussion or skin testing.

Interested individuals can schedule a free consultation and skin test by calling Laser Solutions Medical Spa in Hot Springs, AR at 501-781-0772 or use Contact button below to send request for more info.

Treating Pigmented Lesions

Fri, 21 Jun 2019 15:58:39 GMT

Addressing unwanted pigmented or vascular lesions from skin surfaces

Vascular and Pigmented Lesions

Freckles, birth marks, moles. Almost everybody has some form of hyperpigmentation. Caused by an excess of melanin (the stuff that produces your natural skin color),

Dyspigmentation is simply areas of skin that are darker or lighter in color than the rest of your skin. What’s the difference between a freckle and an age spot? We outline the cause behind each. Hint: sun exposure is a big factor. So slather on your SPF and read on.

Freckles

Freckles are usually inherited and are more prevalent in people with fair skin. They also tend to become darker when exposed to the sun. They are those pale brown spots most commonly found on the face, arms, shoulders, and upper back. And while genetics play a big part in whether you have freckles, if you notice them becoming darker and more prevalent, that’s a sign you’re getting too much sun.

Moles and Birthmarks

Moles, like freckles, are very common. The average person can have between three and 60 moles on their body. They are darker, bigger than freckles and are often raised from the skin. Although most moles are with you for life, some can fade over time. Moles can be present at birth (birthmarks) and can also form due to sun exposure. It’s not necessarily a bad sign for moles to change in size or color, so don’t panic, but if a mole changes in appearance quickly, a visit to your doctor is a good idea.

Age/Liver Spots

Age spots are mainly small, flat patches of skin found on the hands and face. They often start off faint and get darker over time. The sole cause of age spots is sun exposure. Melanin absorbs the sun’s UV rays in order to protect the skin which produces dark spots. Want to avoid them? Wear SPF.

Melasma Spots

Melasma spots are a form of hyperpigmentation caused by hormonal changes, especially in women, often during pregnancy or taking birth control pills. Hormonal changes can trigger overproduction of melanin in the body, leading to large areas of darkened skin. Melasma is made worse with sun exposure.

Other Causes for Dark Spots

Acne scars can lead to hyperpigmented areas on your face. It is best to avoid picking at your pimples in order for your skin to heal properly. Also make sure you apply sunscreen or avoid the sun while blemishes are healing. Skin injuries and surgeries can also leave dark spots on the skin.

Seeing a trend? Of course, there is nothing wrong with having beauty marks—and many, like Marilyn Monroe’s, can be beautiful—but some are signs of sun damage. It is recommended to wear sun protection 24/7/365. Not just in the sunny summer months.

Vascular lesions (rosacea), (telangiectasias), superficial small vessels at skin surfaces and pigmentations (solar lentigo, freckles, "liver spots", “age” spots of the face, hands and body can be reduced or removed with Laser technology with a quick painless process that can leaving you looking the way you want with worrying about those skin imperfection.

Some examples below of utilizing laser IPL energy to remove unwanted hyperpigmentatios.

Using IPL "laser" technologies, light energy can be utilized to damage pigment creating cells to reduce or eliminate skin pigmentations. The light energy targets the hemoglobin in blood vessels to eradicate vascular lesions or the melanin in skin cells to eliminate the pigmented lesions. The depth can be modulated with filters and the energy used adjusted to create a pain free treatment that can show results in a short period of time. Sometimes the effects are seen with a single treatment while other lesions may respond better to multiple therapy sessions.

Regional Body Fat Reduction

Wed, 19 Jun 2019 17:51:42 GMT

Body Sculpting

BODY SCULPTING refers to the directed reduction of fat accumulation in a specific body region targeted by various modalities. This differs from total body fat reduction (weight loss) that refers to the entire body reduction of excess fatty tissue through catabolism.

Sometimes when a person combines calorie reduction, protein supplementation and with appropriate levels of increased exercise the body will reduce excess stores of body fat. Often the reduction is seen in specific regions prioritized by genetics, body shape and a multitude of other sometimes uncontrolled variables. These locations may leave certain areas of the body resistant to fat reduction. We sometimes call these “problem areas” or weight loss resistant regions. The result in total body fat through surgical or non-surgical means may leave an individual frustrated about these regions that persist in retaining excess body fat.

Body sculpting is one way to address these areas independently and the best results are seen when combined total body fat reduction and body sculpting are used together.

Body sculpting options (Not an all-inclusive list) and some commercial examples.

• Invasive

-Liposuction $$$

• Noninvasive

-Combined Ultrasound Radiotherapthy -RF (Ultherapy $$)

-Hydrolipoclasy (Kybella injections $$)( Mesotherapy injections $)

-Radiofrequncy-RF (V-Form $, Thermage $)

-Cryolipolysis (Coolscultping $)

-Laser Fat Reduction (Sculpsure $$)

Each technique has its advantages and disadvantages and the costs are significantly different. Some techniques take longer for results and involve more than one treatment visit. Pain, discomfort and downtime are other aspects to consider when deciding the best option.

By now, you may already have an idea on how an RF treatment works with regards to aging problems common to both men and women. But how exactly does anyone benefit from RF body sculpting techniques and how does it compare to other forms of treatment options?

I will also briefly compare the Radiotherapy (V-Form) vs Cryolipolysis (cool sculpting) modalities.

Benefits of Radiofrequency (V-Form) Body sculpting Treatment

1. Diminishes or Removes Cellulite (also seen in liposuction, Ultherapy)

Given how women’s skin vary from men, part of their uniqueness to men is the affliction of cellulite being gender-selective to them. Cellulite is a skin issue commonly found around the buttocks and at the back of the thighs where people generally store body fat.

RF treatment, however, can address the skin problems caused by cellulite. Cellulite occurs when excessive fat stores in a certain region cause contraction of fibrous bands and this can result in skin dimpling usually associated with cellulite. Reduction of fat stores, disruption of fibrous bands, tightening of dermal skin can all help to reduce the excessive fat deposits as the cause of cellulite.

2. Regional Directed Reduction of Body Fat (seen in all modalities)

Looking at the anatomical level, both cellulites and general obesity have one thing in common – the problem lies with the excessive fatty tissues beneath the skin’s superficial and lower layers.

Luckily, the RF treatment can address the issue of excessive body fats among us regardless of age. The resulting heat energy of the RF treatment causes destruction of a percentage of the underlying fat cells (adipocytes) and the disrupted excess fatty tissue is then removed by the body’s lymphatic system.

3. Tightening of the Skin (also seen in Ultherapy)

Partly what makes skin wrinkles so obvious sometimes are the clear lines that are creased over an elderly person’s skin often as a natural result of the aging process throughout the years.

Others whose skin problems are not limited to wrinkles simply have excessively lumpy and stretched skin, possibly as a result of a sudden decrease in weight.

By applying the RF treatment, deep-seated soft tissues of the dermis are stimulated which facilitates healing through the production of new collagen tissues that are reactive towards the RF waves. This increase in collagen can result in decreasing laxity and resulting in overall skin tightening.

This therapy (performed simultaneously with fat reduction and cellulite intervention) can be utilized to address the loose skin sometimes manifested with weight loss as well as other causes of loose skin (aging, sun damage, etc.).

4. Post-operative Liposuction Smoothing

Not all who go through the process of liposuction have a 100% smooth finish to the affected area. Some individuals end up with noticeable lumps and bumps on the area where body fats were surgically removed, often a not-so-pretty sight in comparison to well-toned and proportional skin tissues and muscles.

Although there are existing measures that address this issue among post-operative liposuction patients, RF treatment can also be employed as a non-surgical treatment for the issue of bulging and sagging skin sometimes occurring after liposuction.

5. Can safely be used in the face and neck regions difficult for Coolsculpting and liposuction techniques.

Comparison of Radiofrequency vs Cryolipolysis techniques

Radiotherapy (V-Form) vs Cryolipolysis (CoolSculpting)

You have choices when it comes to non-invasive procedures for reducing fat, tightening skin and treating cellulite.

What is CoolSculpting (cryolipolysis)?

Cryolipolysis is a method to remove fat by freezing. This FDA approved method released in 2010 involves controlled application of cooling within the temperature range of -11 to +5 °C for the localized reduction of fat deposits. The degree of exposure to cooling causes cell death of subcutaneous fat tissue, while avoiding damage to the overlying skin. The premise is that underlying fat tissue is more easily damaged by cooling temperatures than skin cells by applying cooling applicator to skin surface of bulging body fat region. To avoid frostbite skin damage a set time period of cooling and a specific temperature range are predetermined. The resulting reduction in tissue temperature above freezing results in cell death, followed by a localized inflammatory reaction and reduction of fatty tissue in the area of application.

Adverse effects include transient local redness, bruising, pain and numbness of the skin. These are common side effects of the treatment and are expected to subside. Typically sensory deficits will subside within 3-4 weeks. A less common side effect with more severity is something called paradoxical (abnormal) adipose (fat) hyperplasia (unusual increase in a structure), or PAH for short. Instead of the fatty tissue gradually shrinking, the tissue bulge after cryolipolysis actually gets bigger and usually becomes firmer than surrounding tissues, sometimes having a “stick of butter” appearance that resembles the shape of the cryolipolysis applicator. This tissue damage is thought to be more common then originally thought and may require surgical removal to correct unsightly deformities.

Typical cost per treatment area varies depending on location. Price in the US ranges from $650 to $1,500, per area to be treated. Treatment time for general use/application is 35–60 minutes per site, depending on the applicator used. In the U.S., the cryolipolysis procedure is FDA-cleared for the treatment of visible fat bulges in the thigh, abdomen and flank, along with bra fat, back fat, underneath the buttocks, and upper arm. It is also FDA-cleared for submental area treatments.

Cryolypolisis Cons:

With both modalities the fat reduction is a gradual process, so you won’t notice a difference immediately. If you want to achieve a slimmer look for summer or specific event, you’ll need to schedule your treatment in advance. Some patients report that the cryolipolysis procedure is painful and you may need to take a pain reliever after the procedure. Cryolipolysis works exclusively on fat cells. It doesn’t have the capacity to tighten skin.

How is Viora V-Form different from CoolSculpting?

Radiotherapy has been available for medical use for the last 80 years. The utilization of this modality for body sculpting has been undergoing an evolution for the last 2 decades. Several years ago Viora developed the combination of vacuum utilization and RF therapy to improve the ability of this modality to address regional body fat tissues in a safe, pain free method.

Viora V-Form vacuum-radiotherapy is a painless treatment, cleared by the FDA for body fat reduction, which uses a combination of radio frequency (RF) waves and vacuum therapy to reduce fat and tighten skin. The treatment consists of targeting fat cells initially and then redirecting the frequencies to target the dermis at 2 distinct depths to address skin tightening and collagen formation. The simultaneous reduction of fat cells and dermal tightening is believed to be the mechanism for cellulite reduction.

Your Viora V-Form practitioner applies glycerin oil and then uses a handpiece that emits RF waves combined with vacuum therapy to treat the target area. Each treatment lasts 15 to 45 minutes, and you’ll need between 6-8 treatments for optimal results. Viora V-Form requires more visits to your practitioner than cryolipolysis, but each session is painless and shorter than a Coolsculpting session.

Viora V-Form Advantages over Coolscuplting Fat Freezing:

Treats the face, neck and body, including the nasolabial folds, chin and “jowls”

Tightens skin on the arms, back, abdomen and other areas. Coolsculpting doesn’t have skin tightening capabilities.

Is a quick, painless procedure. Each session is shorter than Coolsculpting procedure but a patient may need more sessions. Most patients can return to normal activity immediately.

The Viora V-Form practitioner can tailor the treatment to every patient’s needs by using one of four RF frequencies. This includes Viora’s fourth, multi-frequency mode, powered by CORE technology. What this means is that if a patient needs more fat reduction in a certain area the therapy can be tailored to compensate vs. someone with recent weight loss and redundant skin who would need more skin tightening than fat cell reduction.

Disadvantages are rare but due to the thermal properties of this technique issues like skin burns/blisters and other thermal injuries can occur.

Whichever therapy is chosen it is recommended to have a skin region tested prior to treatment protocol initiation to decrease the risk of injury and to prepare expectations

I cannot stress enough that body sculpting is a cosmetic technique and does not replace the health benefits of medical (total) weight reduction. I advise all my clients/patients that body sculpting is a good tool but should be used in coordination with a medical weight loss program to optimize results, reduce the potential of body fat return and improve overall health parameters.

All of the non-invasive body sculpting techniques are improved by good hydration. Patients will optimize their own results regardless of the modality by making sure that their cells are well hydrated at the time of the procedure. This means drinking plenty of water on a daily basis to make sure the fat cells are more amenable to energy reception and disruption.