Frequently Asked Questions

To reduce the likelihood of bleeding or bruising, discontinue the use of blood thinning products for 10 days prior to treatment, as approved by your primary care provider. This list includes:

• Aspirin, Ibuprofen (Motrin or Advil), Naproxen, Aleve
• Fish oil, St. John's Wort, Flax Seed, Vitamin E, Vitamin D, Garlic, Ginkgo Biloba, Cumin, Ginseng, Echinacea, Glucosamine
• Alcoholic beverages or excessive caffeine

You can consider taking Arnica Montana, a natural supplement to help prevent bruising (take 5 tablets three times per day starting one week prior to treatment).

• Avoid massaging the treated area.
• Avoid tanning, excessive sun, or heat for 24 hours (no sauna, no hot tub).
• Avoid strenuous exercise & excessive sweating for 24 hours.
• Avoid consuming excess amount of alcohol or salts to avoid excessive swelling.
• Do not lie down or bend over for 4 hours following injection. You may squat instead of
  bending over.
• Avoid facials, massages, exfoliating the area for one day post-procedure.
• Wait 24 hours before wearing hats or headbands.
• Use Tylenol (Acetaminophen) for headache or discomfort. Avoid NSAIDs (Ibuprofen,
  Aspirin) for 24 hours as they can increase bleeding.

Follow-up in 2 weeks for reevaluation, if needed

• Schedule your appointment at a time when possible swelling or bruising will not disrupt your social obligations.
• To reduce the likelihood of bleeding or bruising, discontinue use of blood thinning products for 10 days prior to treatment, if approved by your primary care provider. This list includes:
  - Aspirin, Ibuprofen (Motrin or Advil), Naproxen, Aleve.
  - Fish oil, St. John's Wort, Flax Seed, Vitamin E, Vitamin D, Garlic, Ginkgo Biloba, Cumin, Ginseng, Echinacea, Glucosamine.
• Avoid alcohol or excessive caffeine consumption 24 hours pre- or post- injectable treatment.
• You can consider taking Arnica Montana natural supplement to help prevent bruising (take 5 tablets three times per day starting one week prior to treatment).
• Please notify your provider if you have a history of cold sores, as we will consider pre-medicating with an antiviral prescription prior to treatment. Cancel your appointment if you have any open sores in the treatment area. It is important that you alert us of any medical conditions you may have and/or any prescribed medications you are taking prior to your treatment.
• Any injection introduces the risk for infection. For this reason, the following is taken into consideration
  when proceeding with injections. We will delay injectables if you:
  • Have had any infection, cold, virus, or flu in the past 30 days.
  • Have had any dental procedures in the past 2 weeks or are anticipating dental procedures or
    cleanings in the next 2 weeks.
  • Have had a surgical procedure in the past 30 days or are anticipating a surgery or procedure.
  • Have had any immunizations in the past 30 days or if you’re anticipating immunizations.
  • Have had any tattooing or permanent makeup within the past 30 days.
  • Take any immunosuppressive/injectable medications (ex: Biologics such as Humira, Skyrizi,
    Stelara, Enbrel, Taltz, Cosentyx, Tremfya).
• Additional contraindications include: Pregnancy, breastfeeding, allergies to components of dermal fillers, open sores in areas to be treated.

• DO NOT APPLY ANYTHING TO THE SKIN UNTIL THE DAY AFTER THE TREATMENT: No skin treatments, or makeup.
• Bruising, swelling, tenderness, numbness, and areas of firm nodules may occur.
• Arnica Gel or supplements may be used to help bruising resolve faster.
• Do not massage, touch, or manipulate the injection site. Avoid heavy exercise the day of your treatment.
• Indirect application of ice packs may be used to the treated area during the first 12 hours. Ice for 15 minutes on every hour.
• To prevent product displacement, avoid sleeping on your side or stomach for 24 hours post-treatment.
• Sleep with head elevated for 2-3 days to decrease swelling.
• If you experience any mild tenderness or discomfort, you may take Acetaminophen/Tylenol.
• Avoid skin laser treatments for 3 weeks after. Discontinue Retin-A for 2 days post treatment.

If you experience any of the following symptoms, contact our office immediately: dusky or white discoloration of injected areas, mottling or unusual bruising, severe or increasing pain, redness, increasing warmth or coolness to touch, severe swelling, itching, blisters, difficulty swallowing or smiling, fever, or chills.

5-5-5 RULE

• Massage the treated area 5 times a day, for 5 minutes for 5 days! Massaging with lotion in a circular fashion helps prevent nodule formation. Massaging may be uncomfortable for the first couple of days, but it is still necessary.

WHAT TO EXPECT POST TREATMENT?

• Expect bruising, swelling and tenderness for 48-72 hours. Bruising may last for 7-14 days.
• Immediately after treatment, your face will appear full and puffy. This is due to swelling and the sterile water injected. This is temporary!
• After a few days, you will return to pre-treatment appearance. Most patients can return to their daily activities immediately after treatment.
• Results may appear 4-6 weeks after treatment and will gradually improve up to 12 months. Results last up to 2-3 years after initial treatment.
• Schedule your next appointment in 2-3 months to determine if additional treatments are needed. Most patients require one to four treatments to achieve the desired results.

POST-TREATMENT INSTRUCTIONS

• MASSAGE, MASSAGE, MASSAGE!!
• Arnica Gel may be used to massage area to help minimize bruising and swelling.
• Indirectly apply cold/ice packs to the treated area for the first 24 hours – 10 minutes on, 10 minutes off.
• Avoid/minimize strenuous exercise and exposure to extensive sun, UV lamps, indoor tanning beds, or extreme temperatures within the first 48 hours after treatment.
• Makeup may be applied 4 hours after treatment.
• Avoid facial lasers and chemical peels for at least 1 week after.

NOTIFY YOUR PROVIDER IF THE FOLLOWING OCCURS: Significant swelling, excessive pain, bleeding, fever, eye pain, vision loss, dusky discoloration, or any signs of a stroke (including sudden difficulty speaking, numbness, or weakness in your face, arms, or legs, face dropping, severe headache or confusion) during or shortly after the procedure.

• Does your vaginal area feel loose after childbirth? 
• Are you experiencing menopausal symptoms? 
• Do you suffer from vaginal dryness?  
• Is sexual intercourse painful? 
• Are you experiencing any urinary leakage when you sneeze, jump, etc.? 
• Do you have cosmetic concerns about your vaginal area? 
• Are you interested in treatment options to improve or support vaginal wellness? 

You are not a suitable candidate for ThermiVA: 

• If you are currently menstruating at the time of your appointment
• You have severe vaginal dryness that is not currently being treated by medications or creams
• If there is significant vaginal prolapse
• If you have severe laxity, particularly if muscles were separated during childbirth
• If you are pregnant or breastfeeding
• If you are seeking treatments to increase vaginal muscle strength. (Emsella is the best treatment choice for increasing vaginal muscle strength)

ThermiVA is a device-driven treatment that uses the same radiofrequency (RF) technology prevalent in aesthetic practices for skin rejuvenation. Radiofrequency (RF) is controlled thermal energy that penetrates to the deepest tissue layers (the dermis) where collagen and elastin are produced, and where veins and nerve endings exist. 

ThermiVA employs a smooth, thin wand that serves as a conduit for RF energy. The wand is gently applied to targeted vulvovaginal tissue, emitting RF energy at controlled temperatures and depths. In these target areas, RF energy triggers new collagen and elastin production and induces tissue contraction. Results include tighter, smoother, firmer tissue and overall improved tissue quality. Radiofrequency also promotes increased blood flow and nerve regeneration, resulting in increased lubrication and sensitivity. 

RF Effects on Tissue 

• Each ThermiVA session lasts about 30 minutes.
• Three monthly sessions are recommended.
• Treatments are painless.
• There is no downtime.
• There are no post-treatment limitations.

The results of PRF are only as good as the quality of your platelets and health. To achieve best results, please consider the following-

• If approved by your PCP, avoid the following medications 1 week before treatment: NSAIDs, Ginko Biloba, Garlic, Vitamin E, Vitamin A, Flax Oil, Curcumin, Primrose Oil, Fish Oil, and excessive caffeine
• If you are taking a any blood thinners, please let your provider know as they may present a contraindication to this treatment
• Avoid the use of systemic corticosteroids for 1-2 weeks before the procedure
• Avoid alcohol and Tabacco for 1 week prior to treatment
• Be sure to hydrate extremely well starting 48 hours before treatment

Expect the entire procedure to take about an hour. 

• Compounded numbing cream is applied to vaginal areas to be injected.
• The patient’s blood is drawn. The vial of blood is placed in a centrifuge for the required speed and time to separate the plasma and platelets from the other blood components.
• The provider will confirm the efficacy of numbing cream with the patient.
• PRP is injected into target areas in the vaginal wall, the vulva and the clitoris.
• The patient can leave immediately following the procedure.
• There are no post procedure limitations and no downtime.

Possible Side Effects: 

• Bleeding
• Swelling
• Discomfort at injection site
• Altered urinary stream from swelling
• Persistent arousal
• Spontaneous orgasm
• Perpetual lubrication

Heightened sensitivity from the O-Shot is generally immediate. As swelling and the injected PRP fluid subside, results wane. Results improve with time as regeneration of new cells, tissue, vasculature occurs. Peak regeneration usually occurs between 3-4 months. For most patients, the effects of the O-Shot last well over a year. 

To boost or keep the regenerative effects of the O-Shot, patients usually follow-up with another O-Shot about a year after the first one. 

Because physical aging speeds up with time, repeating the O-Shot for its regenerative capabilities every 1-2 years is ideal to quell the aging process. 

You may not be a candidate for Emsella if you have or are experiencing any of the following:

• Current Menstruation
• Pregnancy
• Cardiac Pacemakers
• Electronic Implants
• Metal Implants
• Drug Pumps
• Heart Disorders

Many patients feel results after the first session, with increased improvement over time and subsequent sessions.

Patients can schedule more treatments as needed to maintain pelvic floor strength.

Regular Kegel exercises can help extend the results of Emsella treatments.

Emsella may be combined with any vaginal rejuvenation treatment, or the P-Shot for men, to maximize results.

Acorn offers significant discounts with vaginal rejuvenation treatment combinations.

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Sitting fully clothed on the Emsella chair (aka. Kegel throne), many patients feel a buzzing or tapping sensation as electromagnetic energy stimulates involuntary muscle contractions along the pelvic floor. Even though they are stronger than regular Kegels, these muscle contractions are painless.

During each 28-minute passive workout session, pelvic floor muscles complete the equivalent of over 11,200 Kegels.

Six sessions are recommended, scheduled at 2-3 times per week.

After six sessions, pelvic floor muscles will have contracted, or “crunched,” the equivalent of over 65,000 Kegels.

There is no downtime or post-treatment limitations.

Incontinence is a loss of bladder control. There are three types of incontinence: stress, urge and mixed.

• Stress incontinence happens when we cough, laugh, sneeze, exercise, etc.
• Urge incontinence is sudden, intense urges to urinate. These urges can happen anytime and happen often.
• Mixed incontinence is a combination of stress and urge incontinence.

The main cause is weak pelvic floor muscles. These floor muscles basically hold up, or support, the bladder, uterus, prostrate and bowels. These muscles can become weak with age, childbirth, hormonal changes and lack of regular Kegel exercises.

Strengthening pelvic floor muscles with Emsella is a highly effective non-surgical choice.

Be proactive in your vaginal and prostate health:

• Maintain a healthy weight. Being overweight puts pressure on your bladder.
• Strengthen the pelvic floor with regular Kegel exercises. By the way, Kegel exercises aren’t just for women. Men commonly suffer from incontinence too and can benefit from daily Kegels and Emsella
• Fiber rich diets are beneficial for so many reasons! Constipation can cause incontinence issues.
• Limit caffeine and alcohol and STOP SMOKING!
• Yearly sessions of Emsella also can help maintain vaginal muscle strength.

Yes. Any vaginal rejuvenation treatment will improve vaginal health and wellness. Treatments such as ThermiVA and the O-Shot are ideal treatments to maximize results of Emsella.

Many patients feel results within days or weeks. For others, it may take a couple of months or pellet insertions later.

It is life changing for so many patients. Renewed vigor, endurance, mental clarity, increased libido and renewed interest are the most common initial effects of BioTE pellet therapy.

Every person’s body is different, but at the end of a pellet cycle or when stopping pellet therapy altogether, symptoms of fatigue, low mood and sleeplessness may recur. Typically, the patient’s symptoms will return to the same state prior to BHRT as their estrogen and testosterone levels begin to drop.

Pellets last up to three to six months depending on gender, weight, absorption rates, and the amount of deficiency or surplus of hormones present within the patient at the time of insertion. Pellets are reinserted between two to four times per year to help keep hormones optimized and balanced and may take up to two insertions before feeling the full benefits.

Pellet dosages are unique for each patient. Dosages are based on required blood labs that include a Complete Metabolic Panel, Complete Lipid Panel, Sex Hormone Levels (Testosterone, Estradiol, Progesterone), Thyroid Panel, Vitamins D and B12, weight, general health condition, any medical issues, the presence or absence of a uterus, history of breast cancer, symptoms, etc.

The hormones employed in BHRT mimic the molecular structure of natural human hormones. Biote bioidentical hormone pellets are made from soy or the yam plant to create estradiol and/or testosterone molecules, unlike synthetic hormones, which are made from animal parts or urine and have a different molecular structure than what the body produces.

• Blood Tests to include: Complete Metabolic Panel, Complete Lipid Panel, Sex Hormone Levels (Testosterone, Estradiol, Progesterone), Thyroid Panel, Vitamins D and B12
• Current mammogram
• Current Well Woman’s Exam or Pap Smear
• Consultation to discuss labs and any patient concerns

Avoid aggressive skincare products (like Retin-A or Salicylic acid) 72 hours prior to treatment.

Avoid excessive sun exposure 48 hours prior to treatment.

To reduce the likelihood of bleeding or bruising, discontinue the use of blood thinning products for 24 hours prior to treatment, as approved by your primary care provider. This list includes:

• Aspirin, Ibuprofen (Motrin or Advil), Naproxen, Aleve
• Fish oil, St. John's Wort, Flax Seed, Vitamin E, Vitamin D, Garlic, Ginkgo Biloba, Cumin, Ginseng, Echinacea, Glucosamine
• Alcoholic beverages or excessive caffeine

• Avoid touching the treated area with unwashed hands.
• Follow your practitioners guidelines for skincare and products (we love Epionce!)
• Avoid tanning, excessive sun, or heat for 1 week (no sauna, no hot tub).
• Avoid strenuous exercise & excessive sweating for 72 hours.
• Use a clean pillowcase at home while sleeping.
• Avoid facials, massages, exfoliating the area for 14 days post-procedure.
• Use Tylenol (Acetaminophen) for headache or discomfort. Avoid NSAIDs (Ibuprofen,
  Aspirin) for 24 hours as they can increase bleeding.
• Full results can take 8-12 weeks.

Follow-up in 2 weeks for reevaluation, if needed

The number of treatments vary based on general skin quality, degree of sun damage, targeted skin issues, location of targeted skin issues, patient compliance with pre and post treatment protocols, patient goals, etc.

Generally, 3 treatments, scheduled monthly, are recommended for most skin issues and goals.

Multiple areas may be treated during a singular appointment if enough time is reserved when scheduling to treat multiple areas.

Visible skin tightening occurs immediately after treatment due to post treatment swelling. Swelling is inevitable after any MNRF treatment. It is comparatively minimal with Scarlet SRF and subsides in a few days. In the meantime, and continuing for several months post-treatment, dermal remodeling is set into motion with the genesis of new collagen, new elastin and vascular regeneration.

Skin continues to improve over 3-6 months, and results can last a year or more after treatments following a single treatment.

Radiofrequency (RF) has been used for years in aesthetic medicine to improve skin laxity, skin textural issues, and general skin aging issues. As RF energy (heat) passes through skin layers, it not only causes collagen contraction, but it also promotes new collagen and elastin production. Collagen and elastin make up the building blocks of skin’s support structure, or foundation: a strong, healthy foundation is reflected as smooth, firm skin on the surface.

Before the addition of microneedling, the challenge was getting RF energy high enough and deep enough to significantly enhance coagulation, or the skin tightening results, of RF. Without a way for increased RF energy to bypass skin’s surface and reach the deepest skin layers where collagen and elastin are produced, there were substantial risks for skin damage and facial fat necrosis.

Microneedling (MN) remains a common aesthetic treatment for skin rejuvenation and improvement of textual issues, such as wrinkles and scars. Basically, microneedling causes “controlled” trauma to the skin, setting into motion the cascade of wound healing. When injured, our bodies send chemical messengers to the site of damage, stimulating fibroblasts for new collagen, elastin and healthy new tissue. Ideally, the healing cascade ends with desired skin remodeling (tightening, lifting and smoothing) and rejuvenation.

Microneedling also is commonly used to create micro-channels for delivery of topical medications and therapies to boost results. Typical therapies used with microneedling include PRP (Platelet Rich Plasma), PRF (Platelet Rich Fibrin), Exosomes, and various chemical acid solutions such as TCA and retinoid acid.

Combining microneedling with radiofrequency creates the “dynamic duo” of aesthetic devices. Combining the two enhances results beyond what either can achieve alone. This combo also provides tissue remodeling at depths that lasers cannot reach without significant skin trauma and extended healing time.

With MNRF, microneedles work as conduits for the RF energy. Controlled RF energy now can bypass skin’s top layers, preserving the epidermis and significantly reducing the chances of hyperpigmentation and downtime. Further, with these conduit-serving microneedles at controlled depths of penetration, RF energy can be intensified and reach the deepest skin layers where it is most beneficial.

No treatment exists that stops the aging process. Time marches on.

The reality: the older we are, the faster we age.

Think of a runaway train, without brakes, or a conductor.

You are the conductor. Skin aging is the train. Scarlet SRF treatments (and other treatments and products) are the brakes.

Scarlet SRF decelerates skin aging. the forward moving process of aging, repeated treatments like Scarlet SRF are necessary.

After completion of recommended treatment sessions (generally three for most areas and issues), yearly treatments are the goal for optimal skin health and maintenance. The number of treatments varies based on goals and existing issues.

The results of PRF are only as good as the quality of your platelets and health. To achieve best results, please consider the following-

• If approved by your PCP, avoid the following medications 1 week before treatment: NSAIDs, Ginko Biloba, Garlic, Vitamin E, Vitamin A, Flax Oil, Curcumin, Primrose Oil, Fish Oil, and excessive caffeine
• If you are taking a any blood thinners, please let your provider know as they may present a contraindication to this treatment
• Avoid the use of systemic corticosteroids for 1-2 weeks before the procedure
• Avoid alcohol and Tabacco for 1 week prior to treatment
• Be sure to hydrate extremely well starting 48 hours before treatment

Simply, PRF amplifies the regenerative powers of PRP.

PRF has a 10x higher concentration of platelets and a more robust release of growth factors than PRP. PRF includes a dense fibrin matrix which extends the cycles of tissue repair and cell regeneration. This fibrin matrix keeps cells active and alive for over a week. With traditional PRP, growth factors can stay active for only a few minutes to a few hours.

The extended life of active cells is important for continued regeneration. The fibrin matrix of PRF allows for a steady, durable release of growth factors.

The fibrin matrix of PRF can form because PRF is fully autologous; there are no anti-coagulants involved in the process. Translation: PRF is a 100% natural, unmodified solution.

Conversely, a fibrin matrix cannot form with PRP. The PRP process uses anti-coagulants.

The process makes the difference:

PRP’s high speed centrifugation is to eliminate red blood cells by pushing them down with gravitational force. It has been shown that spinning blood too fast and too long results in pushing down heavier cells such as white blood cells and stem cells, while “lighter” platelets and plasma collect at the top of the tube. This top part, or lighter cells, is what PRP uses for regeneration and rejuvenation.

PRF’s slow speed centrifugation preserves the vitality of cells that remain undamaged because of the low G-force applied. With slow speed centrifugation of PRF, a considerable amount of white blood cells (WBCs) and mesenchymal stem cells (MSCs) also are obtained. Mesenchymal stem cells are highly desirable as these multipotent stem cells can differentiate into other cell types.

With the high concentration of platelets, approximately 10x more than normal blood, white blood cells and fibrin, PRF has superior regenerative and healing capabilities in comparison to PRP.

PRF is “The Ultimate Blood Concentrate.”

To reduce the likelihood of bleeding or bruising, discontinue the use of blood thinning products for 10 days prior to treatment, as approved by your primary care provider. This list includes:

• Aspirin, Ibuprofen (Motrin or Advil), Naproxen, Aleve
• Fish oil, St. John's Wort, Flax Seed, Vitamin E, Vitamin D, Garlic, Ginkgo Biloba, Cumin, Ginseng, Echinacea, Glucosamine
• Alcoholic beverages or excessive caffeine

You can consider taking Arnica Montana, a natural supplement to help prevent bruising (take 5 tablets three times per day starting one week prior to treatment).

• Avoid massaging the treated area.
• Avoid tanning, excessive sun, or heat for 24 hours (no sauna, no hot tub).
• Avoid strenuous exercise & excessive sweating for 24 hours.
• Avoid consuming excess amount of alcohol or salts to avoid excessive swelling.
• Do not lie down or bend over for 4 hours following injection. You may squat instead of
  bending over.
• Avoid facials, massages, exfoliating the area for one day post-procedure.
• Wait 24 hours before wearing hats or headbands.
• Use Tylenol (Acetaminophen) for headache or discomfort. Avoid NSAIDs (Ibuprofen,
  Aspirin) for 24 hours as they can increase bleeding.

Follow-up in 2 weeks for reevaluation, if needed

• Schedule your appointment at a time when possible swelling or bruising will not disrupt your social obligations.
• To reduce the likelihood of bleeding or bruising, discontinue use of blood thinning products for 10 days prior to treatment, if approved by your primary care provider. This list includes:
  - Aspirin, Ibuprofen (Motrin or Advil), Naproxen, Aleve.
  - Fish oil, St. John's Wort, Flax Seed, Vitamin E, Vitamin D, Garlic, Ginkgo Biloba, Cumin, Ginseng, Echinacea, Glucosamine.
• Avoid alcohol or excessive caffeine consumption 24 hours pre- or post- injectable treatment.
• You can consider taking Arnica Montana natural supplement to help prevent bruising (take 5 tablets three times per day starting one week prior to treatment).
• Please notify your provider if you have a history of cold sores, as we will consider pre-medicating with an antiviral prescription prior to treatment. Cancel your appointment if you have any open sores in the treatment area. It is important that you alert us of any medical conditions you may have and/or any prescribed medications you are taking prior to your treatment.
• Any injection introduces the risk for infection. For this reason, the following is taken into consideration
  when proceeding with injections. We will delay injectables if you:
  • Have had any infection, cold, virus, or flu in the past 30 days.
  • Have had any dental procedures in the past 2 weeks or are anticipating dental procedures or
    cleanings in the next 2 weeks.
  • Have had a surgical procedure in the past 30 days or are anticipating a surgery or procedure.
  • Have had any immunizations in the past 30 days or if you’re anticipating immunizations.
  • Have had any tattooing or permanent makeup within the past 30 days.
  • Take any immunosuppressive/injectable medications (ex: Biologics such as Humira, Skyrizi,
    Stelara, Enbrel, Taltz, Cosentyx, Tremfya).
• Additional contraindications include: Pregnancy, breastfeeding, allergies to components of dermal fillers, open sores in areas to be treated.

• DO NOT APPLY ANYTHING TO THE SKIN UNTIL THE DAY AFTER THE TREATMENT: No skin treatments, or makeup.
• Bruising, swelling, tenderness, numbness, and areas of firm nodules may occur.
• Arnica Gel or supplements may be used to help bruising resolve faster.
• Do not massage, touch, or manipulate the injection site. Avoid heavy exercise the day of your treatment.
• Indirect application of ice packs may be used to the treated area during the first 12 hours. Ice for 15 minutes on every hour.
• To prevent product displacement, avoid sleeping on your side or stomach for 24 hours post-treatment.
• Sleep with head elevated for 2-3 days to decrease swelling.
• If you experience any mild tenderness or discomfort, you may take Acetaminophen/Tylenol.
• Avoid skin laser treatments for 3 weeks after. Discontinue Retin-A for 2 days post treatment.

If you experience any of the following symptoms, contact our office immediately: dusky or white discoloration of injected areas, mottling or unusual bruising, severe or increasing pain, redness, increasing warmth or coolness to touch, severe swelling, itching, blisters, difficulty swallowing or smiling, fever, or chills.

5-5-5 RULE

• Massage the treated area 5 times a day, for 5 minutes for 5 days! Massaging with lotion in a circular fashion helps prevent nodule formation. Massaging may be uncomfortable for the first couple of days, but it is still necessary.

WHAT TO EXPECT POST TREATMENT?

• Expect bruising, swelling and tenderness for 48-72 hours. Bruising may last for 7-14 days.
• Immediately after treatment, your face will appear full and puffy. This is due to swelling and the sterile water injected. This is temporary!
• After a few days, you will return to pre-treatment appearance. Most patients can return to their daily activities immediately after treatment.
• Results may appear 4-6 weeks after treatment and will gradually improve up to 12 months. Results last up to 2-3 years after initial treatment.
• Schedule your next appointment in 2-3 months to determine if additional treatments are needed. Most patients require one to four treatments to achieve the desired results.

POST-TREATMENT INSTRUCTIONS

• MASSAGE, MASSAGE, MASSAGE!!
• Arnica Gel may be used to massage area to help minimize bruising and swelling.
• Indirectly apply cold/ice packs to the treated area for the first 24 hours – 10 minutes on, 10 minutes off.
• Avoid/minimize strenuous exercise and exposure to extensive sun, UV lamps, indoor tanning beds, or extreme temperatures within the first 48 hours after treatment.
• Makeup may be applied 4 hours after treatment.
• Avoid facial lasers and chemical peels for at least 1 week after.

NOTIFY YOUR PROVIDER IF THE FOLLOWING OCCURS: Significant swelling, excessive pain, bleeding, fever, eye pain, vision loss, dusky discoloration, or any signs of a stroke (including sudden difficulty speaking, numbness, or weakness in your face, arms, or legs, face dropping, severe headache or confusion) during or shortly after the procedure.

• Does your vaginal area feel loose after childbirth? 
• Are you experiencing menopausal symptoms? 
• Do you suffer from vaginal dryness?  
• Is sexual intercourse painful? 
• Are you experiencing any urinary leakage when you sneeze, jump, etc.? 
• Do you have cosmetic concerns about your vaginal area? 
• Are you interested in treatment options to improve or support vaginal wellness? 

You are not a suitable candidate for ThermiVA: 

• If you are currently menstruating at the time of your appointment
• You have severe vaginal dryness that is not currently being treated by medications or creams
• If there is significant vaginal prolapse
• If you have severe laxity, particularly if muscles were separated during childbirth
• If you are pregnant or breastfeeding
• If you are seeking treatments to increase vaginal muscle strength. (Emsella is the best treatment choice for increasing vaginal muscle strength)

ThermiVA is a device-driven treatment that uses the same radiofrequency (RF) technology prevalent in aesthetic practices for skin rejuvenation. Radiofrequency (RF) is controlled thermal energy that penetrates to the deepest tissue layers (the dermis) where collagen and elastin are produced, and where veins and nerve endings exist. 

ThermiVA employs a smooth, thin wand that serves as a conduit for RF energy. The wand is gently applied to targeted vulvovaginal tissue, emitting RF energy at controlled temperatures and depths. In these target areas, RF energy triggers new collagen and elastin production and induces tissue contraction. Results include tighter, smoother, firmer tissue and overall improved tissue quality. Radiofrequency also promotes increased blood flow and nerve regeneration, resulting in increased lubrication and sensitivity. 

RF Effects on Tissue 

• Each ThermiVA session lasts about 30 minutes.
• Three monthly sessions are recommended.
• Treatments are painless.
• There is no downtime.
• There are no post-treatment limitations.

The results of PRF are only as good as the quality of your platelets and health. To achieve best results, please consider the following-

• If approved by your PCP, avoid the following medications 1 week before treatment: NSAIDs, Ginko Biloba, Garlic, Vitamin E, Vitamin A, Flax Oil, Curcumin, Primrose Oil, Fish Oil, and excessive caffeine
• If you are taking a any blood thinners, please let your provider know as they may present a contraindication to this treatment
• Avoid the use of systemic corticosteroids for 1-2 weeks before the procedure
• Avoid alcohol and Tabacco for 1 week prior to treatment
• Be sure to hydrate extremely well starting 48 hours before treatment

Expect the entire procedure to take about an hour. 

• Compounded numbing cream is applied to vaginal areas to be injected.
• The patient’s blood is drawn. The vial of blood is placed in a centrifuge for the required speed and time to separate the plasma and platelets from the other blood components.
• The provider will confirm the efficacy of numbing cream with the patient.
• PRP is injected into target areas in the vaginal wall, the vulva and the clitoris.
• The patient can leave immediately following the procedure.
• There are no post procedure limitations and no downtime.

Possible Side Effects: 

• Bleeding
• Swelling
• Discomfort at injection site
• Altered urinary stream from swelling
• Persistent arousal
• Spontaneous orgasm
• Perpetual lubrication

Heightened sensitivity from the O-Shot is generally immediate. As swelling and the injected PRP fluid subside, results wane. Results improve with time as regeneration of new cells, tissue, vasculature occurs. Peak regeneration usually occurs between 3-4 months. For most patients, the effects of the O-Shot last well over a year. 

To boost or keep the regenerative effects of the O-Shot, patients usually follow-up with another O-Shot about a year after the first one. 

Because physical aging speeds up with time, repeating the O-Shot for its regenerative capabilities every 1-2 years is ideal to quell the aging process. 

You may not be a candidate for Emsella if you have or are experiencing any of the following:

• Current Menstruation
• Pregnancy
• Cardiac Pacemakers
• Electronic Implants
• Metal Implants
• Drug Pumps
• Heart Disorders

Many patients feel results after the first session, with increased improvement over time and subsequent sessions.

Patients can schedule more treatments as needed to maintain pelvic floor strength.

Regular Kegel exercises can help extend the results of Emsella treatments.

Emsella may be combined with any vaginal rejuvenation treatment, or the P-Shot for men, to maximize results.

Acorn offers significant discounts with vaginal rejuvenation treatment combinations.

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Sitting fully clothed on the Emsella chair (aka. Kegel throne), many patients feel a buzzing or tapping sensation as electromagnetic energy stimulates involuntary muscle contractions along the pelvic floor. Even though they are stronger than regular Kegels, these muscle contractions are painless.

During each 28-minute passive workout session, pelvic floor muscles complete the equivalent of over 11,200 Kegels.

Six sessions are recommended, scheduled at 2-3 times per week.

After six sessions, pelvic floor muscles will have contracted, or “crunched,” the equivalent of over 65,000 Kegels.

There is no downtime or post-treatment limitations.

Incontinence is a loss of bladder control. There are three types of incontinence: stress, urge and mixed.

• Stress incontinence happens when we cough, laugh, sneeze, exercise, etc.
• Urge incontinence is sudden, intense urges to urinate. These urges can happen anytime and happen often.
• Mixed incontinence is a combination of stress and urge incontinence.

The main cause is weak pelvic floor muscles. These floor muscles basically hold up, or support, the bladder, uterus, prostrate and bowels. These muscles can become weak with age, childbirth, hormonal changes and lack of regular Kegel exercises.

Strengthening pelvic floor muscles with Emsella is a highly effective non-surgical choice.

Be proactive in your vaginal and prostate health:

• Maintain a healthy weight. Being overweight puts pressure on your bladder.
• Strengthen the pelvic floor with regular Kegel exercises. By the way, Kegel exercises aren’t just for women. Men commonly suffer from incontinence too and can benefit from daily Kegels and Emsella
• Fiber rich diets are beneficial for so many reasons! Constipation can cause incontinence issues.
• Limit caffeine and alcohol and STOP SMOKING!
• Yearly sessions of Emsella also can help maintain vaginal muscle strength.

Yes. Any vaginal rejuvenation treatment will improve vaginal health and wellness. Treatments such as ThermiVA and the O-Shot are ideal treatments to maximize results of Emsella.

Many patients feel results within days or weeks. For others, it may take a couple of months or pellet insertions later.

It is life changing for so many patients. Renewed vigor, endurance, mental clarity, increased libido and renewed interest are the most common initial effects of BioTE pellet therapy.

Every person’s body is different, but at the end of a pellet cycle or when stopping pellet therapy altogether, symptoms of fatigue, low mood and sleeplessness may recur. Typically, the patient’s symptoms will return to the same state prior to BHRT as their estrogen and testosterone levels begin to drop.

Pellets last up to three to six months depending on gender, weight, absorption rates, and the amount of deficiency or surplus of hormones present within the patient at the time of insertion. Pellets are reinserted between two to four times per year to help keep hormones optimized and balanced and may take up to two insertions before feeling the full benefits.

Pellet dosages are unique for each patient. Dosages are based on required blood labs that include a Complete Metabolic Panel, Complete Lipid Panel, Sex Hormone Levels (Testosterone, Estradiol, Progesterone), Thyroid Panel, Vitamins D and B12, weight, general health condition, any medical issues, the presence or absence of a uterus, history of breast cancer, symptoms, etc.

The hormones employed in BHRT mimic the molecular structure of natural human hormones. Biote bioidentical hormone pellets are made from soy or the yam plant to create estradiol and/or testosterone molecules, unlike synthetic hormones, which are made from animal parts or urine and have a different molecular structure than what the body produces.

• Blood Tests to include: Complete Metabolic Panel, Complete Lipid Panel, Sex Hormone Levels (Testosterone, Estradiol, Progesterone), Thyroid Panel, Vitamins D and B12
• Current mammogram
• Current Well Woman’s Exam or Pap Smear
• Consultation to discuss labs and any patient concerns

Avoid aggressive skincare products (like Retin-A or Salicylic acid) 72 hours prior to treatment.

Avoid excessive sun exposure 48 hours prior to treatment.

To reduce the likelihood of bleeding or bruising, discontinue the use of blood thinning products for 24 hours prior to treatment, as approved by your primary care provider. This list includes:

• Aspirin, Ibuprofen (Motrin or Advil), Naproxen, Aleve
• Fish oil, St. John's Wort, Flax Seed, Vitamin E, Vitamin D, Garlic, Ginkgo Biloba, Cumin, Ginseng, Echinacea, Glucosamine
• Alcoholic beverages or excessive caffeine

• Avoid touching the treated area with unwashed hands.
• Follow your practitioners guidelines for skincare and products (we love Epionce!)
• Avoid tanning, excessive sun, or heat for 1 week (no sauna, no hot tub).
• Avoid strenuous exercise & excessive sweating for 72 hours.
• Use a clean pillowcase at home while sleeping.
• Avoid facials, massages, exfoliating the area for 14 days post-procedure.
• Use Tylenol (Acetaminophen) for headache or discomfort. Avoid NSAIDs (Ibuprofen,
  Aspirin) for 24 hours as they can increase bleeding.
• Full results can take 8-12 weeks.

Follow-up in 2 weeks for reevaluation, if needed

The number of treatments vary based on general skin quality, degree of sun damage, targeted skin issues, location of targeted skin issues, patient compliance with pre and post treatment protocols, patient goals, etc.

Generally, 3 treatments, scheduled monthly, are recommended for most skin issues and goals.

Multiple areas may be treated during a singular appointment if enough time is reserved when scheduling to treat multiple areas.

Visible skin tightening occurs immediately after treatment due to post treatment swelling. Swelling is inevitable after any MNRF treatment. It is comparatively minimal with Scarlet SRF and subsides in a few days. In the meantime, and continuing for several months post-treatment, dermal remodeling is set into motion with the genesis of new collagen, new elastin and vascular regeneration.

Skin continues to improve over 3-6 months, and results can last a year or more after treatments following a single treatment.

Radiofrequency (RF) has been used for years in aesthetic medicine to improve skin laxity, skin textural issues, and general skin aging issues. As RF energy (heat) passes through skin layers, it not only causes collagen contraction, but it also promotes new collagen and elastin production. Collagen and elastin make up the building blocks of skin’s support structure, or foundation: a strong, healthy foundation is reflected as smooth, firm skin on the surface.

Before the addition of microneedling, the challenge was getting RF energy high enough and deep enough to significantly enhance coagulation, or the skin tightening results, of RF. Without a way for increased RF energy to bypass skin’s surface and reach the deepest skin layers where collagen and elastin are produced, there were substantial risks for skin damage and facial fat necrosis.

Microneedling (MN) remains a common aesthetic treatment for skin rejuvenation and improvement of textual issues, such as wrinkles and scars. Basically, microneedling causes “controlled” trauma to the skin, setting into motion the cascade of wound healing. When injured, our bodies send chemical messengers to the site of damage, stimulating fibroblasts for new collagen, elastin and healthy new tissue. Ideally, the healing cascade ends with desired skin remodeling (tightening, lifting and smoothing) and rejuvenation.

Microneedling also is commonly used to create micro-channels for delivery of topical medications and therapies to boost results. Typical therapies used with microneedling include PRP (Platelet Rich Plasma), PRF (Platelet Rich Fibrin), Exosomes, and various chemical acid solutions such as TCA and retinoid acid.

Combining microneedling with radiofrequency creates the “dynamic duo” of aesthetic devices. Combining the two enhances results beyond what either can achieve alone. This combo also provides tissue remodeling at depths that lasers cannot reach without significant skin trauma and extended healing time.

With MNRF, microneedles work as conduits for the RF energy. Controlled RF energy now can bypass skin’s top layers, preserving the epidermis and significantly reducing the chances of hyperpigmentation and downtime. Further, with these conduit-serving microneedles at controlled depths of penetration, RF energy can be intensified and reach the deepest skin layers where it is most beneficial.

No treatment exists that stops the aging process. Time marches on.

The reality: the older we are, the faster we age.

Think of a runaway train, without brakes, or a conductor.

You are the conductor. Skin aging is the train. Scarlet SRF treatments (and other treatments and products) are the brakes.

Scarlet SRF decelerates skin aging. the forward moving process of aging, repeated treatments like Scarlet SRF are necessary.

After completion of recommended treatment sessions (generally three for most areas and issues), yearly treatments are the goal for optimal skin health and maintenance. The number of treatments varies based on goals and existing issues.

The results of PRF are only as good as the quality of your platelets and health. To achieve best results, please consider the following-

• If approved by your PCP, avoid the following medications 1 week before treatment: NSAIDs, Ginko Biloba, Garlic, Vitamin E, Vitamin A, Flax Oil, Curcumin, Primrose Oil, Fish Oil, and excessive caffeine
• If you are taking a any blood thinners, please let your provider know as they may present a contraindication to this treatment
• Avoid the use of systemic corticosteroids for 1-2 weeks before the procedure
• Avoid alcohol and Tabacco for 1 week prior to treatment
• Be sure to hydrate extremely well starting 48 hours before treatment

Simply, PRF amplifies the regenerative powers of PRP.

PRF has a 10x higher concentration of platelets and a more robust release of growth factors than PRP. PRF includes a dense fibrin matrix which extends the cycles of tissue repair and cell regeneration. This fibrin matrix keeps cells active and alive for over a week. With traditional PRP, growth factors can stay active for only a few minutes to a few hours.

The extended life of active cells is important for continued regeneration. The fibrin matrix of PRF allows for a steady, durable release of growth factors.

The fibrin matrix of PRF can form because PRF is fully autologous; there are no anti-coagulants involved in the process. Translation: PRF is a 100% natural, unmodified solution.

Conversely, a fibrin matrix cannot form with PRP. The PRP process uses anti-coagulants.

The process makes the difference:

PRP’s high speed centrifugation is to eliminate red blood cells by pushing them down with gravitational force. It has been shown that spinning blood too fast and too long results in pushing down heavier cells such as white blood cells and stem cells, while “lighter” platelets and plasma collect at the top of the tube. This top part, or lighter cells, is what PRP uses for regeneration and rejuvenation.

PRF’s slow speed centrifugation preserves the vitality of cells that remain undamaged because of the low G-force applied. With slow speed centrifugation of PRF, a considerable amount of white blood cells (WBCs) and mesenchymal stem cells (MSCs) also are obtained. Mesenchymal stem cells are highly desirable as these multipotent stem cells can differentiate into other cell types.

With the high concentration of platelets, approximately 10x more than normal blood, white blood cells and fibrin, PRF has superior regenerative and healing capabilities in comparison to PRP.

PRF is “The Ultimate Blood Concentrate.”