Friday, June 23, 2023

Reviewing Bioidentical Hormone Replacement with Pellets

 


I've blogged about bioidentical hormone pellets in the past, and I post on social media about them frequently, but with them becoming more popular in our community, I thought it was time for a review. First of all, know the qualifications of the provider doing your pellets! What is their training and who trained them? How long have they been doing them? Where do they purchase their pellets? How do they determine your dose? Is that done with saliva or lab work? Do they consider other things like symptoms, height, weight, any risk factors, menstrual cycles or lack there of, and your full medical history? Cost I know is a concern, but it is definitely not the most important thing when it comes to your health and balancing your hormones. 

Dr. Trussell practiced internal medicine for 20 years before she retired. She opened Sei Bella Med Spa in 2010 and has been providing and receiving bioidentical hormone pellet therapy herself for 13 years now. After retiring from internal medicine she became board certified in Anti-Aging and Regenerative Medicine and went on to complete a fellowship in Aesthetics. 


So what are the symptoms of hormone imbalance? Any and all of the above! Symptoms are very similar in women and men actually. For women, the three main hormones are estrogen, progesterone and testosterone. They don't all fall at once throwing you into "menopause." I see women frequently who are still having regular or irregular periods who can't sleep, have low libido and are tired all the time. Usually their progesterone and testosterone are low and should be replaced. It may be a few months or a few years before I need to give them estrogen pellets. I replace what you need when you need it. I'm not trying to make you super human, just optimize your levels. Optimal is where you were when you were younger and full of vitality and these levels are often higher than the "lab normals" that print out on standard lab work. So don't wait until you're miserable to seek help. 


What are your options for hormone replacement? For men there are creams/gels/patches, weekly shots or pellets. In almost 30 years of medicine I have rarely seen a man stick with the first option. They sweat and the patches come off. They don't want to take the time to rub in the cream or gel and wait to get dressed. Testosterone shots are safe but many men find a weekly shot undesirable and inconvenient. In general, men get pellets every 5 months. Women can do synthetic pills, creams or pellets. I will not prescribe the oral synthetic hormones due to the increased risk of stroke and breast cancer outlined in the Women's Health Initiative done a few decades ago. I tried bioidentical creams myself early on, but couldn't get my levels optimized where they needed to be, and found them undesirable for the same reason men do. Women typically get pellets every 3-6 months. 


What do pellets look like and what are they made from? How do you decide on the dosage? Testosterone pellets are about the size of a grain of rice or smaller. There are approximately10 different doses of those. All estrogen doses, which there are about 10 of as well, are all the size of the end of an ink pen. Progesterone does not come in the pellets because women take it at night. However, the prescription I give you is cheap and it's real progesterone. The pellets are made from sweet potatoes actually. I know. Hard to believe. Through a process in the lab they extract the hormone identical to what we used to make and compress it into pellets. I have always used Well's Pharmacy for my pellet supply. I've never had any quality control issues and they are certified by a third party lab before Well's ships anything to me. Each dose is individualized to each patient based on a full panel of blood work that not only includes your hormones but also pituitary regulatory hormones, a full thyroid panel, B12, Vitamin D, metabolic panel, lipid profile, PSA (men) and CBC. Any irregularities there are treated as well. In determining your particular dosages I also consider height, weight, menstrual cycle status, a list of symptoms (very important) that you fill out with your initial paperwork, as well as a full medical history. For men I also have to consider if they want to remain fertile. Dosages can change over time based on your symptoms and occasional blood work as indicated. 



How do you insert the pellets? What are the risks and benefits? How do I know when I need more? The pellets are inserted into the fat of your upper bottom after I numb it with lidocaine. It's a very tiny incision and there are no stitches afterwards, just a steri-strip. It doesn't hurt, and is a very quick procedure with minimal or no downtime. You can bathe, shower, drive, eat, drink, exercise (except I ask men not to work out their lower bodies for a few days because they get more pellets and I need them seated in there well first). I do ask you stay out of the lake in the summer until that little steri-strip I put over the incision comes off which is in about 3 days. Otherwise resume normal activity. Pellets start to kick in the first week and peak at 6 weeks which is when we bring you back for your post pellet lab to make sure your dosage is correct and monitor a couple other things on the men's lab work like PSA, estrogen level, CBC. Risks are extremely small with bioidentical hormone pellets. Although they do not CAUSE breast cancer or prostate cancer, I'm going to want you to have a normal mammogram and PSA before we get started so that a hormone sensitive cancer we might not know about is not stimulated to grow any with the pellets. If you have a history of a clotting disorder or a hormone sensitive cancer, you will need a clearance letter from your oncologist before you can receive pellets or any kind of hormone replacement. Side effects IF they even occur, can be temporary breast tenderness or hand puffiness if you've been without any estrogen for a long time. If you had black hairs start to grow on your chin at menopause they could grow quicker. But no beards! As far as when you need more.....you will know! Men are easy; they are almost always about every 5 months. Women vary.....3- 6 months. When the symptoms that brought you in to see me in the first place start coming back....hot flashes, night sweats, brain fog, low libido, mood swings, fatigue... it's time to call and get on my schedule!! Besides treating all the symptoms I've already mentioned, an article came out in "Internal Medicine News" Feb 2023 with research showing appropriate hormone replacement may protect against Alzheimer's dementia in women carrying the APOE4 gene, a known risk factor for Alzheimer's.  


I'd encourage you to go to our website at www.seibellamedspa.net. It reviews cost. I will give you receipts, but we do not file insurance. You are welcome to do so yourself to seek reimbursement. Payment is collected at the time of service. Dr. Trussell opted out of Medicare, Medicaid and Tricare over a decade ago, so you will not be able to submit any claims to them.

Please call the office with any questions you may have. Hear some personal testimonies since almost all of us are receiving pellets. I have all age ranges....from a 30 yr old women with a complete hysterectomy to an 83 year old newlywed couple. Dr. Trussell is quite comfortable talking to and treating both women and men after nearly thirty years in medicine so no need to be uncomfortable in any way. You can say and ask her anything. 

Give us a call to set up your consult and lab work appointment.....501-228-6237

Anne R Trussell MD ABAARM FAARM
owner/physician
Sei Bella Med Spa
10310 West Markham 
Suite 202
Little Rock, AR 72205

#estrogen #testosterone #progesterone #bioidentical #hormone #hormones #pellets #bioidenticalhormones #bioidenticalhormonepellets #HTCA #menopause #andropause #lowT #perimenopause #moodswings #nightsweats #hotflashes #lowlibido #sexlife #brainfog #allnatural #depression #internalmedicine #seibellamedspa #drannetrussell #medicalspa #medspa #physician #doctor #fatigue #insomnia #sleepdisturbance #weightgain #menses #menstrualcycle #AYBestof2023 #A4M #antiagingmedicine #anxiety #irritability #jointpain #hormoneimbalance

Tuesday, June 20, 2023

CoolPeel......Reveal Healthier, Younger-looking Skin


CoolPeel is a new way to safely AND comfortably offer the benefits of a traditional CO2 resurfacing laser without all the pain and downtime. CoolPeel targets just the superficial layer of skin. The damaged skin will then slough off revealing younger, healthier-looking skin. 

CO2 lasers really are the gold standard for treating wrinkles, hyperpigmentation and acne scars, while tightening and balancing the skin tone. Damaged skin sloughs off; new collagen is stimulated as heat tightens the skin. A full-on CO2 laser treatment has considerable post procedure discomfort and downtime, often for weeks.

However, the CoolPeel uses a Tetra CO2 laser that has a very precise, controlled energy delivery at the perfect speed for superficial skin resurfacing. A CoolPeel laser peel takes 15-20 minutes. We can even treat hands and decollete in 5-10 minutes. 



You do not have to have sedation or localized numbing, but we can use numbing cream if you have a lower pain threshhold; and we always use cool air to increase the comfort. You can expect to be a little red afterward, as if you have a sunburn, for a day or two, but you can still return to your normal activities. Yor skin will probably feel dry and scaly while you heal so it's important to keep it hydrated. We have the perfect Epionce cream that soothes, hydrates and will not clog pores. 





So you are a great candidate for CoolPeel laser treatment if you are looking to reduce the appearance of fine lines and sun damage, minimize pores and improve skin texture. You can have this done during the summer months, but we will ask you to wear sunscreen and a hat. If you have a beach trip or big trip to the lake planned, you should wait to get your CoolPeel treatment until you are back home. 

Give us a call to schedule!

501-228-6237

#CoolPeel #Cartessa, Tetralaser #Tetra #antiaging #acnescars #skin #skinresurfacing #hyperpigmentation #sundamage #laser #CO2laser #wrinkles #skintightening #Epionce #collagen #drannetrussell #seibellamedspa #face #hands #decollete #laserenergy #hydration #pores

Tuesday, June 13, 2023

EmFace....Less Wrinkles, More Lift, Needle-Free

 


One of our newest BTL devices is EmFace, commonly referred to as the nonsurgical facelift. It is totally painless and noninvasive. It simultaneously delivers HIFES (high intensity facial electromagnetic stimulation) and synchronized RF (radiofrequency). HIFES delivers up to 25,000 contractions per session to help tighten muscles while synchronized RF uses radiofrequency energy to heat the skin; this helps promote production of new collagen and elastin essential for wrinkle treatment, contours the face, tightens saggy skin, and improves your overall complexion. This is very similar to the technology of EmsculptNeo that we use for noninvasive body contouring. Watch the video below so you can better visualize just how it works.




The aging process of the face is a complex 3 dimensional process that involves the skin, connective tissue and muscle. You can achieve a 37% wrinkle reduction of the skin because the synchronized RF remodels and smooths the skin by heating the dermis to increase levels of collagen and elastin. EmFace will also increase muscle tone on average by 30% with HIFES by selectively contracting muscles and shortening ligaments to increase their density and quality. And finally, EmFace offers an average of 23% more lift of the skin and muscle because of the combined effect of RF and HIFES. Results are proven across 9 clinical studies. There is no downtime whatsoever. 

Sold as a package of 4 treatments. Each session is about 20 minutes. Although you look and feel a little tighter after one treatment, full effects are 30-60 days after your 4th treatment. 





Sei Bella Med Spa is proud to own the first EmFace device in Arkansas. We now own 6 BTL devices....EmsculptNeo, Emtone, EmFemme, Emsella, EmFace and Exion. This company does very rigorous clinical studies to prove efficacy and safety. They even have some FDA approvals for medical diagnoses. This is impressive and important to me.

To schedule an appointment you may call the office at 501-228-6237 or to book directly with our RN, Kathy, you can text her at 501-757-1128

Anne R Trussell MD ABAARM FAARM
owner/physician
Sei Bella Med Spa

10310 West Markham
Suite 202
Little Rock, AR 72205

www.seibellamedspa.net
501-228-6237

#EmFace #EmsculptNeo #Emtone #Emsella #Exion #EmFemme #facelift #bodycontouring #RF #HIFEM #HIFES #cellulite #urinaryincontinence #RF #microneedling #ultrasound #elastin #collagen #hyaluronicacid #face #BTL #BTLAesthetics #coretofloor #noninvasive #nonsurgical #noneedles



Monday, January 2, 2023

Emtone for Cellulite


Almost all of us have cellulite, especially women. Ugh! 80-90% of women develop cellulite after puberty whereas only 10% of men have it. And let me be perfectly clear.....being overweight is not THE cause so stop beating yourself up. Cellulite can appear anywhere but is most common on the butt, thighs and tummy. 


The cause of cellulite is multifactorial and represents a chronic inflammatory process.  Cellulite forms when fibrous bands connecting your skin to the underlying muscle tighten irregularly. This tightening pulls down on your skin, and the layer of fat beneath the skin pushes upward. This results in a puckered appearance to the skin.


In women the subcutaneous tissue connects to the muscles differently than in men. In men, the fibers that make up the connective bands crisscross together. In women, the fibers that make up the connective bands run the same direction and are an equal distance apart. (see above) These "parallel"  bands may show puckering more than crisscross bands. Hormonal factors play a role too. Higher amounts of estrogen cause cellulite. Cellulite often develops more rapidly when women produce more estrogen, like during adolescence or pregnancy.  A high-calorie diet that features a lot of carbs, fats, salt and preservatives can also contribute to the development of more cellulite. And since cellulite is a chronic inflammatory process, it can be made worse by smoking which diminishes blood flow to the area and weakens the formation of collagen. 



Again, cellulite is a chronic inflammatory process, therefore it can be hard to get rid of and keep away. Treatments include liposuction, Qwo, and Cellfina for example, all of which can work but have their associated costs, swelling, bruising and down time. There are multiple at home devices and other noninvasive medical devices as well, none of which we have been very satisfied with in the past. Until now.......

EMTONE IS OUTSTANDING!!



Emtone is the first and only device that delivers both thermal and mechanical energy to treat all the contributing factors to cellulite. In clinical studies Emtone showed a 93% visible reduction in cellulite. 

It is appropriate for all skin and body types. It is completely noninvasive, painless, requires no downtime and requires no anesthesia. We sell Emtone in a package of 4 that usually last 20-30 minutes for each treatment and are done 1 or 2 times per week. Many many people see results after the first treatment. Results typically continue to improve over the next few months as well. 




With this monopolar radiofrequency combined with a targeted pressure energy and  mechanical effect, after an Emtone treatment the size of the fat chambers are diminished. Collagen begins to remodel. Blood flow to the area is enhanced and skin elasticity is restored. Plus, there is an increase in metabolic waste removal. 





It's very popular to combine an Emtone package with an EmsculptNeo package (see previous blog on Emsculptneo.)  Both are noninvasive and painless; they can remove fat, build & tone muscle plus treat cellulite. Ask us about our January 2023 special! 501-228-6237



We look forward to helping you achieve some of your New Year's goals!

Anne R Trussell MD ABAARM FAARM
owner/physician
Sei Bella Med Spa

10310 West Markham
Suite 202
Little Rock, AR 72205

501-228-6237
www.seibellamedspa.net

#Emtone #cellulite #EmsculptNeo #Emsculpt #Emsella #bodycontouring #coretofloor #RF #radiofrequency #monopolarRF #HIFEM #BTL #BTLEsthetics #urinaryincontinence #bodysculpting #bodyshaping #core #musclebuilding #fatloss #fitness #abdomen #booty #legs #physician #doctor #medspa #medicalspa #seibellamedspa #drannetrussell #LittleRock #fatreduction #bodypositivity #newyearsresolutions #nonsurgical #noninvasive 

Tuesday, December 14, 2021

Emsella

 

 
 Emsella is one of our most exciting devices! As a med spa, and as a retired internal medicine physician, I like to focus on health and wellness, not just beauty. Emsella offers just that. It is FDA approved to treat urinary incontinence in women AND men. It is completely noninvasive and you get to stay fully clothed!



Emsella strengthens all the pelvic floor muscles with HIFEM technology (High Intensity Focused Electromagnetic Energy). It's like doing 11,000 Kegels in one 28 minute session. 

BTL has performed multiple studies with multiple providers. An article published in Lasers and Surgery in Medicine, 2019 reported that on average 64.42% of patients showed improvement in their ICIQ-UI score (a score of incontinence severity) and 53.68% decrease in absorbent pad use. 34.3% considered themselves completely cured. 64.29% of patients reported less leakage with sleeping. 44.19% reported they did not need to use absorbent pads at all! This study was done in patients who received 6 treatments. 

Another study published in Female Pelvic Medicine and Reconstructive Surgery Journal, December 19, 2019 showed significant improvement of pelvic floor integrity proven by 3D ultrasound. Treated patients achieved a 3X higher level of improvement in their PDFI-20 questionnaire (another marker of improvement in symptoms.) All assessment methods showed the HIFEM technology (Emsella) is more effective than electrostimulation for treatment of weakened pelvic floor muscles. 


Now let's talk about sexual wellness. Emsella is not FDA approved to improve sexual wellness, orgasms, etc., HOWEVER, studies are showing it works very well in this area! A study presented at the Annual Meeting of the American Society for Laser Medicine and Surgery 2021, reported on 33 females (around 50 years of age) who showed decreased interest in sexual activity accompanied by urinary incontinence.  Both desire and incontinence improved. Makes sense doesn't it? I mean who wants to dribble during sex?! Their ICIQ-UI (see above) score decreased by 61%. FSFI score (sexual function score) increased by 33%. PISQ-12 (another continence, sexual wellness questionnaire) increased significantly by 24%. Patients also benefited from increased sexual desire, improved lubrication, and orgasmic response.



If you're ready to stop dribbling when you cough, laugh or sneeze, ready to stop using pads, sitting with your legs crossed all the time, or having to carry around a change of clothes......give us a call! Emsella is completely noninvasive and painless and may be a great option for you!

501-228-6237

Anne R Trussell MD ABAARM FAARM
owner/physician
Sei Bella Med Spa
10310 West Markham, Suite 202
Little Rock, AR 72205

#drannetrussell #seibellamedspa #BTL BTLEsthetics #urinaryincontinence #coretofloor #sexualwellness #EmsculptNeo #noninvasive #RF #HIFEM #LittleRock #medicalspa #medspa #doctor #physician #incontinence #pelvicfloormuscles #Kegel #pelvicfloor #Kegelexercises

Monday, November 22, 2021

EMSCULPT NEO

 


We are so excited about EMSULPT NEO! We were able to offer noninvasive permanent fat loss with SculpSure, but now we can offer better permanent fat loss painlessly AND build and tone muscle in multiple areas of the body at the same time! BMI up to 35 can benefit unlike other devices!

EMSCULPT NEO is the only non-invasive technology that simultaneously uses Radiofrequency (RF) and HIFEM+ (high intensity focused electromagnetic field) to permanently eliminate fat and build muscle. This results in more fat reduction and more muscle growth than with any other single device. Due to the RF heating, EMSCULPT NEO is the only aesthetic procedure that works out heated muscles, similar to what a warm up activity does before any workout. Fat destruction temperature is reached in less than 4 minutes. Bypassing brain limitations, HIFEM+ energy contracts muscle fibers at intensities not achievable during a voluntary workout. On average muscle volume increases by 25% and fat decreases by 30%.




The synchronized RF is the only patented radiofrequency heating in the world that works simultaneously within a magnetic field. HIFEM+ is the #1 muscle sculpting technology and the Emsculpt Neo has newly designed protocols that operate simultaneously with the RF heating. It offers the fastest thermal effect on the market, with settings that are fully adjustable. And with the Edge applicators that were introduced in December 2022, we can treat flanks and love handles now. In total, we can treat 11 different body areas.



Check out this patient testimonial:




Reproducible results are supported by 7 clinical studies in more than 500 patients and 30 peer-reviewed HIFEM publications since 2018 with more than 30 investigators. This makes HIFEM the most intensively researched technology used in non-invasive body shaping. These results were proven by ultrasound, MRI and electron microscopy.


Multiple applicators allow for effective treatment of multiple body parts including abdomen, buttocks, inner thighs, outer thighs, front of thighs, back of thighs, biceps, triceps, and calves, flanks and love handles. The temperature and intensity of muscle contractions is customizable to each patient and the computer saves all information from previous treatments.


Treatments are usually done in a series of 4-6 sessions approximately a week apart. Call for your appointment today! 501-228-6237. Individual treatments are available, but only recommended for maintenance of results. Treatment packages are needed to achieve optimal results. Price varies depending on area treated and number of treatments. We will go over that with you when you call! 501-228-6237



501-228-6237

#EmsculptNeo #bodysculpting #bodyshaping #bodycontouring #Emsella #BTL #BTLEsthetics #coretofloor #core #musclebuilding #HIFEM #RF #radiofrequency #fitness #fatloss #booty #abdomen #abs #thighs #arms #biceps #triceps #exercise #beauty #weightloss #bodygoals #drannetrussell #LittleRock #seibellamedspa #femaleownedbusiness #physician #doctor #medspa #medicalspa #noninvasive #fatreduction #nonsurgical #nononvasive #sculpting #health #bodypositivity

Sei Bella Med Spa
Anne R Trussell MD ABAARM FAARM
10310 West Markham
Suite 202
Little Rock, AR 72205

www.seibellamedspa.net

Monday, July 19, 2021

SCULPSURE......Permanent Non-Invasive Fat Loss

SculpSure or, "warmsculpting, " as it has come to be called, offers permanent noninvasive fat loss in multiple areas such as arms, bra fat, abdomen, flanks, banana roll (right under the buttocks), love handles, saddle bags and inner & outer thighs. Surgical options include various forms of liposuction which are effective, but can be more costly and definitely result in downtime which SculpSure does NOT have. There is also Coolsculpting which offers permanent non-invasive fat loss as well, but the treatment sessions are longer, and patients usually have bruising and swelling in the treated area that requires massage. With SculpSure there is zero downtime. No bruising. No swelling. 

y


SculpSure uses a 1060 nm laser that targets only fat and has a cooling plate that rests on your skin. This wavelength is clinically proven to selectively target and reduce fat cells without disrupting the skin. "Feathering of heat" ensures that the area being treated is continuous and consistent. It is effective on all skin types and ethnicities. During the laser lipolysis, fat cells are destroyed and naturally eliminated from the body via the lymphatic system. Most results are seen at the 6 and 12 week mark, but permanent fat loss can continue up to 6 months. Tissue samples in clinical studies showed fat cell damage begins as early as the first week and continues up to 6 months.  


So how well does SculpSure work and how satisfied were patients and clinicians with the results in clinical studies?

  • 95% of patients' results could be see in post-treatment photos of the abdomen
  • There was a 1.5 mm reduction at 6 weeks and 2.65 mm reduction in measurements at 12 weeks after just one treatment.
  • 91% of patients were satisfied with their results. 
  • 90% of patients' results could be seen in post treatment photos of the flanks. 
  • Age and BMI have no effect on the results of the treatment.
  • 96% of patients were satisfied with the results on their flanks. 
  • 100% of patients who received SculpSure for post liposuction deformities were graded as improved by blinded evaluators.
  • Physicians rated 100% of the patients as improved who were treated for post liposuction deformities. ,
  • In patients treated for fat removal in the inner thighs and upper arms, 91% were satisfied with their results.
  • There was a 9mm reduction of fat on the arms recorded 6 months after one treatment of SculpSure. 
  • 90% of patients showed a significant change in their fat layer as proven by ultrasound. 






Ask about our SculpSure Club for year long savings. You can treat multiple areas, more than once as needed, for a huge cost savings! Call today to schedule your appointment! 501-228-6237



Anne R Trussell MD ABAARM

owner/physician

Sei Bella Med Spa

 www.seibellamedspa.net

References:

Bass L. Safety and Efficacy of a Noninvasive 1060 nm Diode Laser for Fat Reduction of the Abdomen, Journal of drugs in dermatology: JDD. 2018;17 (1): 106-112

Katz B, Doherty S. Safety and Efficacy of a 1060 nm Diode Laser for Fat Reduction of the Flanks. Dermatologic Surgery. 2018;44(3):388-396

Schilling L, Saedi N, Weiss R. 1060 nm Diode Hyperthermic Laser Lipolysis: The Latest in Non-invasive Body Contouring. Journal of drugs in dermatology: JDD 2017;16(1):48-52

Balaratnam S. Evolution of laser lipolysis in non-invasive fat reduction and body sculpting. Journal of Aesthetic Nursing. 2017;6(9):466-471

Petti C. Stoneburner J. Clinical Study to Assess the 1060 nm Diode Laser for the Treatment of Post-Liposuction Deformities. Lasers in Surgery and Medicine. 2019;51(9):785-789

Petti C. Lasers in Surgery and Medicine. 2018;50(4):369-392

Hoffman, K., Hoffman K. Lasers in Surgery and Medicine. 2017;49(S28)

Bass, L. et al. Lasers in Surgery and Medicine. 2016;48(S27)

McDaniel D., et al. [51} Lasers in Surgery and Medicine. 2016;48(S27)

R. Sierra, J. Decorato, B. Chen. [91] Lasers in Surgery and Medicine. 2014;46(S25)

#SculpSure #fatloss #Coolsculpt #Warmsculpt #bodycontouring #laser #drannetrussell #seibellamedspa #medspa #medicalspa #physician #LittleRock #BMI #SculpSureClub #liposuctionalternative #laserlipolysis #lipolysis #apoptosis