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Frequently Asked Questions

Weight Management

Medication Program

What is considered overweight or obese?
For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the "body mass index" (BMI). BMI is used because, for most people, it correlates with their amount of body fat.
  • An adult who has a BMI between 25 and 29.9 is considered overweight.
  • An adult who has a BMI of 30 or higher is considered obese.
What are the health risks associated with obesity?
The health problems associated with obesity are numerous. Obesity is not just a cosmetic problem. It's a health hazard. Someone who is 40% overweight is twice as likely as an average-weight person to die prematurely. This is because obesity has been linked to several serious medical conditions, including:
  • Heart disease and stroke
  • High blood pressure
  • Diabetes
  • Cancer
  • Gallbladder disease and gallstones
  • Osteoarthritis
  • Gout
  • Breathing problems, such as sleep apnea (when a person stops breathing for a short time during sleep) and asthma
What should I expect when I start a weight loss program?
We offer a comprehensive, medically managed program specially customized to your individual needs, personal medical history and lifestyle requirements, thus ensuring your success.
After filling out the necessary paperwork and forms, see our qualified provider to design and prescribe your program.
Our initial visit includes:
  • Medical history
  • Physical exam
  • Laboratory tests
  • Computerized body analysis
  • Nutritional counseling
  • Personalized food plan
Medication and other products may also be prescribed at this visit and are part of your weekly program regimen.
Routine follow-up visits are scheduled based on your personalized plan and monitored on an individual need basis – weekly, biweekly or monthly.
Counseling by our medical providers on nutrition and behavior modification for permanent lifestyle changes and effective exercise suggestions are tailored to your personal needs.
What appetite suppressants are available? Are they FDA-approved?
Phentermine, Phendimetrazine and Tenuate are FDA-approved prescription medications used to control appetite and aid in weight loss.
What contributes to being overweight and obese?
Overall, a variety of factors play a role in obesity. This makes it a complex health issue to address. Research shows that behavior, environment and genetic factors may have an effect in causing people to be overweight and obese.
Being overweight or obese results from an energy imbalance. This involves eating too many calories and not getting enough physical activity.
Body weight is the result of genes, metabolism, behavior, environment, culture and socioeconomic status.
Behavior and environment play a large role in causing people to be overweight and obese. These are the greatest areas for prevention and treatment actions.

OPTIFAST Program

What are the benefits of the OPTIFAST diet?
People eat less when they have fewer food choices. OPTIFAST is a full meal-replacement diet, restricting your food options for a limited time. This helps control your calorie intake and gives you time to focus on making healthy lifestyle changes.
The OPTIFAST products help you cut calories, not nutrients. They provide 100% of your daily vitamin and mineral needs in convenient, portion-controlled formulas and nutrition bars.
How does the OPTIFAST program work?
Before you enter the OPTIFAST program, you'll receive an initial evaluation to determine if OPTIFAST is right for you. Once you start the program, you'll progress through the three phases described below.
  • Active weight loss: You'll consume the OPTIFAST meal replacement formulas instead of your typical foods so you don't need to worry about counting calories.
  • You will also begin important lifestyle changes.
  • Transition: You'll gradually learn how to add self-prepared foods back into your diet while continuing with lifestyle change education.
  • Long-term management: You can participate in ongoing classes and support sessions to help you manage your weight in the future.
Why would I want to use a product like OPTIFAST without eating food? That sounds like some sort of weird, fad diet!
Have you tried losing weight by carefully measuring your food portions and noticed that the scale still doesn't move? Many people find it difficult to accurately determine portion sizes and eat consistent amounts of food day after day. In fact, studies show that most people actually consume about 50% more calories than they think they do. This is mostly because they are in denial about what they eat. They simply do not have the skills to accurately track what they are eating.
Clinical studies also show that when people are given very few food choices, or even no food choices, it is easier to decrease the amount of calories they consume each day. By taking away the selection and preparation of foods and reducing the array of available foods, people lose weight. This is the concept called "stimuli narrowing." In a portion-controlled formula diet such as OPTIFAST, all the nutrition needed each day is included. The benefits of this type of diet are in the reduced calories, complete nutrition and (perhaps mostly important) ability to stick with the diet because no food choices are made.
Imagine taking a break from food. While your body loses weight and your health improves, you will use the time to learn about good nutrition and healthy eating habits so that when you are again eating food, you are better equipped to manage it.
OPTIFAST weight management products offer:
  • High-quality, complete nutrition
  • Preportioned, calorie-controlled servings
  • Quick, simple preparation
OPTIFAST has been used for over 25 years – hardly a fad diet.
I've read that liquid diets are dangerous and people gain all of their weight back once they start eating regular food. Is this true?
The OPTIFAST formula has all the nutrients that are required for good health. This is something that nearly all fad diets do not have. In fact, the initial liquid diets that were used in the 1970s were much different – they used low-quality protein with few other essential nutrients. Today, liquid diets are medically supervised to ensure safety.
When was the last time you were on a diet and were being closely followed by a physician who was trained specifically to help you, and to ensure the safety of your treatment?
As far as gaining back the weight, this could happen if a person just did the liquid formula diet and made no other changes, like the latest fad diets. Our team of professionals, including behaviorists, dietitians and exercise specialists, provides very intensive education and support. This is necessary to help individuals successfully discover their own issues related to weight management and help guide their habits. Plus our maintenance program provides the ongoing support needed to help make these long-term changes in your lifestyle.
Will I be hungry if I'm not eating regular foods?
The feeling of hunger and the impulsive desire to eat are real concerns. The causes of hunger, whether physical or emotional, are difficult to determine. To increase success in sticking with the diet program, controlling hunger is the primary objective. This control involves both preventing and managing hunger sensations. The program staff will suggest various techniques to accomplish this goal. The good news is that, for most participants, hunger sensations fade within a few days to two weeks after starting the program.

HGC Program

What is HCG?
Human chorionic gonadotropin (HCG) is a naturally occurring hormone produced by the placenta during pregnancy. This hormone allows the body to mobilize fat and use it as energy, helping to protect and preserve our lean body mass – our muscle.
How and why does HCG work?
HCG injections keep you from losing muscle while you diet. By elevating hormone levels in the body, including testosterone, the HCG hormone creates an anabolic (muscle-building) state, which counteracts the catabolic (muscle-breakdown) state. There are hormone receptors on muscle fibers that respond to the increased hormone levels in patients taking the HCG hormone.
During low-calorie crash dieting, a high amount of muscle is lost. Because muscle is heavy, the pounds are dropping quickly, and this loss looks good on the scale. But when you lose muscle, it’s bad for your metabolism, body and shape. The metabolism slows so much that dieters regain weight quickly, often regaining all the weight that was lost and then some. Additionally, it takes quite a bit of work to build back the muscle that has been lost. Our HCG protocol protects muscle from being lost and promotes more fat loss. The great result is that one can become leaner, in a smaller clothing size, but with more muscle. This muscle allows for a stronger metabolism and helps people maintain their weight loss long after their diet is completed.
Is HCG an appetite suppressant?
HCG is not an appetite suppressant medication. It does not curb your appetite. However, because the HCG diet causes a release of excess stored fat into your body to use as fuel, you won't feel hungry on our low-calorie, high-protein diet.
Do I have to have a shot, and does it hurt?
HCG is a prescribed medication administered by your provider. HCG drops or pills do not contain any noticeable HCG because HCG is only available by prescription by your provider. HCG is given in the fatty tissue and is absorbed into the body to get the full effect of the medication. The needle is very tiny, and the shot has little to no discomfort.
What do I eat on the HCG diet?
A low-calorie, high-protein diet. The food plan must be followed faithfully. The diet begins at 500 calories. Each patient's food plan is based on their needs and health conditions. Calories could be increased but will not go higher than 1,000.
What is the Diet Shot?
The Diet Shot is an injection that will help you keep your energy up and lose inches at the same time.
Do I need to exercise?
Exercise is not mandatory on this diet, but moderate cardio activity can be beneficial to any diet plan.
Will the weight come back after I am finished with the HCG diet?
When you follow the HCG diet, your metabolism and eating habits improve. After the program is completed, a maintenance plan is followed for several weeks. The knowledge and discipline learned while dieting help you long-term to successfully keep the weight off.
What are the benefits of the HCG diet?
  • Reduced appetite
  • Increased energy
  • Rapid weight loss
  • Maintaining lean muscle tissue
  • Converts fat to energy
  • Improved sense of well-being
  • Decreased risk of rebound weight gain
  • No reported adverse side effects

Diet Shot

What is the Diet Shot?
The Diet Shot is an injection that will help you keep your energy up and lose inches at the same time.
What does the Diet Shot do?
The Diet Shot helps increase energy and helps fat cells release their stored fat to be burned as energy, thus aiding in inch loss.
What does the Diet Shot contain?
The Diet shot contains our special formulas of B12, B6 and Adenosine-5-Monophosphate.
What is Adenosine-5-Monophosphate?
It is a substance that occurs naturally in your body. It is currently being used in the treatment of chronic fatigue syndrome and fibromyalgia. While treating people for these conditions, researchers discovered that there was a side effect of using the adenosine. The patients had a noticeable reduction in their waistlines and other areas. Further research led to the discovery that the adenosine actually has a cellular-level effect on the body, causing fat cells to release their stored fat to be burned as energy.
Why can’t I just take a pill?
The medication in the shot is absorbed better when taken orally, especially B12.
How often can I get a shot?
You can have three regular-size shots or two large shots per week. Having regular shots helps keep the level of medication at its peak; however, having only one shot per week can still be beneficial.

Metabolic Syndrome

What is metabolic syndrome?
Metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke and diabetes.
Having just one of these conditions – increased blood pressure, elevated insulin levels, excess body fat around the waist or abnormal cholesterol levels – isn't diagnosed as metabolic syndrome, but it does contribute to your risk of serious disease. If more than one of these conditions occur in combination, your risk is even greater.
What are the symptoms?
Having metabolic syndrome means you have several disorders related to your metabolism at the same time, including:
  • Obesity, particularly around your waist (having an "apple shape")
  • Elevated blood pressure
  • An elevated level of the blood fat called triglycerides and a low level of high-density lipoprotein (HDL) cholesterol – the "good" cholesterol
  • Resistance to insulin, a hormone that helps to regulate the amount of sugar in your body
Having one component of metabolic syndrome means you're more likely to have others. The more components you have, the greater the risks to your health.
If you have metabolic syndrome or any of the components of metabolic syndrome, you have the opportunity to make aggressive lifestyle changes. Making these changes can delay or derail the development of serious diseases that may result from metabolic syndrome.
What are the causes?
Research into the complex underlying process linking the group of conditions involved in metabolic syndrome is ongoing. As the name suggests, metabolic syndrome is tied to your body's metabolism, possibly to a condition called insulin resistance. Insulin is a hormone made by your pancreas that helps control the amount of sugar in your bloodstream.
Normally, your digestive system breaks down some of the foods you eat into sugar (glucose). Your blood carries the glucose to your body's tissues, where the cells use it as fuel. Glucose enters your cells with the help of insulin. In people with insulin resistance, cells don't respond normally to insulin, and glucose can't enter the cells as easily. Your body reacts by churning out more and more insulin to help glucose get into your cells. The result is higher than normal levels of both insulin and glucose in your blood.
Although perhaps not high enough to qualify as diabetes, an elevated glucose level still interferes with your body processes. Increased insulin raises your triglyceride level and other blood fat levels. It also interferes with how your kidneys work, leading to higher blood pressure. These combined effects of insulin resistance put you at risk of heart disease, stroke, diabetes and other conditions.
Combination of factors – Researchers are still learning what causes insulin resistance. It probably involves a variety of genetic and environmental factors. They think some people are genetically prone to insulin resistance, inheriting the tendency from their parents. But being overweight and inactive are major contributors.
Disagreement among experts – Not all experts agree on the definition of metabolic syndrome or whether it even exists as a distinct medical condition. Doctors have talked about this constellation of risk factors for years and have called it many names, including syndrome X and insulin resistance syndrome. Whatever it's called, and however it's precisely defined, this collection of risk factors is apparently becoming more prevalent.
What are the risk factors?
The following factors increase your chances of having metabolic syndrome:
  • Age – The prevalence of metabolic syndrome increases with age, affecting less than 10% of people in their 20s and 40% of people in their 60s. However, some research shows that about one in eight schoolchildren has three or more components of metabolic syndrome. Other research has identified an association between childhood metabolic syndrome and adult cardiovascular disease decades later.
  • Race – Hispanics and Asians seem to be at greater risk of metabolic syndrome than other races are.
  • Obesity – Obesity has been recognized as a disease since 1985. A body mass index (BMI) – a measure of your percentage of body fat based on height and weight – greater than 25 increases your risk of metabolic syndrome. So does abdominal obesity (having an apple shape rather than a pear shape).
  • History of diabetes – You're more likely to have metabolic syndrome if you have a family history of type 2 diabetes or a history of diabetes during pregnancy (gestational diabetes).
  • Other diseases – A diagnosis of high blood pressure, cardiovascular disease or polycystic ovary syndrome – a similar type of metabolic problem that affects a woman's hormones and reproductive system – also increases your risk of metabolic syndrome.
When to seek medical advice?
If you know you have at least one aspect of metabolic syndrome – such as high blood pressure, high cholesterol, an apple-shaped body or being overweight – you may have the others and not know it. It's worth checking with Etcetera Medical Group, specializing in weight loss and lifestyle changes.   Ask our doctor whether you need testing for other components of the syndrome and what you can do to avoid serious disease.
What are the tests and diagnosis?
Although your doctor is not typically looking for "metabolic syndrome," the label may apply if you have three or more of the traits associated with this condition.
Several organizations have criteria for diagnosing metabolic syndrome. The National Cholesterol Education Program (NCEP) created these guidelines with modifications by the American Heart Association. According to these guidelines, you have metabolic syndrome if you have three or more of these traits:
  • Elevated waist circumference (greater than 35 inches for women and 40 inches for men). Certain genetic risk factors, such as having a family history of diabetes or being of Asian descent – which increases your risk of insulin resistance – lower the waist circumference limit. If you have one of these genetic risk factors, waist circumference limits are 31-35 inches for women and 37-39 inches for men. Elevated level of triglycerides of 150 milligrams per deciliter (mg/dL) or higher, or you're receiving treatment for high triglycerides.
  • Reduced HDL (less than 40 mg/dL in men or less than 50 mg/dL in women), or you're receiving treatment for low HDL.
  • Elevated blood pressure of 130 millimeters of mercury (mm Hg) systolic (the top number) or higher or 85 mm Hg diastolic (the bottom number) or higher, or you're receiving treatment for high blood pressure.
  • Elevated fasting blood sugar (blood glucose) of 100 mg/dL or higher, or you're receiving treatment for high blood sugar.
What are the treatments used?
Tackling one of the risk factors of metabolic syndrome is tough; taking on all of them might seem overwhelming. Contacting Etcetera Medical's professional staff, who are experienced in weight loss and can prescribe appropriate medication when warranted – and lifestyle changes – can improve all of the metabolic syndrome components. Losing weight, getting more physical activity and quitting smoking help reduce blood pressure and improve cholesterol and blood sugar levels.
These changes are key to reducing your risk.
  • Lose weight – Losing as little as 5-10% of your body weight can reduce insulin levels and blood pressure and decrease your risk of diabetes.
  • Eat healthy – The Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean Diet, like many healthy-eating plans, limit unhealthy fats and emphasize fruits, vegetables, fish and whole grains. Both of these dietary approaches have been found to offer important health benefits (in addition to weight loss) for people who have components of metabolic syndrome. Ask your doctor for guidance before starting a new eating plan.
  • Exercise – Doctors recommend getting 30-60 minutes of moderate intensity exercise, such as brisk walking, every day.
  • Stop smoking – Smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help kicking the cigarette habit.
Etcetera Medical works with you to monitor your weight, blood glucose, cholesterol and blood pressure levels to ensure that your diet and lifestyle modifications are working. Our doctor may also prescribe medications to help control your appetite and to help your body use insulin more effectively.
How to help prevent and combat metabolic syndrome?
Whether you have any of the components of metabolic syndrome, the following lifestyle changes will help you control your weight and reduce your risk of heart disease, diabetes and stroke:
  • Lose weight – Losing as little as 5-10% of your body weight can reduce insulin levels and blood pressure and decrease your risk of diabetes.
  • Commit to a healthy diet – Eat fiber-rich foods. Make sure you include whole grains, beans, fruits and vegetables in your grocery cart. These items are packed with dietary fiber, which can lower your insulin levels. Choose lean cuts of white meat or fish over red meat. Avoid processed or deep-fried foods. Eliminate table salt and experiment with other herbs and spices.
  • Exercise – Doctors recommend getting 30-60 minutes of moderate-intensity exercise, such as brisk walking, every day.
  • Stop smoking – Smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help kicking the cigarette habit.
Schedule regular checkups. Check your blood pressure, cholesterol and blood sugar levels on a regular basis. Make additional lifestyle modifications if the numbers are going the wrong way. Contact Etcetera Medical for the professional help you may need.

Laser Treatments

IPL Photo Facial

What type of skin problems does a photo facial correct?
The photorejuvenation process uses pulsed light to treat pigmented and vascular lesions, for overall improvement of skin tone.
  • Pigmented lesions – There are two types of pigmented lesions: solar lentigines (more commonly known as sunspots, age spots or liver spots) and actinic bronzing (overall browning of the skin).
  • Vascular lesions – There are two types of vascular lesions. Telangiectasia (also known as spider veins) are tiny capillaries that appear near the surface of the face. They may be red, blue or purple in color. Rosacea is an inflammation and swelling of the face.
Pulsed light – how does it work?
The photorejuvenation process is performed by Palomar pulsed light systems. Pulsed light systems are similar to lasers but with a larger beam for wider coverage and faster, more comfortable treatments. During photorejuvenation treatments, pulses of filtered light are directed onto the skin and absorbed by the melanin for pigmented lesions and by the blood for vascular lesions.
  • Pigmented lesion treatments – The Photorejuvation light pulse is directly absorbed by the pigment in the lesion. The light heats the pigment and breaks it up. The lesion darkens and crusts after treatment and is naturally shed from the skin after approximately 10 days.
  • Vascular lesion treatments – Photorejuvenation light pulses heat to the small capillaries that cause telangiectasia, rosacea and other vascular lesions. The heat shrinks these capillaries, which may redden or become gray after treatment. They then fade from view after approximately 10 days.
Will photorejuvenation treatments hurt?
Photorejuvenation uses a unique long pulse width that delivers energy to the skin over a relatively long period of time without overheating the epidermis. This makes the pulses safer and more comfortable. You may experience a feeling similar to that of a rubber band being snapped on the skin, but most people do not report this sensation as painful.
Are there any adverse reactions to treatment?
You may experience temporary redness and a mild sunburnlike effect that may last a few hours to a few days.

IPL Laser Hair Removal

Pulsed light hair removal – how does it work?
Pulses of concentrated light are directed onto the skin and absorbed by the hair follicles. Pulsed light systems are similar to lasers, but with a larger, smooth beam, and a long pulse for safe, fast and comfortable treatments.
Please explain the hair growth cycles.
  • Anagen phase – Anagen is the active phase of hair growth and generally lasts for several months. This is the best phase for the pulsed light systems to disable new hair as it grows.
  • Catagen phase – During this brief phase, the hair bulb regresses and begins to shrink.
  • Telogen phase – At the end of this resting phase, which typically lasts a few months, hair is released from the shriveled follicles and the anagen phase begins again.
Will the treatments hurt?
Palomar pulsed light systems use a unique long pulse width that delivers energy to the skin over a relatively long period of time. This makes the pulses safer and more comfortable. You may experience a feeling similar to that of a rubber band being snapped on the skin, but most people do not report this sensation as painful.
Are there any adverse reactions to treatment?
You may experience temporary redness and a mild sunburnlike effect that may last a few hours to a few days.
How many treatments will I need?
The number of treatments varies depending on the person, the body part being treated and how much of the hair is in the active phase of growth. Your treatment provider will be able to give you a better assessment after consultation.

Fractional Skin Resurfacing

What is laser resurfacing?
Palomar 1540 Fractional Laser is a revolutionary approach to all laser resurfacing procedures. It is used to treat lines, wrinkles, age spots and melasma from years of accumulated sun-damaged skin and scarring. It can treat all types of scars, especially acne scars and stretch marks.
There is no cutting of the skin, so patients can achieve the same positive effects of ablative laser procedures (CO2 and Erbium lasers) and deep chemical peels without the associated downtime or potential side effects.
How does Star Lux Fractional Skin Resurfacing System work?
The Palomar Lux1540 Fractional Laser handpiece delivers light in an array of narrow, focused “microbeams” to create columns of coagulation (heat) within the skin. Think of pixels in a photo when you think of fractional laser treatment (FLT). If you look at a newsprint photo up close, you’ll see that the image is actually comprised of thousands of tiny spots of ink. Similarly, FLT produces thousands of tiny treatment zones on the skin known as microthermal zones (MTZs) in the emerging science of fractional photothermolysis. The spared healthy tissue between treatment zones contains viable cells that promote a rapid natural healing process that forms new healthy tissue. The result is a fresher, more youthful skin tone and texture. Thus, FLT strives to achieve the skin improvements obtained with conventional CO2 laser resurfacing but without the associated side effects or downtime.
What areas can I have treated?
The1540 Fractional Laser can treat areas on the face (including around the lips and eyes), neck, arms, hands, stomach, buttocks and most other areas of the body.
What makes StarLux fractional treatments different from other skin resurfacing methods?
Some skin resurfacing devices, such as CO2 lasers, use the ablative method, which removes the epidermis and some of the dermis. While good results are eventually seen, the drawbacks include red and raw skin and a risk of infection for several weeks after treatment.
Other devices use the nonablative method, sending light pulses into the dermis while leaving the epidermis intact. This allows quick recovery, but when the light pulses don’t penetrate far into the dermis, the change in skin tone and texture is less effective.
StarLux fractional skin resurfacing offers both superior results and little to no downtime. The Lux1540 beams penetrate deeper into the dermis than competing devices for effective, long-term results. The fractional, nonablative approach stimulates quick healing in the dermis while leaving the epidermis intact, with no lasting redness.
StarLux fractional skin resurfacing treatments are also easier than other technologies, which can involve long prep and clean-up time. Some devices even require that dye be applied to your skin, which is difficult to rinse off after treatment. StarLux doesn’t require dye or prolonged appointments. Treatments are quick and convenient to your schedule.
Are these treatments safe?
By delivering light as individual pulses of microbeams, the Lux1540 protects the skin from the overheating that can result from many other resurfacing treatments. There is limited, if any, risk of infection or scarring. No oozing or crusting occurs as with other ablative technology.
Do the treatments hurt?
The Lux1540 features built-in cooling of the skin, so you feel only minor discomfort during treatment. The treatment is well tolerated and has been explained as feeling a prickling sensation. A topical anesthetic ointment is applied prior to treatment to allay the discomfort.
What should I expect after treatment? When can I return to my daily activities?
The Lux1540 Fractional Laser offers the benefits of speedy healing and minimal to no downtime. Side effects are minimal for most patients, and typically involve redness, warmth, swelling or tightness in the treated area. Most mild swelling should subside within a day or so, and redness usually fades over several days. The skin may often have a pinkish tone for five to seven days. Patients can apply makeup immediately after treatment to cover the redness. Generally, you can receive a treatment and go back to work or to other activities without any recovery time.
When will I see results?
Because the light pulses are confined to narrow columns in the skin, much of the skin is left unaffected and there is a quick healing process. Most people notice a positive change in skin tone and texture within a few days. The skin gradually becomes softer, smoother and fresher. Fine lines around your eves and mouth will noticeably fade. So will uneven coloring and the brown spots caused by aging and sun exposure.
How many treatments do I need?
You will see improvements with each treatment session. Clinical studies suggest that three to five treatments spaced about two to six weeks apart produce a gradual remodeling of dermal matrix components, until complete healing occurs and “good” material that contains collagen and elastin replaces old epidermal and dermal tissue. Over a period of one to three months, clinical improvement in photo-aged skin correlates with dermal repair and positive skin changes.

Rejuvenating Treatments

BOTOX®

What causes lines and wrinkles?
The lines that appear on your face actually result from muscle movement and the passage of time. For example, two muscles are largely responsible for frown lines between the brows. When those muscles contract, they draw the brows together. As skin becomes less elastic over time, repeated frowning can result in those moderate to severe lines between your brows.
How does BOTOX® cosmetic help?
BOTOX® Cosmetic works by blocking nerve impulses, which reduces the movement of those muscles. With less movement, the skin surface gradually smooths out, and the moderate to severe frown lines between your brows begin to fade. BOTOX® treats the cause of these lines by reducing the muscle contractions that cause the lines to form over time.
How does BOTOX® help excessive sweating of underarms, hands and feet?
BOTOX® treatment helps control this condition by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. When the sweat glands don't receive chemical signals, the severe sweating stops. BOTOX® treatment is very effective. Clinical studies involving 322 patients show that 81% achieved a greater than 50% reduction in sweating – compared to only 41% not treated with BOTOX®.
What is the treatment like?
BOTOX® Cosmetic is a quick and minimally invasive treatment. Our doctor makes a few tiny injections into the muscles that cause moderate to severe lines, or just under the skin of the underarm, hands or feet in the area of severe sweating. The doctor will determine exactly where to administer the injection to achieve the best results. No anesthesia is required. The entire procedure takes approximately 10 minutes. Discomfort is minimal and brief, most patients compare the sensation to a bug bite. You may resume normal activity immediately.
How soon will I see a difference, and how long will it last?
For lines and wrinkles, you can expect to see results within days after your treatment; however, the full benefit is usually reached in about 10 days. Touch-ups may be necessary.
Visible results can last up to four months. After that, you may be ready to return for a follow-up treatment. Your own results may vary. Be sure to talk to the doctor about what you can expect.
For excessive underarm sweating, and excessive sweating of the hands and feet, you should notice a significant reduction in sweating within four weeks of your first treatment. There is a possibility that some sweat glands may be missed, and you may continue to experience some sweating from untreated areas. If you do not see a significant reduction in sweating, you should contact the doctor for a follow-up consultation. The median duration of response was 201 days, or 6.7 months. It is not a cure; your symptoms will return gradually, and you will know when the time is right for another treatment.
For your convenience, schedule your follow-up treatment in advance. If you decide not to continue with BOTOX®, the area treated will eventually go back to its pretreatment appearance or condition.
Are there any adverse reactions to treatment?
For those who have encountered adverse effects, the most common include headache, respiratory infection, flu-like symptoms, temporary eyelid droop and nausea. Other side effects include pain and redness at the injection site, pain in the face and muscle weakness. These effects generally occur within the first week and usually go away on their own. Patients with neurological disorders such as ALS, myasthenia gravis, or Lalmbert-Eaton syndrome may be at increased risk of serious side effects. Most patient do not have any adverse reactions.
How does BOTOX® cosmetic compare to other options?
Compared to other aesthetic treatment options, BOTOX® Cosmetic is relatively inexpensive. According to a survey by The American Society for Aesthetic Plastic Surgery, it is one of the least costly facial aesthetic procedures.
BOTOX® Cosmetic can make a big difference in the appearance of your lines and wrinkles. It is a great way to invest in yourself!

JUVÉDERM® Ultra XC & Ultra Plus XC

What is JUVÉDERM®?
JUVÉDERM® is the only HA filler with FDA approval to last up to one year. Ask your physician how you can get long-lasting results with JUVÉDERM®.
JUVÉDERM® injectable gel is a "next-generation" smooth-consistency gel dermal filler that helps to instantly restore your skin's volume and smooth away facial wrinkles and folds such as "smile lines" (or nasolabial folds – the creases that run from the bottom of your nose to the corners of your mouth). JUVÉDERM® comes in two formulations: JUVÉDERM® Ultra and JUVÉDERM® Ultra Plus.
JUVÉDERM® is indicated for injection into the mid- to deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds).
What does JUVÉDERM® do?
JUVÉDERM® injectable gel temporarily adds volume to facial tissue and restores a smoother appearance to the face.
What is JUVÉDERM® indicated for?
JUVÉDERM® Ultra and JUVÉDERM® Ultra Plus injectable gels are indicated for injection into the mid- to deep dermis (below the outer layer of skin) for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds (the creases running from the bottom of your nose to the corners of your mouth, aka smile lines or parentheses).
Why does JUVÉDERM® come in two formulations?
JUVÉDERM® injectable gel is available in two formulations to allow your health care professional to tailor treatment to your unique needs. JUVÉDERM® Ultra provides versatility in contouring and volumizing facial wrinkles and folds. JUVÉDERM® Ultra Plus is a more robust formulation for volumizing and correcting deeper folds and wrinkles.
What makes JUVÉDERM® different from other dermal fillers?
JUVÉDERM® is the only hyaluronic acid (HA) filler FDA-approved to last up to one year. The unique manufacturing process provides a high concentration of cross-linked hyaluronic acid for long-lasting results. It also works to create a smooth-consistency gel that flows easily into the skin and provides a smooth, natural look and feel. All other hyaluronic acid dermal fillers currently on the market are made of granular-consistency gels. JUVÉDERM® is the first hyaluronic acid dermal filler that has demonstrated its safety and effectiveness in persons of color.
What is hyaluronic acid?
Hyaluronic acid is a naturally occurring substance found in all mammals that helps to hydrate and add volume to your skin. In addition to its use as an aesthetic treatment, hyaluronic acid has also been used for more than 20 years for injection into arthritic joints to aid movement, as well as for eye surgeries and wound repair.
What is cross-linked hyaluronic acid?
"Uncross-linked" hyaluronic acid in its natural form is in a liquid state. "Cross-linking" is the process through which hyaluronic acid is made into a gel product that can be injected into the skin for long-lasting results.
How is JUVÉDERM® injectable gel used in treatment?
Our health care provider eases JUVÉDERM® injectable gel into the skin using a fine needle to temporarily fill in and augment the treatment area and smooth moderate to severe facial wrinkles and folds such as "smile lines" (nasolabial folds) and "marionette lines" (oral commissures). JUVÉDERM® temporarily adds volume to the skin and may give the appearance of a smoother surface.
What will treatment with JUVÉDERM® injectable gel accomplish?
JUVÉDERM® injectable gel will help to smooth moderate to severe facial wrinkles and folds. Most patients need one treatment to achieve optimal wrinkle smoothing. One treatment could smooth your lines and wrinkles for up to one year. Ask your doctor what you should expect from your initial treatment and when they would recommend rescheduling another appointment.
Is treatment with JUVÉDERM® injectable gel painful?
Injections may cause some discomfort during and after the injection. The smooth-consistency gel of JUVÉDERM® allows your doctor to administer it easily and smoothly. JUVÉDERM® is injected directly into the skin using a fine needle to reduce injection discomfort. An anesthetic may be used to numb the treatment area to further minimize discomfort. The new JUVÉDERM® XC injectable gel is a colorless hyaluronic acid gel that contains a small quantity of local anesthetic lidocaine to help prevent discomfort.
How long does treatment usually take?
The injection process takes only about 15 minutes. You'll also need to allow time to consult with your doctor prior to treatment.
Does the correction last forever?
No. Correction is temporary; therefore, touch-up injections (as well as repeat injections) are usually needed to maintain optimal corrections.
How long do results last?
JUVÉDERM® is the only hyaluronic acid (HA) filler FDA-approved to last up to one year.
What are the possible side effects of JUVÉDERM® injectable gel?
Most side effects are mild or moderate in nature, and their duration is short-lasting (seven days or less). The most common side effects include, but are not limited to, temporary injections site reactions such as redness, pain/tenderness, firmness, swelling, lumps/bumps, bruising, itching and discoloration. As with all skin injection procedures, there is a risk of infection.
Can people with different skin tones/colors be treated with JUVÉDERM®?
Yes. In fact, JUVÉDERM® injectable gel is the first FDA-approved hyaluronic acid dermal filler that has proven its safety and effectiveness in persons of color. Studies with JUVÉDERM® showed no increased risk of hyperpigmentation or hypertrophic scarring in patients of color.

JUVÉDERM® VOLBELLA® XC

What is VOLBELLA®?
VOLBELLA® is the newest dermal filler from the JUVÉDERM® family of products, uniquely designed for the lips and perioral area. Composed of hyaluronic acid (HA), VOLBELLA® immediately plumps the lips. Right away, patients can see better definition and fuller, more contoured lips.
What does VOLBELLA® treat?
VOLBELLA® is specifically designed for the lips and the areas around the lips. In the lips, it provides volume and can shape the lips, enhancing the borders and improving the definition. It will also smooth out the lines that form on the lips over time. In the areas directly around the lips, VOLBELLA® can fill in fine lines, such as the smoker’s lines which are frequently seen as smokers or nonsmokers age.
VOLBELLA® can help to:
  • Define the natural contour by accentuating the vermillion border (outline of the lips)
  • Smooth the fine, vertical lines appearing around the lips (also known as smoker’s lines)
  • Enhance the cupid’s bow (the dip in the middle of the upper lip) leading to a pouty/sexy appearance
  • Treat oral commissures (where the corners of the mouth turn down)
  • Treat marionette lines, which appear from the corners of the mouth and course down to the chin
How does it work?
VOLBELLA® is a smooth gel injected by an Etcetera practitioner, using an ultra-fine needle. VOLBELLA® is a lip filler specifically developed to give a soft, natural feel and to make the injection easier and less painful. The gel fills in lip lines and wrinkles while the hyaluronic acid within attracts and retains moisture so results can last up to a year.
Because it also includes a local anesthetic, clients will find this lip injection process much more comfortable than currently available treatments.
VOLBELLA® is formulated with Vycross™, a proprietary filler technology from Allergan, engineered to address specific concerns such as lip fullness and fine lines.
Allergan’s trademarked Vycross™ technology provides the following benefits:
  • Softer filler, making the injection easier and less painful
  • Less swelling post-treatment
  • Natural-looking results
  • Longer-lasting results
Who is the ideal candidate for VOLBELLA®?
JUVÉDERM® VOLBELLA® is intended for patients over the age of 21, unhappy with the look of their lips. Men and women with deflating or small lips, or noting diminishing lip borders, can make excellent candidates for the noninvasive technique. VOLBELLA® is safe for all skin types and ethnicities. The ideal patient will be in overall good health and hold a general understanding of the lip filler process, as well as have reasonable expectations for their final results. Anyone with a known allergy to lidocaine or gram-positive bacteria, or a history of hypertrophic scarring, may not be right for VOLBELLA®. Additionally, women who are pregnant or nursing may be encouraged to postpone their VOLBELLA® treatment.
Ideal candidate:
  • Good lip structure
  • Wanting subtle enhancement
  • Perfect for first-time patients
  • Complaining of dried cracked lips – provides a glossy, hydrated look
Is treatment with VOLBELLA® painful?
Injections may cause some discomfort during and after the injection. The smooth-consistency gel of VOLBELLA® allows our providers to administer it easily and smoothly. VOLBELLA® is injected using a fine needle to reduce injection discomfort. At Etcetera, we numb the treatment area with a topical cream or injection to maximize your comfort.
When can I return to work after my VOLBELLA® injections?
There is no downtime necessary after VOLBELLA® injections, so patients are free to return to work or class immediately after treatment.
When will I see results from my VOLBELLA® injections?
Patients can see the benefits of VOLBELLA® injections immediately after treatment. Then, as the HA stimulates the body’s production of collagen, the results will continue for up to 12 months.
What are the possible side effects of VOLBELLA®?
Treating wrinkles with VOLBELLA® is fast and safe and leaves no scars or other traces on the face. Most side effects are mild or moderate in nature, and their duration is short-lasting (seven days or less). The most common side effects include, but are not limited to, temporary injections site reactions such as redness, pain/tenderness, firmness, swelling, lumps/bumps, bruising, itching and discoloration. As with all skin-injection procedures, there is a risk of infection. People with a history of cold sores may experience a recurrence after the treatment, although this can be minimized by the use of antiviral medicines.
What makes VOLBELLA® different from other dermal fillers?
VOLBELLA® is the only hyaluronic acid filler FDA-indicated for lip enhancement approved to last up to one year after initial treatment with full correction. The manufacturing process provides a more efficient and tightly cross-linked hyaluronic acid gel for long-lasting results. It also works to create a smooth-consistency gel that flows easily into the skin and provides a smooth, natural look and feel. The JUVÉDERM® family of fillers, made of monophasic gel, provides a smooth consistency that feels natural to the patient, resulting in higher satisfaction.
Can VOLBELLA® be used with JUVÉDERM®?
Yes. VOLBELLA® treats the fine lines first; then JUVÉDERM® can be used as a plumping agent to augment the lips when fuller lips are desired.

JUVÉDERM® VOLUMA® XC

What is JUVÉDERM® VOLUMA® XC?
JUVÉDERM® VOLUMA® XC injectable gel is a smooth, colorless, hyaluronic acid (HA) gel that contains a small quantity of local anesthetic (lidocaine). HA is a naturally occurring sugar found in the human body. The role of HA in the skin is to deliver nutrients and help the skin retain its natural moisture and softness. The addition of lidocaine helps to improve the comfort of the injection. JUVÉDERM® VOLUMA® XC injectable gel is manufactured using Vycross™ technology to give a specialized smooth-gel filler that produces long-lasting results at the treatment site. JUVÉDERM® VOLUMA® XC is delivered by an injection into the cheek and the surrounding area of the midface to correct volume and fullness.
What is it for?
JUVÉDERM® VOLUMA®XC is indicated for deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation to correct age-related volume deficit in the midface in adults over the age of 21.
What does it do?
As you age, the cheek area loses its youthful shape. The cheeks flatten out and the skin may begin to sag. JUVÉDERM® VOLUMA® XC injectable gel is designed to temporarily reverse these signs of aging. It is a gel that is injected into the cheek area to lift the skin. It temporarily adds volume to the cheek area and results in a smoother contour and more youthful appearance to the face.
How is it used?
It is injected into the cheek area using a small needle. It temporarily corrects volume in the cheek area and gives the appearance of a more youthful, smoother skin surface.
What should I expect after a JUVÉDERM® VOLUMA® XC injection?
Results are immediate and can last up to two years. The duration of filler correction depends on the facial area treated, the injection technique and the rate at which the patient’s tissues break down the filler. The majority of patients can resume their daily activities immediately after treatment. Some patients may experience slight swelling and bruising, but this typically improves rapidly.
Is there any downtime after a JUVÉDERM® VOLUMA® XC injection?
There is no downtime after treatment, and patients may return to their normal activities. In some patients, there are transient side effects, such as minor swelling and bruising, but these are usually mild.
What are the common side effects of a VOLUMA® treatment?
Side effects are generally minor, such as bruising or mild swelling, and can be easily concealed with makeup. Avoiding certain medications and supplements, such as baby aspirin and fish oil, can minimize bruising.
How do I know if VOLUMA® is right for me?
Etcetera's providers will perform a complete evaluation and consultation to determine if VOLUMA™ is right for you.
Can JUVÉDERM® VOLUMA® XC be removed or dissolved?
One of the major advantages of JUVÉDERM® VOLUMA™ XC is that it is composed of hyaluronic acid (HA). If necessary, HA fillers can be dissolved with an enzyme in a very simple procedure. Experienced injectors rarely need to remove any filler after it has been injected, but this is a benefit to have as a potential option.
Are the treatments with JUVÉDERM® VOLUMA® XC painful?
Patients usually report only minimal or mild discomfort during treatment. Etcetera uses a specially formulated numbing cream that alleviates most discomfort. JUVÉDERM® VOLUMA® XC is also formulated with lidocaine to enhance patient comfort. During treatment, ice may also be used for some patients.
Can JUVÉDERM® VOLUMA® XC be combined with other facial fillers?
JUVÉDERM® VOLUMA® XC can often be combined with other facial fillers. In fact, our providers often use different fillers for the same patient in order to achieve a more natural result. VOLUMA® is well suited for many areas of the face, such as the cheeks, but is not ideal for certain areas such as the lips.
What ages are most appropriate for treatment with JUVÉDERM® VOLUMA® XC?
While theoretically, any patient with a deficiency in the midface could benefit from VOLUMA® treatment, there are some important principles to understand when it comes to selecting appropriate patients for VOLUMA® treatment. Younger patients with early fat volume loss often notice a more dramatic restoration of their facial volume due to excellent skin elasticity. Older patients, on the other hand, typically require more filler in order to achieve optimal correction. Often these patients benefit from other treatments, such as BOTOX® and laser resurfacing, to create a more complete facial rejuvenation. But overall, there are no absolute age limits for VOLUMA® treatment.

LATISSE®

What is LATISSE® (bimatoprost ophthalmic solution) O.03%?
LATISSE® solution is a prescription treatment for hypotrichosis used to grow eyelashes, making them longer, thicker and darker.
What is hypotrichosis of the eyelashes?
Hypotrichosis is another name for having inadequate or not enough eyelashes.
How does LATISSE® work?
The active ingredient in LATISSE® is bimatoprost. Although the precise mechanism of action is not known, research suggests that the growth of eyelashes occurs by increasing the percentage of hairs in, and the duration of, the anagen (or growth) phase. Lashes can grow longer, thicker and darker because bimatoprost can also prolong this growth phase.
How do I apply LATISSE®?
LATISSE® is a once-a-day treatment you apply yourself each evening to the base of the upper eyelashes.
How soon will I see results?
LATISSE® users may see results starting at four weeks, with full results after 16 weeks. The growth is gradual overnight, over time.
Is LATISSE® a replacement for mascara?
No, LATISSE® does not work in place of mascara. However, mascara is a nice complement to LATISSE® to help make your new longer eyelashes look even more attractive.
Is LATISSE® different from nonprescription products that indicate eyelash growth?
LATISSE® solution is the first and only prescription treatment approved by the FDA for inadequate or insufficient eyelashes, growing them longer, fuller and darker.
What if I forget to apply one night? Or a few nights?
If you miss an application or a few, don't try to catch up. Just apply the LATISSE® treatment the next evening and stay on schedule.
What happens if I stop using LATISSE®?
If you stop using LATISSE®, expect your eyelashes to return to their previous appearance over several weeks to months.
Can I get a prescription for LATISSE® from any doctor?
First, ask your doctor if LATISSE® is right for you. Although any doctor can prescribe LATISSE®, some may be more familiar with this product than others. Etcetera Medical specializes in Allergan products.
What are the possible side effects of LATISSE®?
The most common side effects after using LATISSE® solution are an itching sensation in the eyes and/or eye redness. This was reported in approximately 4% of patients. LATISSE® solution may cause other less common side effects, which typically occur on the skin close to where LATISSE® is applied or in the eyes. These include skin darkening, eye irritation, dryness of the eyes and redness of the eyelids.
What should I do if I get LATISSE® in my eye?
LATISSE® solution is an ophthalmic drug product. If any gets into the eye, it is not expected to cause harm. The eye should not be rinsed.
Who should NOT use LATISSE®?
Do not use LATISSE® solution if you are allergic to one of its ingredients.
What are the ingredients in LATISSE®?
Active ingredient: bimatoprost Inactive ingredients: benzalkonium chloride; sodium chloride; sodium phosphate, dibasic; citric acid; and purified water. Sodium hydroxide and/or hydrochloric acid may be added to adjust pH. The pH during its shelf life ranges from 6.8 to 7.8.
What is skin hyperpigmentation?
This is a common, usually harmless condition in which patches of skin become abnormally darker than the surrounding skin color. This occurs when an excess of melanin, the brown pigment that produces normal skin color, forms deposits in the skin. Hyperpigmentation is a possible side effect of LATISSE® but may be reversible after you discontinue use.
What is elevated intraocular pressure (lOP)?
This is a condition where the pressure inside the eye is higher than normal. LATISSE® may decrease IOP. So talk to your doctor if you are using lOP-lowering medications. Concurrent administration of LATISSE® and certain lOP-lowering medications in ocular hypertensive patients should be closely monitored for changes in intraocular pressure.

KYBELLA®

What is KYBELLA®?
KYBELLA® (deoxycholic acid) injection is the first and only FDA-approved injectable treatment that is used in adults to improve the appearance and profile of moderate to severe fat below the chin (submental fat), also called double chin. It is not known if KYBELLA® is safe and effective in children under 18 years of age. It is not known if KYBELLA® is safe and effective for use outside of the submental area.
What is submental fullness?
Submental fullness, sometimes referred to as double chin, is a common yet undertreated facial aesthetic condition. It can impact a broad range of adult men and women; can be influenced by several factors such as aging, genetics and weight gain; and is often resistant to diet and exercise alone.
How does KYBELLA® work
KYBELLA® is an injectable treatment to reduce the double chin. KYBELLA® contains a naturally occurring ingredient called deoxycholic acid. Your body already produces this ingredient that destroys fat cells. When injected into the fat beneath your chin, KYBELLA® causes the destruction of fat cells. Once destroyed, those cells cannot store or accumulate fat.
Is KYBELLA® right for me?
Only you and your doctor can decide if KYBELLA® is right for you. If you’re bothered by submental fullness or double chin, ask your doctor about KYBELLA®.
How is KYBELLA® administered?
KYBELLA® is administered by injections into the fat cells under the chin, personalized to the treatment goals of the patient. Each in-office treatment session takes approximately 20-30 minutes. Treatments are spaced six to eight weeks apart.
How many treatments will I need?
You and your provider will customize your KYBELLA® treatment regimen, including how many treatments you need, based on your desired chin profile. Many patients experience visible results in two to four treatment sessions. During these sessions, your provider will administer KYBELLA® into the fat under your chin using multiple injections. Treatments are spaced six to eight weeks apart.
Does KYBELLA® firm loose skin?
KYBELLA® is intended to melt fat under the chin and not to tighten loose skin, though some patients in clinical trials have reported tighter skin under the chin.
Will I experience any side effects?
The safety profile of KYBELLA® is well characterized. The most common side effects are swelling, bruising, pain, numbness, redness and areas of hardness around the treatment area. KYBELLA® can cause serious side effects, including trouble swallowing and nerve injury in the jaw that can cause an uneven smile or facial muscle weakness. These are not all of the possible side effects of KYBELLA®. Call your health care provider for medical advice about side effects.
How long will the results last?
When injected into the fat under your chin, KYBELLA® causes the destruction of fat cells. Once destroyed, those cells cannot store or accumulate fat. After the aesthetic response is achieved, retreatment with KYBELLA® is not expected.
What are the contraindications?
KYBELLA® is not to be used in patients with a history of dysphagia (difficulty swallowing) or bleeding abnormalities, or those currently taking blood thinner medication.
What other treatments are there to reduce submental fullness?
Prior to KYBELLA®’s development, more invasive techniques such as liposuction and surgery were the go-to treatment options. KYBELLA® is the only noninvasive treatment available today.