Workshop
Q&A Series™

Combination Therapies using PDO, Fillers, PRP and more – Dr. Chris Croley

• What is the amount of time it takes for filler migration to occur? Years, months, etc?
• What gauge of needle should be used for Botox? How diluted should the formula be for microtoxins?
• Can PRP be injected in superficial [unclear] on the facial surface as an alternative to micro-needling? Are there areas that should not be injected?
• Is there something that you would like to cover in the full lecture that has not necessarily been covered that you find valuable?
• Will laser light energy affect PDO threads?
• How long does your practice spend on an initial consultation?

Acne Therapies for an Aesthetic Practice – Dr. Jennifer Thomas-Goering, DO

• Can you talk about laser therapy and acne light therapy as alternatives to traditional acne cleansers and topical acne treatments?
• What is the acne injection protocol? How do you prevent atrophy with injections, and if you get atrophy, how do you effectively treat it?
• What is the dilution for acne injections?
• What are your preferences for laser devices? Between Fotona and Aerolase, which do you utilize in your practice?
• Do you have a preferred red/blue light device that you utilize in your practice?
• What are your preferences for micro-needling devices? What are your recommendations on how to get started with this treatment in your practice?

Complete Facial Aesthetics – Rachel Lowe, LE

• What cleanser do you prefer prior to procedures?
• Can you put topical vitamin C while microneedling, or is there a risk of granuloma?
• Do you apply topical anesthesia or cream before microneedling?
• Have you ever used Aquagold for microneedling?
• Which plasma pen do you recommend specifically? I see many listed that state FDA-approved, but only in the $1200 range. Wondering if these are legit and where to find the one you mentioned at $5k-$10k, and what the differences are.
• How often can you do botox and microneedling?
• When do you see the best effect from this and how long does it last?
• How much, on average, does a Hydradermabrasion system cost? Also, how much does a plasma pen cost?
• What are the usual side effects of plasma pens for thrust with Fitzpatrick type 4 or 5?
• Is it still worth it to use that procedure on somebody with a Fitzpatrick type 4?
• Another question about botox and microneedling. Will it decrease in effect the long run due to maybe antibody production?
• Could you apply PRP with microneedling, or does it need to be buffered with sodium bicarbonate?
• What depth needle do you use? Is it the same guideline for different parts of the body?
• Is there a difference between the PCA and the Vi Peel?
• Can you elaborate why people with telangiectasias are contraindicated with peels, and are there any peels that you can use?
• Is it that the eyelid skin is thinner and that we don't apply the peel inside the orbital rim, or the possibility of getting it into the eye?
• Can you use an isomer peel or any peel for PIH after a peel?
• Can you please compare the Vi Peel with traditional peels, like pure TCA, with regards to effectiveness, PIH and downtime?
• What treatment do you recommend for PIH after a peel?
• Do you have any experience with the PRXT33?
• Is a mandelic peel good for acne prone skin?
• What is the best peel for hormonal acne?
• Would it be safer to use sodium bicarb to neutralize the skin instead of water?
• In the last video we watched, you were doing a peel on somebody’s back and you used water to neutralize it instead of the sodium bicarb. Can you elaborate?
• Is IPL good for post-peel hyperpigmentation?

Allergy Test and Treatment – Dr. Margaret "Sherry" Wehner, MD

• Do you still use PTS on ACE inhibitors in your practice or do you send them to a specialist?
• How long of an appointment do you schedule for the whole skin prick test?
• In your practice, do you test patients for communication disabilities?
• Do you feel that the blood tests are as effective and accurate as the skin prick tests?
• Does insurance cover blood tests for allergies? Do you test and treat both adults and children?
• Is the RAST test a panel that has all the common allergens or do you need to add allergens that you want to test for?
• You said IDG is your favorite but not covered by insurance * please check comment box
• How much does the ALCAT test cost?
• How much do you charge for the ALCAT test?
• How does your clinic do the build-up phase treatment? How often do patients come for injections?
• What company or brand do you recommend for a patch test?
• For your cash patients would right away test with ALCAT instead of doing skin test or blood?
• When would you choose the ALCAT test?

Anti-Aging Module 1 & 2 – Dr. Chris Croley, MD

• I have a 22-year-old male patient with a past medical history of childhood cancer – Hodgkin's Lymphoma which was treated with chemotherapy. In adulthood, he has gastrointestinal issues and low libido. I have done a full workup and diagnosis, with food sensitivity testing and GI candida. His hormonal panel revealed normal lab results, with his testosterone levels being at the very low end of normal. With treatment, his GI issues have been resolved, but he continues to have a low libido. Would a low dose of testosterone be an appropriate treatment for this patient?
• What is a normal range of testosterone when you are giving a man bioidentical testosterone replacement?
• Would you give progesterone to women who have had hysterectomies when developing a hormone replacement plan?
• Any suggestions on where to get hormone supplements for patients?
• Are testosterone injections more effective than creams? Which form do you use in your practice?
• How long can a man be on Clomid for low testosterone treatment?
• When working with patients, do you measure free testosterone, total testosterone, or both?
• How do you stop breakthrough bleeding on a menopausal patient when you place them on estrogen and progesterone?
• What are some of your favorite and recommended supplement lines for hair loss and thyroid support?
• Do patients come to your practice for testosterone injections or do you allow them to self-administer these hormones at home?
• What is the value for estrogen-progesterone ratio?
• Regarding pellet therapy, how often do these need to be placed? Are there benefits to this form of treatment due to no effect on the body’s natural circadian rhythms?

Dr. Wesley Robinson

• Please explain troubleshooting the HGH (human growth hormone) process, AKA what happens with potential downregulation/atrophy of the anterior pituitary.
• Do you suggest taking one day off a week from applying topical hormonal creams?
• How long is it safe to use HRT (hormone replacement therapy) in terms of years or months? Is there a recommended time to discontinue HRT if the patient is doing well without any side effects?
• Will the hormone pellet course discuss pellet therapy in greater detail?
• Is it okay to use progesterone alone for motor skill symptoms?

Dr. Betsy Greanleaf, DO

• I have heard that having more visceral body fat will protect me from menopausal side effects. Is it true that having less body fat and a more lean physique will exacerbate menopausal symptoms?
• How do you prevent gynecomastia for men on testosterone, while still protecting their arteries by not putting them on an anti-estrogen treatment?
• Please give us some insight about the use of cortisol support. What are your thoughts on this treatment, as well as your recommendations on how to implement it?

ACP & Biologics for Pain Management – Dr. Magdalena Kerschner, MD

• For these types of injections, How long is the recovery time afterwards?
• Discuss injection amounts to locations.
• Do you have Ultrasound recommendations and costs?
• How many Cortisone injections can you give?
• What website has demonstrations of joint injections? Are there any other online resources you would recommend?
• When can you exercise after injection?
• In regards to insurance, do you need to show prior failed treatments to get reimbursement from insurance?
• Is it recommended to space out PRP treatments when used for cosmetic and hair restoration?
• Do you use PRP for Dupuytrens syndrome?
• Can you share information about how you price these procedures?
• Can you discuss Gout and how it presents in joints, outside of the toes and fingers?
• How do we incorporate pluripotent stem cell injections into PRP?
• What vendors do we utilize for PRP?
• With the single spin device, can you spin it twice to get it therapeutic?