Patient Resources for all Services
Pre & Post Care Instructions
Find your service below, review your instructions, and download your PDF for easy reference. Questions? Call (916) 243-5098.
Injectables
Pre-Care
- Avoid alcohol 24 hours before treatment.
- Avoid blood thinners and NSAIDs (aspirin, ibuprofen, naproxen) for 5–7 days before — unless prescribed by your doctor.
- Avoid fish oil, vitamin E, ginkgo, and St. John's Wort for 5 days before.
- Arrive with a clean face — no makeup in treatment areas.
- Inform NP Sarah of any recent dental work, illness, skin infections, or cold sore history.
- Stay well hydrated the day before and day of your appointment.
- Do not schedule if you are pregnant or breastfeeding.
- Contraindications: Neuromuscular disorders (myasthenia gravis, ALS); known allergy to botulinum toxin.
Post-Care
- Remain upright for 4 hours — no lying down or bending forward.
- Do not rub, massage, or touch treated areas for 4 hours.
- Avoid strenuous exercise, saunas, and hot yoga for 24 hours.
- Avoid alcohol for 24 hours.
- No facials, chemical peels, or laser treatments for 2 weeks.
- Results appear in 5–14 days (Daxxify typically 5–7 days onset). Daxxify lasts 6+ months.
- Mild redness, swelling, or tenderness at injection sites is normal and resolves within hours.
- Bruising is possible — arnica cream or gel may help. Use Tylenol only, not NSAIDs.
- 2-week touch-up assessment recommended for first-time patients.
Red Flag — Call Immediately
Eyelid drooping, difficulty swallowing, or asymmetry not resolved by 2 weeks.
Pre-Care
- Avoid blood thinners and NSAIDs for 5–7 days before.
- Avoid alcohol 24 hours before.
- Avoid fish oil, vitamin E, ginkgo, St. John's Wort for 5 days before.
- Arrive with a clean, makeup-free face.
- Disclose all medications, supplements, and medical conditions.
- No dental work 2 weeks before — dental procedures can introduce bacteria.
- Inform NP Sarah of any history of cold sores, herpes simplex, or active skin infection.
- Stay well hydrated the day before and day of your appointment.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Avoid pressure, massage, or manipulation of treated areas for 48 hours.
- Avoid extreme heat (saunas, hot yoga) and extreme cold for 48 hours.
- Swelling and bruising are normal — resolve within 7–14 days.
- Sleep with head elevated the first night.
- Avoid strenuous activity for 24 hours.
- No facials, peels, laser, or microneedling for 2 weeks.
- Arnica gel or bromelain may help with bruising. Use Tylenol only.
- Final results visible at 2–4 weeks once swelling subsides.
Red Flag — Call Immediately
- Unusual asymmetry
- Skin blanching, mottling, or pain — possible vascular occlusion (emergency)
- Increasing redness or discharge
- Vision changes
Pre-Care
- Avoid blood thinners and NSAIDs for 5–7 days before.
- Avoid alcohol 24 hours before.
- Avoid fish oil, vitamin E, ginkgo, St. John's Wort for 5 days before.
- Arrive with a clean, makeup-free face.
- Disclose all medications and medical conditions.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Massage treated areas 5 minutes, 5 times per day, for 5 days (the 5-5-5 rule) — this is essential to prevent nodule formation.
- Avoid extreme heat and extreme cold for 48 hours.
- Swelling and bruising are normal.
- Results build gradually over 3+ months as collagen is stimulated — a series of treatments is typically recommended.
- Avoid strenuous activity for 24 hours.
Red Flag — Contact NP Sarah
Firm lumps or nodules not resolving after 2 weeks.
Pre-Care
- Avoid NSAIDs and blood thinners for 5–7 days before.
- Stay well hydrated — proper hydration supports platelet quality.
- Arrive with a clean face or treatment area.
- Disclose any blood disorders, platelet conditions, anticoagulant medications, or recent illness.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Mild swelling and bruising at injection sites is normal and resolves within 1–2 weeks.
- Avoid strenuous activity for 24 hours.
- Do not take anti-inflammatory medications — they interfere with the PRP healing response.
- Avoid alcohol 24 hours post-treatment.
- Results are visible progressively over 4–8 weeks; a series of treatments is recommended for optimal outcomes.
Red Flag — Contact NP Sarah
Increasing redness, warmth, or swelling after 72 hours.
Pre-Care
- Arrive with clean skin in the treatment area.
- Stop retinoids and active ingredients 3 days before.
- Disclose any active skin infections, allergies, or blood thinners.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Mild redness or swelling at injection sites is normal and resolves quickly.
- Avoid strenuous activity for 24 hours.
- Avoid active skincare ingredients for 48 hours post-treatment.
- Results build cumulatively with consistent treatment sessions.
Red Flag — Contact NP Sarah
Increasing redness, warmth, or swelling after 72 hours.
Skin & Body
Pre-Care
- Stop retinoids, tretinoin, AHAs, BHAs, and active exfoliants 5 days before.
- No facial waxing, threading, or depilatory creams in the treatment area.
- Avoid extended sun exposure and sunburn for 2 weeks before.
- Inform NP Sarah of Accutane use in the past 6 months, active cold sores, or any skin infections.
- Disclose all medications and recent treatments.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Peeling and flaking typically begin on days 3–7 — do not pick, pull, or peel the skin.
- Use only a gentle cleanser and a heavy, bland moisturizer during the peeling phase.
- Apply SPF 50+ every morning — your skin is highly photosensitive.
- Do not reintroduce retinoids, acids, or actives until peeling is completely finished.
- Avoid heat, saunas, and vigorous exercise until peeling resolves.
Red Flag — Contact NP Sarah
Blistering, open sores, or signs of infection.
Pre-Care
- Arrive with clean skin — no makeup or skincare products.
- Stop retinoids and active ingredients 3 days before.
- Disclose active skin infections, psoriasis, eczema, or open wounds in the treatment area.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Mild peeling and flaking begin on day 2–5 — do not pick or force the skin off.
- Use only a gentle cleanser and moisturizer during the recovery phase.
- Apply SPF 30+ daily.
- Avoid active skincare ingredients until peeling is complete.
- Results are often visible after the first treatment and continue to improve with a series.
Red Flag — Contact NP Sarah
Blistering or significant skin changes.
Pre-Care
- Arrive with clean skin — no makeup or skincare products.
- Stop retinoids and active ingredients 3 days before.
- Disclose active breakouts, rosacea, or other skin conditions.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Mild redness is normal and resolves within hours to 24 hours.
- Apply hyaluronic acid and a gentle moisturizer as directed.
- Apply SPF 30+ if going outdoors.
- Avoid active skincare ingredients for 48 hours.
- Results are cumulative — a series of treatments is recommended.
Pre-Care
- Stop retinoids, tretinoin, retinol, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid facial waxing or threading in the treatment area.
- 48 hours before: avoid alcohol, stay hydrated, no self-tanner.
- Arrive with clean, makeup-free skin.
- Disclose: active acne, eczema, psoriasis, rosacea, cold sore history, keloid scarring history, blood thinners.
- Contraindications: Active skin infection, pregnancy, keloid history, active chemotherapy or radiation.
Post-Care
- Do not wash face for 4 hours post-treatment.
- Apply only provider-approved gentle products: hyaluronic acid + simple moisturizer.
- No makeup. Sleep on a clean pillowcase (silk/satin preferred).
- Apply SPF 30+ mineral sunscreen if going outside.
- Days 2–7: gentle cleansing only; mild redness/flaking normal; no actives until day 7; avoid saunas/steam/heat 5 days; no vigorous exercise 48 hrs.
- Results: Week 1–2 initial glow; Week 4–6 collagen remodeling; Month 3 full response. Recommended series: 3 treatments 4–6 weeks apart.
Red Flag — Contact NP Sarah
Increasing redness, warmth, swelling, or discharge after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, retinol, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid facial waxing or threading in the treatment area.
- 48 hours before: avoid alcohol, stay hydrated, no self-tanner.
- Arrive with clean, makeup-free skin.
- Disclose: active acne, eczema, psoriasis, rosacea, cold sore history, keloid scarring history, blood thinners.
- Contraindications: Active skin infection, pregnancy, keloid history, active chemotherapy or radiation.
Post-Care
- Do not wash face for 4 hours post-treatment.
- Apply only provider-approved gentle products: hyaluronic acid + simple moisturizer.
- No makeup. Sleep on a clean pillowcase (silk/satin preferred).
- Apply SPF 30+ mineral sunscreen if going outside.
- Days 2–7: gentle cleansing only; mild redness/flaking normal; no actives until day 7; avoid saunas/steam/heat 5 days; no vigorous exercise 48 hrs.
- Results: Week 1–2 initial glow; Week 4–6 collagen remodeling; Month 3 full response. Recommended series: 3 treatments 4–6 weeks apart.
Exosome Booster Note
The Exosome Booster amplifies your healing response — extra hydration and gentle care in the first 48 hours is especially important.
Red Flag — Contact NP Sarah
Increasing redness, warmth, swelling, or discharge after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, retinol, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid facial waxing or threading in the treatment area.
- 48 hours before: avoid alcohol, stay hydrated, no self-tanner.
- Arrive with clean, makeup-free skin.
- Disclose: active acne, eczema, psoriasis, rosacea, cold sore history, keloid scarring history, blood thinners.
- Contraindications: Active skin infection, pregnancy, keloid history, active chemotherapy or radiation.
Post-Care
- Do not wash face for 4 hours post-treatment.
- Apply only provider-approved gentle products: hyaluronic acid + simple moisturizer.
- No makeup. Sleep on a clean pillowcase (silk/satin preferred).
- Apply SPF 30+ mineral sunscreen if going outside.
- Days 2–7: gentle cleansing only; mild redness/flaking normal; no actives until day 7; avoid saunas/steam/heat 5 days; no vigorous exercise 48 hrs.
- Results: Week 1–2 initial glow; Week 4–6 collagen remodeling; Month 3 full response. Recommended series: 3 treatments 4–6 weeks apart.
PDRN Note
PDRN (Polydeoxyribonucleotide) enhances cellular regeneration — expect enhanced healing and skin renewal over 4–6 weeks.
Red Flag — Contact NP Sarah
Increasing redness, warmth, swelling, or discharge after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, retinol, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid facial waxing or threading in the treatment area.
- 48 hours before: avoid alcohol, stay hydrated, no self-tanner.
- Arrive with clean, makeup-free skin.
- Disclose: active acne, eczema, psoriasis, rosacea, cold sore history, keloid scarring history, blood thinners.
- Contraindications: Active skin infection, pregnancy, keloid history, active chemotherapy or radiation.
Post-Care
- Do not wash face for 4 hours post-treatment.
- Apply only provider-approved gentle products: hyaluronic acid + simple moisturizer.
- No makeup. Sleep on a clean pillowcase (silk/satin preferred).
- Apply SPF 30+ mineral sunscreen if going outside.
- Days 2–7: gentle cleansing only; mild redness/flaking normal; no actives until day 7; avoid saunas/steam/heat 5 days; no vigorous exercise 48 hrs.
- Results: Week 1–2 initial glow; Week 4–6 collagen remodeling; Month 3 full response. Recommended series: 3 treatments 4–6 weeks apart.
PDGF+ Note
PDGF+ supports accelerated tissue repair and collagen stimulation — results may be visible sooner than with microneedling alone.
Red Flag — Contact NP Sarah
Increasing redness, warmth, swelling, or discharge after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid sun exposure and tanning for 2 weeks before.
- Arrive with clean, makeup-free skin — numbing cream will be applied at the office.
- Disclose: pacemaker or metal implants, blood thinners, history of keloid scarring, active skin infections.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Redness, swelling, and small micro-scabbing are normal for 3–5 days.
- Apply only gentle products: hyaluronic acid and a bland moisturizer.
- Do not reintroduce retinoids, acids, or actives for 7–10 days.
- Avoid heat, saunas, steam rooms, and vigorous exercise for 48 hours.
- Apply SPF 30+ mineral sunscreen every morning — skin is photosensitive.
- Micro-scabs will shed naturally — do not pick.
- Results build progressively over 3 months. Series of 3 treatments recommended.
Red Flag — Contact NP Sarah
Increasing redness, warmth, blistering, or signs of infection after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid sun exposure and tanning for 2 weeks before.
- Arrive with clean, makeup-free skin — numbing cream will be applied at the office.
- Disclose: pacemaker or metal implants, blood thinners, history of keloid scarring, active skin infections.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Redness, swelling, and small micro-scabbing are normal for 3–5 days.
- Apply only gentle products: hyaluronic acid and a bland moisturizer.
- Do not reintroduce retinoids, acids, or actives for 7–10 days.
- Avoid heat, saunas, steam rooms, and vigorous exercise for 48 hours.
- Apply SPF 30+ mineral sunscreen every morning — skin is photosensitive.
- Micro-scabs will shed naturally — do not pick.
- Results build progressively over 3 months. Series of 3 treatments recommended.
Exosome Booster Note
The Exosome Booster amplifies healing — extra hydration in the first 48 hours is especially important.
Red Flag — Contact NP Sarah
Increasing redness, warmth, blistering, or signs of infection after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid sun exposure and tanning for 2 weeks before.
- Arrive with clean, makeup-free skin — numbing cream will be applied at the office.
- Disclose: pacemaker or metal implants, blood thinners, history of keloid scarring, active skin infections.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Redness, swelling, and small micro-scabbing are normal for 3–5 days.
- Apply only gentle products: hyaluronic acid and a bland moisturizer.
- Do not reintroduce retinoids, acids, or actives for 7–10 days.
- Avoid heat, saunas, steam rooms, and vigorous exercise for 48 hours.
- Apply SPF 30+ mineral sunscreen every morning — skin is photosensitive.
- Micro-scabs will shed naturally — do not pick.
- Results build progressively over 3 months. Series of 3 treatments recommended.
PDRN Note
PDRN enhances cellular regeneration — expect enhanced healing and skin renewal.
Red Flag — Contact NP Sarah
Increasing redness, warmth, blistering, or signs of infection after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid sun exposure and tanning for 2 weeks before.
- Arrive with clean, makeup-free skin — numbing cream will be applied at the office.
- Disclose: pacemaker or metal implants, blood thinners, history of keloid scarring, active skin infections.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Redness, swelling, and small micro-scabbing are normal for 3–5 days.
- Apply only gentle products: hyaluronic acid and a bland moisturizer.
- Do not reintroduce retinoids, acids, or actives for 7–10 days.
- Avoid heat, saunas, steam rooms, and vigorous exercise for 48 hours.
- Apply SPF 30+ mineral sunscreen every morning — skin is photosensitive.
- Micro-scabs will shed naturally — do not pick.
- Results build progressively over 3 months. Series of 3 treatments recommended.
PDGF+ Note
PDGF+ supports collagen synthesis — results may appear sooner.
Red Flag — Contact NP Sarah
Increasing redness, warmth, blistering, or signs of infection after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid sun exposure and tanning for 2 weeks before.
- Arrive with clean, makeup-free skin — numbing cream will be applied at the office.
- Disclose: pacemaker or metal implants, blood thinners, history of keloid scarring, active skin infections.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Redness, swelling, and small micro-scabbing are normal for 3–5 days.
- Apply only gentle products: hyaluronic acid and a bland moisturizer.
- Do not reintroduce retinoids, acids, or actives for 7–10 days.
- Avoid heat, saunas, steam rooms, and vigorous exercise for 48 hours.
- Apply SPF 30+ mineral sunscreen every morning — skin is photosensitive.
- Micro-scabs will shed naturally — do not pick.
- Results build progressively over 3 months. Series of 3 treatments recommended.
- A compression garment may be recommended for body treatment areas — wear as directed.
Red Flag — Contact NP Sarah
Increasing redness, warmth, blistering, or signs of infection after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid sun exposure and tanning for 2 weeks before.
- Arrive with clean skin — numbing cream will be applied at the office.
- Disclose: pacemaker or metal implants, blood thinners, history of keloid scarring, active skin infections.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Redness, swelling, and small micro-scabbing are normal for 3–5 days.
- Apply only gentle products: hyaluronic acid and a bland moisturizer.
- Do not reintroduce retinoids, acids, or actives for 7–10 days.
- Avoid heat, saunas, steam rooms, and vigorous exercise for 48 hours.
- Apply SPF 30+ mineral sunscreen every morning — skin is photosensitive.
- Micro-scabs will shed naturally — do not pick.
- Results build progressively over 3 months. Series of 3 treatments recommended.
- A compression garment may be recommended for body treatment areas — wear as directed.
Exosome Booster Note
The Exosome Booster amplifies healing — extra hydration in the first 48 hours is especially important.
Red Flag — Contact NP Sarah
Increasing redness, warmth, blistering, or signs of infection after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid sun exposure and tanning for 2 weeks before.
- Arrive with clean skin — numbing cream will be applied at the office.
- Disclose: pacemaker or metal implants, blood thinners, history of keloid scarring, active skin infections.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Redness, swelling, and small micro-scabbing are normal for 3–5 days.
- Apply only gentle products: hyaluronic acid and a bland moisturizer.
- Do not reintroduce retinoids, acids, or actives for 7–10 days.
- Avoid heat, saunas, steam rooms, and vigorous exercise for 48 hours.
- Apply SPF 30+ mineral sunscreen every morning — skin is photosensitive.
- Micro-scabs will shed naturally — do not pick.
- Results build progressively over 3 months. Series of 3 treatments recommended.
- A compression garment may be recommended for body treatment areas — wear as directed.
PDRN Note
PDRN enhances cellular regeneration — expect enhanced healing and skin renewal.
Red Flag — Contact NP Sarah
Increasing redness, warmth, blistering, or signs of infection after 72 hours.
Pre-Care
- Stop retinoids, tretinoin, AHAs, BHAs 5 days before.
- Discontinue NSAIDs unless medically necessary.
- Avoid sun exposure and tanning for 2 weeks before.
- Arrive with clean skin — numbing cream will be applied at the office.
- Disclose: pacemaker or metal implants, blood thinners, history of keloid scarring, active skin infections.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Redness, swelling, and small micro-scabbing are normal for 3–5 days.
- Apply only gentle products: hyaluronic acid and a bland moisturizer.
- Do not reintroduce retinoids, acids, or actives for 7–10 days.
- Avoid heat, saunas, steam rooms, and vigorous exercise for 48 hours.
- Apply SPF 30+ mineral sunscreen every morning — skin is photosensitive.
- Micro-scabs will shed naturally — do not pick.
- Results build progressively over 3 months. Series of 3 treatments recommended.
- A compression garment may be recommended for body treatment areas — wear as directed.
PDGF+ Note
PDGF+ supports collagen synthesis — results may appear sooner.
Red Flag — Contact NP Sarah
Increasing redness, warmth, blistering, or signs of infection after 72 hours.
Pre-Care
- Avoid sun exposure and tanning for 4 weeks before treatment.
- Stop retinoids and active ingredients 5 days before.
- No self-tanner for 4 weeks before.
- Arrive with clean skin — no makeup.
- Disclose: Accutane use in the past 6 months, all medications (especially photosensitizing drugs), recent sun exposure, skin conditions.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Avoid sun strictly for 2 weeks post-treatment — apply SPF 50+ every morning.
- Darkening of pigmented spots before they flake off is completely normal — this is the "pepper effect" and means it's working.
- Do not pick at darkened spots — allow them to shed naturally.
- Avoid heat, vigorous exercise, and saunas for 24–48 hours.
- Use only gentle skincare — no retinoids, acids, or actives for 5–7 days.
Red Flag — Contact NP Sarah
Blistering, severe redness, or swelling.
Pre-Care
- Avoid sun exposure and tanning for 4 weeks before treatment.
- Stop retinoids and active ingredients 5 days before.
- No self-tanner for 4 weeks before.
- Arrive with clean skin — no products in the treatment area.
- Disclose: Accutane use in the past 6 months, all medications (especially photosensitizing drugs), recent sun exposure, skin conditions.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Avoid sun strictly for 2 weeks post-treatment — apply SPF 50+ every morning.
- Darkening of pigmented spots before they flake off is completely normal — do not pick.
- Avoid heat, vigorous exercise, and saunas for 24–48 hours.
- Use only gentle skincare — no retinoids, acids, or actives for 5–7 days.
Red Flag — Contact NP Sarah
Blistering, severe redness, or swelling.
Pre-Care
- Arrive with clean skin — no makeup or skincare products.
- Inform NP Sarah of any metal implants or pacemaker.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Mild redness and warmth are normal and resolve within a few hours.
- Apply a light moisturizer and SPF after treatment.
- Avoid extreme heat for 24 hours.
- Results improve progressively over 3–6 months with a recommended series of treatments.
Pre-Care
- Arrive with clean skin — no makeup or skincare products in the treatment area.
- Inform NP Sarah of any metal implants or pacemaker.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Mild redness and warmth are normal and resolve within a few hours.
- Apply a light moisturizer after treatment.
- Avoid extreme heat for 24 hours.
- Results improve progressively over 3–6 months with a recommended series of treatments.
Pre-Care
- Shave the treatment area 24 hours before your appointment — do not wax or pluck.
- No waxing, plucking, or electrolysis for 4 weeks before — the hair follicle must be intact.
- Avoid sun exposure and tanning for 4 weeks before.
- No self-tanner for 4 weeks before.
- Arrive with clean, dry skin — no lotions, deodorant, or products in the treatment area.
- Disclose all medications (especially photosensitizing drugs) and skin conditions.
Post-Care
- Redness and follicular swelling (like small raised bumps) are normal for 24 hours.
- Apply a cool compress if needed for comfort.
- Avoid sun exposure, heat, saunas, and vigorous exercise for 24 hours.
- Apply SPF 30+ if the treated area will be exposed to sun.
- Avoid irritants (retinoids, AHAs, fragranced products) for 48 hours.
- Hairs will shed over the next 1–3 weeks — this is normal.
- Multiple sessions are required (typically 6–8) for permanent reduction.
Wellness
Before Starting Your Medication
- Complete all required baseline labs before starting. Your provider will confirm clearance.
- Review your Program Guide in full — know your starting dose and injection technique.
- Store medication refrigerated, protected from light.
- Use only the syringes and needles provided or recommended by your provider.
- Choose a consistent injection day each week and stick to it.
- Inject subcutaneously into the abdomen, thigh, or upper arm — rotate sites each week. Never inject into a vein or muscle.
- Lifestyle: Prioritize protein with every meal — aim for 80–120g daily. Stay hydrated: 64–80 oz of water daily. Move your body consistently — strength training preserves lean mass. Avoid alcohol. Take recommended supplements as outlined in your Program Guide.
Side Effects & Monitoring
- Nausea — eat small, bland meals; avoid fatty or spicy foods; ginger tea, peppermint, and B6 can help.
- Vomiting — stay hydrated with electrolytes; contact us if you cannot keep fluids down.
- Constipation — increase water, fiber, and movement; magnesium oxide can help.
- Diarrhea — avoid high-fat or high-sugar foods; stay hydrated.
- Fatigue — common in first 1–2 weeks; rest, hydrate, maintain protein.
- Injection site reactions — mild redness, bruising, or itching; rotate sites each week.
- Reduced appetite — do not skip meals entirely; focus on nutrient-dense foods.
- Heartburn or acid reflux — eat smaller portions; avoid lying down after eating.
- When to call: Side effects not improving after 1–2 weeks; missed dose; not losing weight or losing too rapidly; any new medication or health change; any concern.
"This medication is a tool — not a magic solution. The lifestyle habits you build now are what make the results permanent. NP Sarah is your partner in this process every step of the way."
Red Flag — Stop Medication & Seek Care
- Severe persistent abdominal pain especially radiating to the back — may indicate pancreatitis; STOP medication and call or go to ER.
- Yellowing of skin or eyes.
- Racing or irregular heartbeat, chest pain.
- Severe allergic reaction — call 911.
- Inability to keep fluids down for 24+ hours.
- Severe mood changes or thoughts of self-harm.
Compounded Medication Notice
This medication is compounded by a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy, or quality. Results may vary. This medication is prescribed and administered under the supervision of a licensed nurse practitioner and should be used only as directed.
Before Starting Your Medication
- Complete all required baseline labs before starting. Your provider will confirm clearance.
- Tirzepatide is a dual GIP/GLP-1 receptor agonist — once-weekly subcutaneous injection.
- Review your Program Guide in full — know your starting dose and injection technique.
- Store medication refrigerated, protected from light.
- Use only the syringes and needles provided or recommended by your provider.
- Choose a consistent injection day each week and stick to it.
- Inject subcutaneously into the abdomen, thigh, or upper arm — rotate sites each week. Never inject into a vein or muscle.
- Lifestyle: Prioritize protein with every meal — aim for 80–120g daily. Stay hydrated: 64–80 oz of water daily. Move your body consistently — strength training preserves lean mass. Avoid alcohol. Take recommended supplements as outlined in your Program Guide.
Side Effects & Monitoring
- Nausea — eat small, bland meals; avoid fatty or spicy foods; ginger tea, peppermint, and B6 can help.
- Vomiting — stay hydrated with electrolytes; contact us if you cannot keep fluids down.
- Constipation — increase water, fiber, and movement; magnesium oxide can help.
- Diarrhea — avoid high-fat or high-sugar foods; stay hydrated.
- Fatigue — common in first 1–2 weeks; rest, hydrate, maintain protein.
- Injection site reactions — mild redness, bruising, or itching; rotate sites each week.
- Reduced appetite — do not skip meals entirely; focus on nutrient-dense foods.
- Heartburn or acid reflux — eat smaller portions; avoid lying down after eating.
- When to call: Side effects not improving after 1–2 weeks; missed dose; not losing weight or losing too rapidly; any new medication or health change; any concern.
"This medication is a tool — not a magic solution. The lifestyle habits you build now are what make the results permanent. NP Sarah is your partner in this process every step of the way."
Red Flag — Stop Medication & Seek Care
- Severe persistent abdominal pain especially radiating to the back — may indicate pancreatitis; STOP medication and call or go to ER.
- Yellowing of skin or eyes.
- Racing or irregular heartbeat, chest pain.
- Severe allergic reaction — call 911.
- Inability to keep fluids down for 24+ hours.
- Severe mood changes or thoughts of self-harm.
Compounded Medication Notice
This medication is compounded by a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy, or quality. Results may vary. This medication is prescribed and administered under the supervision of a licensed nurse practitioner and should be used only as directed.
Before Starting Your Medication
- Complete all required baseline labs before starting. Your provider will confirm clearance.
- Retatrutide is a triple agonist (GIP, GLP-1, and glucagon receptor) — once-weekly subcutaneous injection.
- Review your Program Guide in full — know your starting dose and injection technique.
- Store medication refrigerated, protected from light.
- Use only the syringes and needles provided or recommended by your provider.
- Choose a consistent injection day each week and stick to it.
- Inject subcutaneously into the abdomen, thigh, or upper arm — rotate sites each week. Never inject into a vein or muscle.
- Lifestyle: Prioritize protein with every meal — aim for 80–120g daily. Stay hydrated: 64–80 oz of water daily. Move your body consistently — strength training preserves lean mass. Avoid alcohol. Take recommended supplements as outlined in your Program Guide.
Side Effects & Monitoring
- Nausea — eat small, bland meals; avoid fatty or spicy foods; ginger tea, peppermint, and B6 can help.
- Vomiting — stay hydrated with electrolytes; contact us if you cannot keep fluids down.
- Constipation — increase water, fiber, and movement; magnesium oxide can help.
- Diarrhea — avoid high-fat or high-sugar foods; stay hydrated.
- Fatigue — common in first 1–2 weeks; rest, hydrate, maintain protein.
- Injection site reactions — mild redness, bruising, or itching; rotate sites each week.
- Reduced appetite — do not skip meals entirely; focus on nutrient-dense foods.
- Heartburn or acid reflux — eat smaller portions; avoid lying down after eating.
- When to call: Side effects not improving after 1–2 weeks; missed dose; not losing weight or losing too rapidly; any new medication or health change; any concern.
"This medication is a tool — not a magic solution. The lifestyle habits you build now are what make the results permanent. NP Sarah is your partner in this process every step of the way."
Red Flag — Stop Medication & Seek Care
- Severe persistent abdominal pain especially radiating to the back — may indicate pancreatitis; STOP medication and call or go to ER.
- Yellowing of skin or eyes.
- Racing or irregular heartbeat, chest pain.
- Severe allergic reaction — call 911.
- Inability to keep fluids down for 24+ hours.
- Severe mood changes or thoughts of self-harm.
Compounded Medication Notice
This medication is compounded by a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy, or quality. Results may vary. This medication is prescribed and administered under the supervision of a licensed nurse practitioner and should be used only as directed.
Before Your Appointment
- Complete these forms in your Boulevard patient portal before you arrive: Medical Intake Form, Female Sexual Function Index (FSFI), How Is Your Quality of Life?, Exercise History Questionnaire, Sleep Questionnaire.
- Bring labs from the past 6 months if you have them — NP Sarah will review. If not, she will order them.
- Bring a list of all current medications and supplements with doses.
- Bring any records from other providers.
- Write down your top 3–5 symptoms in order of priority.
- If still cycling, note your current cycle length and any recent changes.
After Your Appointment — What to Expect
- Week 1–2: Better sleep and mood lift. Some breast tenderness or bloating as estrogen begins — resolves in 2–3 weeks.
- Week 3–4: Reduced hot flashes, night sweats, improved vaginal comfort. More consistent energy.
- Month 2–3: Libido, skin hydration, and mental clarity improve. Joint discomfort eases.
- Month 3–6: Full hormonal balance establishing. Body composition shifts. Most patients feel like themselves again.
- Month 6+: Follow-up labs required. Long-term benefits: bone density, cardiovascular and cognitive health.
- Managing the Transition: Mild spotting or irregular bleeding in the first 1–3 months can be normal — always report it. Breast tenderness/bloating in weeks 1–4 are signs your body is adjusting. Do not stop medication abruptly. Give each dose adjustment at least 6–8 weeks.
Red Flag — Call 911 or Contact NP Sarah
- Sudden severe headache, vision changes, or slurred speech.
- Chest pain, shortness of breath, or calf pain/swelling — possible clot.
- Heavy or prolonged vaginal bleeding, or any bleeding after menopause is established.
- Severe abdominal or pelvic pain.
- New breast lump, nipple discharge, or significant breast changes.
- Severe mood changes or thoughts of self-harm.
- Allergic reaction.
- Injection site increasingly red, warm, or swollen after 48 hours.
Before Your Appointment
- Complete forms in your Boulevard patient portal: Medical Intake Form and relevant intake forms.
- Bring labs from the past 6 months if available.
- Bring a list of all current medications and supplements.
- Write down your top symptoms in priority order.
After Your Appointment — What to Expect
- Weeks 2–4: Energy and mood improvements begin.
- Months 2–3: Libido and body composition changes become noticeable.
- Months 3–6: Full effects established. Most patients feel significantly better in overall vitality.
- Month 6+: Follow-up labs required for ongoing optimization.
- Managing the Transition: Give each dose adjustment 6–8 weeks. Track symptoms to help optimize your protocol. Do not self-adjust.
Red Flag — Contact NP Sarah
- Injection site increasingly red, warm, or swollen after 48 hours.
- Cardiovascular symptoms (chest pain, shortness of breath).
- Significant mood changes.
- Any concern.
Compounded Medication Notice
Testosterone may be compounded by a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy, or quality. Results may vary. This medication is prescribed and administered under the supervision of a licensed nurse practitioner and should be used only as directed.
Pre-Care
- Baseline labs required before starting.
- Review injection technique with NP Sarah.
- Store medication as directed.
Post-Care
- Rotate injection sites consistently.
- Mild redness or bruising at injection site is normal.
- Report any excessive hair growth, acne, or mood changes to NP Sarah.
- Labs monitored regularly.
Compounded Medication Notice
This medication is compounded by a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy, or quality. Results may vary. This medication is prescribed and administered under the supervision of a licensed nurse practitioner and should be used only as directed.
Pre-Care
- Baseline labs required before starting.
- Review injection technique with NP Sarah.
- Store medication as directed.
Post-Care
- Rotate injection sites consistently.
- Mild soreness at IM injection sites is normal for 1–2 days — warm compress can help.
- Labs monitored regularly.
- Do not self-adjust dose.
Compounded Medication Notice
This medication is compounded by a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy, or quality. Results may vary. This medication is prescribed and administered under the supervision of a licensed nurse practitioner and should be used only as directed.
Pre-Care
- Baseline labs required before starting.
- Apply to inner wrist, inner arm, or inner thigh as directed.
- Wash hands thoroughly after application.
Post-Care
- Allow to fully dry before contact with others — avoid skin-to-skin transfer, especially to children or partners.
- Rotate application sites.
- Report any excessive hair growth or mood changes to NP Sarah.
- Labs monitored regularly.
Compounded Medication Notice
This medication is compounded by a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy, or quality. Results may vary. This medication is prescribed and administered under the supervision of a licensed nurse practitioner and should be used only as directed.
Pre-Care
- Baseline labs required before starting.
- Follow the specific cycling schedule provided by NP Sarah.
Post-Care
- Take at bedtime — progesterone has a calming, sleep-supportive effect.
- Mild breast tenderness or bloating in the first 1–2 cycles can be normal.
- Track your cycle and symptoms.
- Do not adjust your schedule without speaking to NP Sarah.
Pre-Care
- Baseline labs required before starting.
- Review your daily dosing schedule with NP Sarah.
Post-Care
- Take at bedtime for best sleep support.
- Mild breast tenderness in the first few weeks can be normal and resolves.
- Do not stop abruptly.
- Follow-up labs at 3 and 6 months.
Pre-Care
- Baseline labs required before starting.
- Review application method (patch, cream, or spray) and rotation sites with NP Sarah.
Post-Care
- Patches: Apply to clean, dry skin on the lower abdomen or buttocks. Rotate sites. Press firmly for 10 seconds. If patch falls off, replace with a new one.
- Cream / Evamist: Apply to inner wrist or forearm as directed. Allow to dry fully. Avoid skin-to-skin transfer.
- Mild breast tenderness or spotting in the first 1–2 months can be normal.
- Report any unexpected bleeding to NP Sarah.
- Follow-up labs required.
Pre-Care
- Arrive well hydrated — drink plenty of water before your appointment.
- Wear comfortable clothing with easy access to your arm.
- Eat a light meal before arriving — do not come fasting.
- Disclose all current medications, supplements, and any kidney conditions.
Post-Care
- Mild soreness at the IV site is normal and resolves within 24 hours.
- Stay well hydrated after your infusion.
- Rest if you feel fatigued — this is normal and temporary.
- You may notice increased energy, improved mood, or a slight flush — all normal responses.
- Avoid vigorous exercise immediately after your infusion.
Pre-Care
- Arrive well hydrated.
- Wear comfortable clothing with easy access to your arm.
- Eat a light meal before — do not come fasting.
- Session lasts 2–4 hours — plan your schedule accordingly.
- Disclose all medications and health conditions.
Post-Care
- Common during infusion: mild chest tightness, nausea, flushing, or muscle cramping — all managed by slowing the infusion rate. Always tell your provider if you feel uncomfortable.
- After infusion: rest as needed. Increased energy, mental clarity, and mood improvement are common in the following days.
- Stay hydrated. Avoid alcohol for 24 hours post-infusion.
Compounded Medication Notice
This medication is compounded by a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy, or quality. Results may vary. This medication is prescribed and administered under the supervision of a licensed nurse practitioner and should be used only as directed.
Pre-Care
- No specific preparation required for most IM injections.
- Disclose all medications, allergies, and health conditions before your injection.
- Wear clothing that allows easy access to the injection site (upper arm, glute, or thigh as directed).
Post-Care
- Mild soreness, redness, or a small lump at the injection site is normal for 1–2 days.
- A warm compress can help relieve soreness.
- Avoid vigorous use of the injected muscle for 24 hours.
- If you experience increasing pain, swelling, fever, or signs of allergic reaction, contact NP Sarah immediately.
Pre-Care
- Wash hands thoroughly before handling medication or syringes.
- Use only the syringes and needles recommended by NP Sarah.
- Store vials as directed — most require refrigeration.
- Rotate injection sites (abdomen, thigh, upper arm) to prevent tissue buildup.
Post-Care
- Mild redness, bruising, or a small bump at the injection site is normal and resolves within a few days.
- Rotate sites consistently to minimize reactions.
- Do not reuse needles.
- If you experience increasing pain, warmth, redness, or signs of infection, contact NP Sarah.
Pre-Care
- Inject subcutaneously once daily, typically in the morning.
- Rotate injection sites (abdomen preferred).
- Do not eat for 30 minutes before injection if advised by NP Sarah.
- Wash hands thoroughly before every injection.
- Refrigerate vials; do not freeze.
- Inform NP Sarah of any pituitary disorders, active cancer, or pregnancy.
- Contraindications: Active malignancy, pituitary tumor, pregnancy.
Post-Care
- Mild injection site reactions (redness, itching) are possible — rotate sites.
- Some patients experience mild fluid retention or joint aches in the first 2–4 weeks as GH levels adjust — this resolves.
- Expected results over 3–6 months: reduced visceral fat, improved body composition, increased energy.
- Labs (IGF-1) monitored by NP Sarah every 3 months.
Compounded Medication Notice
This medication is compounded by a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy, or quality. Results may vary. This medication is prescribed and administered under the supervision of a licensed nurse practitioner and should be used only as directed.
Hair Restoration
Pre-Care
- Wash your hair the night before — arrive with a clean scalp and no styling products.
- Disclose any scalp conditions (psoriasis, seborrheic dermatitis, active infections) before treatment.
- Disclose blood thinners or medications that affect healing.
- Do not schedule if pregnant or breastfeeding.
Post-Care
- Do not wash your hair for 24 hours post-treatment.
- Avoid vigorous scalp massage or rubbing for 48 hours.
- Avoid heat styling (blow dryer, flat iron) for 48 hours.
- Mild redness or tenderness of the scalp is normal for 24–48 hours.
- XVIE Exosomes amplify the healing response — keep the scalp clean and avoid products for 24 hours.
- Results are visible over 3–6 months with a consistent series of treatments — hair loss reduction and new growth take time.