FAQ topics:

Anti-aging or Age-Management Medicine

Regenerative Medicine

Functional Medicine

Controversy Surrounding Anti-Aging Medicine

IPL – Intense Pulsed Light Therapy / Photo-Rejuvenation

Hair Removal

Bio-Identical Hormone Replacement

Forms Policy

What is Anti-Aging or Age-Management Medicine?
Anti-aging medicine is a clinical/medical specialty and field of scientific research aimed at the early detection, prevention, treatment, and reversal of age-related decline. It is well documented by peer-reviewed medical and scientific journals and employs evidence-based methodologies to conduct patient assessments. The American Academy of Anti-Aging Medicine was established in 1997 as a professional physician certification and review board, which offers physician recognition in the form of specialty-based examination in Anti-Aging Medicine. It represents 12,500 physicians, scientists, health professionals, and the health minded public from 73 countries worldwide. We can manage the process and symptoms of aging through the optimization of relevant aspects – such as lifestyle, nutrition, habits, hormones, and medications. Aging happens to all of us, but with technology we can slow the degenerative aspects, and improve the state of the body and mind. Maximizing health, vitality and the quality of life is our goal. We cannot legally promise a longer life, but we will do everything we can, to improve upon and maximize your health!

What is Regenerative Medicine?
Regenerative Medicine optimizes the body’s endogenous mechanisms of self-repair and adds proven and near future exogenous treatments and technologies. Adult stem cells appear to be our most powerful tool at this time. Previous dogma concerning adult stem cells taught that neurons and myocytes did not have stem cells and the cells present at birth just declined in quantity and quality. It was also believed that hematopoietic stem cells in the bone marrow lacked plasticity and could not transform to other tissues. Current medical literature proves that adult stem cells exist in most tissues including brain, heart, muscles and liver. Hematopoietic stem cells (HSC) and endothelial progenitor cells (EPC) in the bone marrow have plasticity to potentially transform and repair all tissues and organs. In the hormone optimization component of Anti-Aging Medicine we are already optimizing stem cells. Progesterone via its metabolite allopregnanolone stimulates neural stem cells, testosterone stimulates muscle stem cells and EPC’s which can improve erectile function, and growth hormone treatment for adult growth hormone deficiency improves the quantity and quality of EPC’s. Estradiol improves incorporation and mobilization of EPC’s. In the lifestyle component of Anti-Aging medicine, we are optimizing our adult stem cells with exercise and control of glucose and insulin. In the nutraceutical component of Anti-Aging Medicine, we are optimizing our adult stem cells with Resveratrol as we turn on genes such as SIR1 and with blueberry, green tea and vitamin D3. DHA in omega 3 fish oil promotes neurogenesis from neuronal stem cells. A new phase of Regenerative Medicine has recently commenced with cryogenic preservation of adult stem cells in healthy patients for future use. These patients are the same pro-active population who follow Anti-Aging programs. After stimulation with granulocyte colony stimulating factor adult stem cells can be collected by aphaeresis and stored in separate aliquots for treatment of specific pathologies such as acute myocardial infarction or for overall immune system reconstitution. This paradigm shift is referred to as bio-insurance.

What is Functional Medicine?
Functional Medicine is an integrative, science-based healthcare approach that treats illness and promotes wellness by focusing on the bio-chemically unique aspects of each patient, and then individually tailoring interventions to restore physiological, psychological, and structural balance. Functional Medicine focuses on understanding the fundamental physiological processes, the environmental inputs, and the genetic predispositions that influence health and disease so that interventions are focused on treating the cause of the problem, not just masking the symptoms.

What about the controversy surrounding Anti-Aging Medicine?
I am an open-minded doctor and I believe in recommendations backed up by research and sound scientific evidence. The process of prescribing treatments in this relatively new area of medicine can be challenging, because information is changing rapidly. Research is constantly being done. So, if the scientific research comes up with something new or shows me something about the way I am caring for my patients is wrong, then I will change the way I practice. However, despite the overwhelming evidence that these treatments are not only safe, but also effective, Age Management patients should expect that there may be naysayers and controversy about their treatments. I will always be happy to back up your treatments with scientific evidence from the medical literature. Just ask!

Will using the IPL increase my risk of skin cancer?
Skin cancer, or the DNA changes thought to be responsible for it, is caused ultraviolet (UV) light damage. These technologies use concentrated visible light, not UV light, so there is no increased risk of skin cancer or DNA damage.

How does hair removal work?
The machine we use for permanent hair reduction has a special actively cooled tip that makes direct contact with the skin, through a sapphire, cooled to 4 degrees Celsius with circulating liquid that passes continuously from a chiller through the handpiece. It is one of the most comfortable systems around. As the light beam passes through the cooling shield and reacts with the pigment in each hair follicle, it heats the follicle to damage it and shut it down. It is effective with all skin types and hair colors except light blonde, red and gray hair. The laser works on hair in its active growth phase, or “Anagen” phase. During this phase the hair contains an abundance of pigment, which is necessary to create the reaction. Since all the hair follicles are never in the active growth phase at one time, most patients will require 4 to 6 treatments at 6-to-8-week intervals to achieve optimal results.

What is Bio-Identical Hormone Replacement?
What exactly is hormone modulation & how does it work? Hormone modulation is the science of optimizing hormones that are no longer being adequately produced by the body. While genetic programming does many wonderful things, nature’s plan brings us to the age of reproduction and nurturing, and then seems to have little use for us. At that point, we begin to fail. In fact, much of aging can be seen as deficiencies in many of the substances that our body once produced in abundance. Regaining and maintaining metabolic and endocrine functions at the upper end of the normal range for your age gives you the best opportunity for a healthy and vigorous life. This optimal range is in the upper third of the normal range for age. How long before you can actually see results? While this changes with each person, some people feel results within days. Just like beginning an exercise program, you can expect results within three to six months after beginning hormone management. Often the results of proper modulation are manifested by what you don’t feel, i.e., sick, tired, moody, etc. How long do I have to be on these therapies? You should give your program at least four to six months to see significant benefits. Most people experience benefits before three months and continue to see improvement beyond that point. Your body needs that much time to heal and rebuild. You should remain on the program for as long as you want to optimize your health. What happens if I stop the program? You will have gained time while you were on the program, but if you should elect to stop, you will not experience accelerated aging. Should you stop the program, your body will return to aging at its normal rate. The benefits will fade over time after stopping, however you still have benefited. When is a good age to start? Thirty-five is generally an appropriate age for the first evaluation, because that is when deficiencies begin to appear. Around thirty years of age, we lose hormones from 1%-3%. It’s never too early for any adult to begin a nutraceutical program. A person does not need to begin hormone modulation therapy until the body begins to lower its hormone production. Blood tests and assessments help determine exactly where you may be most deficient and how we can help you. Every person is different and will have different needs as far as hormone modulation goes. Will Hormone Replacement Treatment interfere with my currently prescribed medications? Not usually. In some instances, other medications may actually be reduced or no longer needed. Your Hormone Management physician will be able to advise you on this.

Forms Policy
If a patient asks us to fill out forms this is how we will handle such requests.  Examples may be insurance prior authorizations, insurance billing forms, physical exam forms for work or school, etc.  Please be prepared to compensate us for our time as follows:

  • Our rate for our doctors is $350 per hour, billed in increments of 5 min.
  • If another staff member can fill out the form or make the phone call, it will be billed at $100 per hour, in increments of 5 min.

Please keep in mind that there are many things that we do for patients that we do not charge for such as processing of paperwork required for the chart and visits (Dr. Farnesi and staff spend 20 minutes or more preparing for each consultation), laboratory requisitions and results, processing of prescription refill requests, the occasional patient email, and more.

This policy allows us to better manage our practitioners’ office hours so that we may continue to provide excellent patient care.

Medical Age Management is a premier anti-aging and aesthetic skin care services provider in Southern California