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While many plastic surgeons and gynecologist promote the benefits of vaginoplasty for vaginal tightening and labiaplasty for cosmetic enhancement to the outer pelvic structures, few perform Dr. David Matlock’s Laser Vaginal Rejuvenation or the Designer Laser Vaginoplasty procedure.

These innovative techniques, pioneered by Dr. Matlock, provide safe and successful surgeries by utilizing state-of-the-art laser technology, reducing blood loss and providing quicker healing.

Dr. Matlock’s ingenious approach for these two cosmetic procedures is shared by those physicians who have been accepted to his Laser Vaginal Rejuvenation Institute of America in Beverly Hills, California.

Dr. Randy Birken is an Associate of LVRIA and has operated with Dr. Matlock.  Dr. Birken offers these procedures both in Houston as well as The Woodlands, Texas

For more information call Liz at 281-419-3231 or email at

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HCG stands for human chorionic gonadrotropin, or pregnancy hormone.  A metabolic regulatory hormone, it reduces weight by metabolizing fat without affecting lean muscle.  Patients can lose from 1/2 to 3 pounds per day without significant side effects.

While not FDA approve, studies have shown good success.

Check out this website for more information:

www.hcgdietinfo.com

To view a short presentation on Bioidentical Hormones and Vitamins for Healthy Aging and Weight Loss, click the following link:

http://tiny.cc/IXM36

For more information, call Liz at 281-419-3231 or email at

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While controversy concerning “Hormone Replacement” remains, Dr. Randy Birken, a board certified gynecologist and Clinical Assistant Professor at Baylor College of Medicine, is an advocate of bio-identical hormone replacement (BHRT).

BHRT is compounded from plants and has similar molecules to human hormones,” Dr Birken said.  “This allows the practitioner to customized estrogen, progesterone, testosterone, as well as metabolic hormones for each individual.”

Patients who are menopausal or peri-menopausal and suffer from symptoms such as hot flashes, night sweats, fatigue, difficulty sleeping, low libido, and weight gain will usually see significant improvement. While more expensive than pharmaceutical synthetic hormones, BHRT offers patients a more precise and natural approach to declining hormone function.

For more information, call Liz at 281-419-3231 or email at

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Interesting article on in-office tumescent liposuction.

Tumescent Liposuction

Ron M Shelton, MD, Assistant Professor, Department of Dermatology, Mount Sinai School of Medicine; Director, The New York Aesthetic Consultants, LLP

Liposuction is the most commonly performed cosmetic procedure in the United States. It is also referred to as liposculpture, lipoplasty, and suction-assisted lipectomy. The ideal candidate is physically fit and eats well-balanced meals but is unable to reduce a fatty deposit that is well localized and often seems to involve a genetic susceptibility.

In the past, the surgery required blood transfusions because blood loss in the aspirate was significant. Dr Jeffrey Klein, a dermatologic surgeon, is credited as the originator of the tumescent technique, which has allowed liposuction to be performed with the patient under local anesthesia while minimizing blood loss and the risks of general anesthesia. Since its inception, liposuction performed with the tumescent technique has had an excellent safety profile.

For more information, call Liz at 281-419-3231 or email at

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Anti-aging medicine has become the description for those clinicians who offer evaluations for bioidentical hormones, nutritional status, and neuro-transmitter testing.

“With the use of sophisticated lab tests, we can determine the vitamin, anti-oxidant, mineral, amino acids, and other essential nutritional values of a patient,” Dr. Randy Birken, founder of Birken Medical Aesthetics said.  “Additionally, we test for hormones that influence sleep, stress, energy, depression, anxiety, and weight control.  With this valuable information, we can recommend appropriate supplements and prescribe bioidentical hormones.  Patient feel well and are healthier as they age.  This, with good diet and exercise, are the cornerstones to anti-aging medicine.”

Dr. Birken is a Clinical Assistant Professor at Baylor College of Medicine. For more information:
Liz – 281-419-3231

or email at

[email protected]

Over the past several years, the buzz surrounding compounding, or bio-identical hormones (BHRT), grew louder in my ears, like a pesky mosquito that wouldn’t go away. While Suzanne Somers’ books, The Sexy Years and Ageless, provided enlightening information to the public, her media blitz expounding the virtues of BHRT seemed self-serving.

But the ever-present comments from my patients, such as “My friend takes natural hormones and is losing weight,” “My sister sleeps better on bio-identical hormones,” and “Bio-identical hormones are safer than synthetic hormones,” were hard to ignore without understanding these substances.

My first reaction was to dismiss BHRT. As a board-certified specialist, I read my journals and took the appropriate CME courses. The American College of Obstetricians and Gynecologists Committee Opinion from November 2005 emphatically stated that “there is no scientific evidence to support claims of increased efficacy or safety for individualized estrogen or progesterone regimens.”¹

So it would have been easy for me to reject bio-identical hormones. But as a physician, I have an obligation to explore the treatments my patients ask about. Do they actually feel better on bio-identical substances? Do they have more endurance, better sleep and improved libido? I needed to find out, but without the hype and high-priced courses offered by some physicians whose interest may be clouded by monetary factors.

While strolling through the plethora of “hits” from a Google search, past the glut of anti-aging sponsored Web sites, I find one with a genuine feel from Neal Rouzier, MD.² Was this good karma or just plain luck? Who knows, but off I went to Salt Lake City for a two-day weekend course titled, “The Effects of Hormonal Therapies on Quality of Life Issues: The Medical Management of Aging.” I was intrigued, but skeptical.

The upscale hotel accommodations contrasted with the Spartan conference room. Instead of sophisticated PowerPoint slides, Dr. Rouzier uses an overhead projector sans microphone, his voice loud and commanding. And so began a two-day course unlike any other CME seminar I have ever attended. From 8:00 a.m. sharp until almost 6:00 p.m., Dr. Rouzier meticulously covers all the topics with an occasional five minute respite for a bathroom break. Even lunch is a working session, as we cover seminal medical publications. Coupled with practical clinical applications, the course moves rapidly with constant edifications. It’s so enlightening that the two days seem like an hour lecture.

First, Dr. Rouzier presents material on human growth hormone (HGH), a pituitary substance that affects nearly every organ in the body. It’s necessary for proper growth and development. A landmark study by Rudman et al. concluded that diminished secretion of HGH was responsible, in part, for a decrease in lean body mass, expanded adipose tissue mass and the thinning of skin during old age.³

Various publications conclude that physiologic HGH replacement therapy might reverse or prevent some of the inevitable sequela of aging. Dr. Rouzier slowly and methodically walks up and down the conference room with his head slightly tilted downward, a gesture of contemplation, articulately referencing all the good things about HGH in the medical literature. The man, dedicated to the quest for knowledge, reviews a legion of medical publications per week. This is not a show, but a well-organized and researched seminar from a doctor who has practiced using bio-identical hormones for 10 years.

Just as interesting is the next section on testosterone, revealing that its physiologic replacement in men and women increases muscle mass, strength and endurance and decreases fat. It also increases exercise tolerance, as well as libido and sexual performance. Thoroughly, Dr. Rouzier covers a review article from the New England Journal of Medicine on the risks of testosterone replacement therapy and recommendations for monitoring. His survey is honest and fair while raising points about proper use and potential complications.⁴

What about DHEA, a substance patients ask about often? Is it for real? Can a hormone secreted by nerve tissue and adrenal glands result in a shift from a catabolic to an anabolic or protein-building state, reducing cardiovascular risks while improving mood, memory and energy? Articles from the American Journal of Physiology, the Journal of Endocrinology and Metabolism and the New England Journal of Medicine support some of these claims. One article from 1994 concluded that DHEA was associated with a remarkable increase in physical and psychological well-being in men and women.⁵ I lean back in my chair, a bit overwhelmed, but wanting to learn more.

Estrogen and progesterone, those much maligned hormones, suddenly seem amazingly safe and necessary from a bio-identical perspective. These are not just plant-derived hormones, but structures that are chemically identical and, therefore, physiologically beneficial, protecting against heart disease, stroke, osteoporosis, Alzheimer’s and memory disorders. They also can eliminate menopausal hot flashes and vaginal atrophy. Because progesterone is not progestin, a synthetic formulation, it ameliorates PMS and menopausal symptoms while lowering cholesterol, increasing bone density and providing a natural mood calming effect. A study from Hargrove et al. revealed that the combination of micronized estradiol and progesterone offered substantial clinical benefits for women with postmenopausal symptoms and an intact uterus.⁶

Dr. Rouzier is just warming up. His strongest opinions are saved for the controversial section on thyroid treatment, stating that it’s the “most misunderstood hormone.” Expertly, he dissects nearly 40 medical articles about thyroid treatment, emphasizing that bio-identical thyroid—not synthetic—reduces fatigue, improves thinning hair as well as cold intolerance, while promoting weight loss and reducing body fat.⁷ His wrath against the synthetics crescendos as he justifies bringing triodothryronine (T3) levels back to physiological levels, interspersing actual patient lab results on the overhead projector, teaching the correct interpretation of the most clinically useful blood tests.

Does the man ever get tired? I wondered if his Olympian stamina is related to his using bio-identical hormones? Maybe it’s the melatonin he takes, that great sleep promoter and immune enhancer that provides him with Superman endurance? Or could his encyclopedic knowledge be enhanced by pregnenolone, a hormone that may protect against memory loss? His educational program is more than impressive. It’s inspirational. Dr. Rouzier’s enthusiasm is contagious, especially when he relates clinical stories of patients who not only respond to BHRT, but who also stop taking other medications, such as statins, anti-depressants and bisphosphonates. I leave Salt Lake City anxious to begin bio-identical hormone assessment and treatment and to register for his part II and part III courses, further probing the mostly untapped benefits of hormone therapy.

Putting It into Practice

I re-read the 550 pages of Dr. Rouzier’s handout, searching for a way to begin BHRT counseling. How do I start? Will patients be interested in BHRT or satisfied with their current regimen? I don’t know, but the first patient I treat is my wife, who has been on synthetic estrogen and progesterone for several years. While she isn’t thrilled about being a guinea pig, she agrees to have blood levels tested, but remains skeptical to the concept. Eagerly, I wait for the results: an estrogen level pitifully low, the expected, almost nonexistent progesterone level, and testosterone and DHEA values well below optimal range.

“Are you game?” I ask. After some coaxing, she reluctantly agrees. Instead of one pill per day, she now takes three and uses a cream. She finds it inconvenient, but I ask her to be patient and to see what happens.

Surprisingly, most of my patients who take HRT are interested in either changing to BHRT or learning more about it. Even patients who have been off hormones are intrigued by the possibility of improved stamina and sleep, as well as weight loss. Lab tests are ordered, the results reviewed and patient consultations are made with recommendations for estrogen, progesterone and testosterone replacement, along with thyroid and DHEA supplementation, if indicated by suboptimal values and clinical symptoms. It will be a month before I see these initial patients again, so I cautiously watch my wife and wait to hear her take on it.

Just three days after starting her BHRT, she tells me she thinks something is working. I raise my eyebrows. “How so?” A tilt of her head suggests deep thought. “Not sure,” she says, “but I feel different, better, not sure exactly why or how.”

And so it goes with my patients. Most feel better, and many claim to sleep longer, have more energy, fewer hot flashes and/or night sweats. They seem happier, have less vaginal dryness, and most comment on their improved libido.

But not all will be elated, and sure enough, I’m right. Those with no or little clinical response have lab values consistent with minimal changes. Customizing the dosages, as well as the combination of estradiol to estriol and T4 to T3, makes me feel like an internist instead of a gynecologist. Yet, it all makes sense, and even these poor responders return with some improvement and positive feedback. The most difficult patient, my wife, also requires some tweaking to her hormone dosages and combinations until the desired values and clinical responses are met.

Anecdotally, I make an interesting observation. Every patient who takes testosterone seems to have better-looking skin. Is this for real or just my imagination?

“You’re right,” my wife says. “I now have some oil to my skin when before it was dry. My skin feels soft and silky like when I was young.”

I don’t want to get too excited. This seems like the real deal and maybe I should convert everyone to BHRT, but some drawbacks exist. First, because they are bio-identical substances, they cannot be patented by pharmaceutical companies and, therefore, are not regulated by the FDA. As physicians, we have the knowledge and expertise to use bio-identical hormones, but some clinicians feel uncomfortable using non-FDA approved medications.

Second, most insurance companies won’t cover these compounded hormones. Patients usually pay significantly more for them compared to hormones on insurance formularies.

Third, it takes time to find the right combination for each person. Several follow-up visits and repeat blood tests are needed so patients can reach optimal levels and realistic clinical improvement.

While BHRT may or may not slow the aging process, it works well clinically, improving quality of life and well-being. Many of my patients are happy with BHRT, and I’m glad I listened to them. This experience taught me that we need to learn from others. Often, the best ones to teach us are our patients.

For a list of references, go to advanceweb.com/healthyaging and click on the references toolbar.

Randy A. Birken, MD, is a clinical assistant professor at Baylor College of Medicine and medical director of Birken Medical Aesthetics.

For more information, call Liz at 281-419-3231 or email at

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Childbirth, age, menopause – all contributors to a poorly recognized gynecologic problem – vaginal looseness and its effect on diminished sexual gratification. Today’s women are looking for a way to tighten the vaginal musculature and ligament support to improve sexual response. Yet, most gynecologist are not aware that pelvic relaxation can seriously effect a female’s response to intimacy, and only concentrate other associated conditions, such as urinary incontinence or difficulty with stool evacuation. Medical schools and postgraduate training programs usually ignore the sexual aspect to this problem; hence the lack of knowledge or expertise on a condition that can lead to emotional or relationship difficulties.

Laser vaginal rejuvenation, or LVR, is a combination of simple surgical repairs that strengthens tissue stretched and injured usually secondary to childbirth trauma. This innovative procedure was pioneered by Dr. David Matlock, founder of the Laser Vaginal Rejuvenation Institute of America located in Los Angeles, California. His comments on his website, www.drmatlock.com summarizes his mission:

We have learned a tremendous amount from listening to women we have treated from 50 states and over 30 countries. Women come to us because they want knowledge, choice, and alternatives. Women want their gynecologist to listen to them and provide viable solutions. Women throughout this nation and the world have told us that Kegels do not work-but no one is listening. Women who have had children want a solution to rejuvenate the vagina and achieve the best sexual experience possible. For women with no children, solutions are available through design modification to accomplish their desires.

What is involved with LVR? By using a fine tipped laser, tissue is gently removed and underlying connective tissue, muscles, and ligaments are restored to normal anatomy. The operation takes about one hour and is performed on an outpatient basis. Those women who suffer from urinary incontinence or stool evacuation will have improvement, if not cure, for these embarrassing problems as well; but most importantly, the patient will experience the kind of sexual response she had before children – an important part for the women as well as her partner.

Here is a typical patient response to LVR:

I did not feel the same sensation while having sexual intercourse. Things had changed dramatically for me. Trying to reach climax was all but impossible. I felt very uncomfortable having sex. It began to have a negative affect on me mentally, not to mention physically.
After the 6 weeks of healing took place I felt as good as new, having this procedure was the best decision I had made regarding my health. I felt confident and vibrant again. And my love life was back on track. Having no problem reaching sexual gratification. Even my husband noticed the difference and was very pleased. I would recommend this procedure to anyone who is suffering from this discomfort, and who best to hand the problem than a Gynecologist.
It gave me a whole new outlook on things, it was a motivational experience that took place. I soon lost unwanted weight, cut my hair, and made more personal improvements physically since then. It was just what I needed to get things going again.

In summary, Laser vaginal rejuvenation is a combination of minimal invasive techniques utilizing laser technological to correction vaginal looseness and provide anatomical correct restoration to the vaginal canal providing improvement in sexual gratification leading to overall improvement in psychological well-being, a significant part of a healthy relationship between a woman and her partner.

For more information, call Liz at 281-419-3231 or email at

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Dr. Randy Birken, founder of Birken Medical Aesthetics and board certified gynecologist, now offers no-needle mesotherapy or lipodissolve for fat and cellulite reduction.

“I’m please to offer the Transdermal Ionto to Houston-The Woodlands and South Texas,” Dr. Birken said.  “This advanced transdermal device delivers solutions without needles into unwanted fat without the trauma, bruising, swelling, or pain associated with injections.”

Dr. Birken can use the Transdermal Ionto to deliver collage to the face to reduce wrinkles and “plump up” the skin without needles as required for Restylane or Juvederm.

“This advanced technique is an huge advantage over traditional injectables,” Dr. Birken said.

For more information, call Liz at 281-419-3231 or email at

[email protected]

No needle, or needle free, collagen combined with laser photo-rejuvenation is a safe and effective way to improve skin texture, fine wrinkles, laxity, sun-damage, and pore size without surgery of down-time.

Dr. Randy Birken, founder of Birken Medical Aesthetics, has created an excitement new development for non-surgical facial rejuvenation.

“It makes sense,” Dr. Birken, Clinical Assistant Professor at Baylor College of Medicine said.  “The laser stimulates natural collagen production while the no-needle technique adds new collage – the best marriage for skin facial improvement.”
For more information, call Liz at 281-419-3231

or email at

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What is mesotherapy and how does it work?

“Mesotherapy was developed in the early 1950′s and is used widely in Europe and gaining popularity in the U.S.,” Dr. Randy Birken, founder of Birken Medical Aesthetics, said.  “The science is fascinating.  Solutions are either injected or applied without needles through a transdermal technique.  Fat is slowly absorbed into the blood and excreted in the urine and stool.”

Dr. Birken has been performing mesotherapy for many years with great success.

“You must be patient,” he continued.  “It takes several sessions to reduce fat to a clinically acceptable level; but now with a no-needle approach, treatment is simple, safe, and without pain.”

For more information, call Liz at 281-419-3231 or email at

[email protected] or call 281-419-3231