Monique Ramsey (00:07):
You are listening to The La Jolla Cosmetic Podcast. Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey, and today I'm joined by Brittany Haley. She is one of our wonderful providers in the med spa. So hi, Brittany. Welcome.

Brittany Haley (00:29):
Thank you. I'm happy to be here.

Monique Ramsey (00:32):
So last time you were here, we talked about lasers. Now today we're talking about a device, but it's not a laser. Right? We're going to talk about ThermiVa. Tell us about what ThermiVa does and what kind of technology it uses.

Brittany Haley (00:49):
Absolutely. Yeah. So ThermiVa is, we classify it into our device type of category for treatments we do here, but it's not a true laser wave link. It actually utilizes radio frequency, so electricity, heat energy, and it uses this in a temperature controlled manner to convey our tissues up to this certain temperature that stimulates things to happen.

Monique Ramsey (01:16):
Interesting. So you said the technology behind ThermiVa is radio frequency, so that heats the tissue to stimulate the changes that you're after?

Brittany Haley (01:28):
Definitely. Yeah. So in the studies that ThermiVa has done, they show that in order to create a change in the tissue, you want to heat the tissue to a certain temperature. So the temperature that we set the machine at is 38 to 45 degrees Centigrade. Once we hit that 40 range, we're in that temperature mode where we can promote blood flow in the area where we can see those changes happen. Most of my patients have no problem, I'm getting up to even 45 or even 46 degrees centigrade, but as long as we can get them up to that 42, that's where the changes start to happen clinically. And the way they did the study, and it was a more recent study. It was done in 2018. With their sample pool, they actually did a little histology. So they took a tiny little punch biopsy in the tissue in the vaginal wall, and then they had the participants do the recommended protocol.

(02:26):
So the protocol for ThermiVa is doing three treatments that are 30 minutes each a month apart, and then they measured their baseline 60 days, so two months after that third treatment. And they saw some really amazing, really cool changes in that tissue histology. They saw increased blood vessels, so increased blood flow to the area, changes in the dermal layer of the tissue. And interesting enough, they actually saw a new system and nervous system, so they actually stimulated new nerve tissue to grow which would show how it increases sensitivity. So all of the samples I had showed improvements in one of these areas or more. So it can help with all those things a little bit.

Monique Ramsey (03:13):
So what are the main complaints that maybe the ladies who come to you have and want you to fix and that ThermiVa addresses?

Brittany Haley (03:25):
Yeah. This is a very, very popular procedure for our postpartum women. When you've gone through this traumatic childbirth or even C-section, there can still be some changes there and things just aren't looking the same as they used to pre-pregnancy. You have some laxity, stress urinary incontinence is a big one, and those are the two that I think that we see the most. And then I also have women who want to just increase lubrication, increase sensitivity, especially during the early menopausal period. I recently did a consult with a woman and she was having some issues there and she's like, I'm 65, I know I'm getting older, but I don't want this to be the end for me. I'm feeling great. I'm looking great. I want to feel and look the same as I do down there, as I do on the outside. And so this was just a slam dunk recommendation for her. It's a fairly easy treatment to do. It's quick. There's no healing time. There's no downtime. It's very comfortable to perform and it works well.

Monique Ramsey (04:32):
And I think that you mentioned earlier, because I was looking around the web, and the only time I saw dissatisfaction is people who had only one treatment and what you stressed earlier was it's not a one and done thing. It's a series of treatments done a month apart. They build on each other and that then I think you were mentioning earlier before we started some really amazing satisfaction rates.

Brittany Haley (04:57):
Definitely. I mean the RealSelf satisfaction rate for ThermiVa is actually 95%, which is very impressive. As with all non-surgical procedures, of course we would love to have that one and done and have that be taken care of, but it just doesn't work that way. And it takes sometimes one or two treatments to see an improvement, especially if your concerns are a little bit more severe. On the flip side of that, for some of my younger patients or some that are experiencing very mild symptoms, they do one treatment and they're thrilled. So that does happen too. It does happen. I've had that happen, and that's wonderful when that happens and I love that and I'm so happy, but that's not the norm. And most people who are experiencing symptoms enough to seek out a consultation, they do really need to do the full treatment protocol. So doing those three treatments a month apart and then we do do maintenance treatments every six months to a year to maintain those results.

Monique Ramsey (05:57):
That's great. So you said it can address more than one thing if say, stress urinary incontinence is a problem, but also maybe dryness is a problem and maybe sensitivity is a problem. Do you tailor it for each patient depending on what's their biggest complaint or does it hit all three or four things no matter what their complaint is?

Brittany Haley (06:20):
I think with this procedure, consultation and being able to talk about what's really bothering you and how we can address that directly is super important. So I do have a consultation with every ThermiVa patient before we discuss these things. And then no, sometimes it's not easy to discuss these things, so we make it a very open, comfortable environment. I'm always very open and honest that I've had this procedure done and I know how it works and I've had babies and I know all of these things too, and they happen to everyone. You're not alone. So for example, if a patient says, hey, what I really want to focus on is the stress incontinence. I'm jumping and I'm having urine leak and I've never had this before and this is a real issue for me, then we will focus where you need it. And so when I'm doing a treatment customized for that particular need where I'm focusing the energy of the treatment time is in a specific spot. It's in the anterior wall of your vagina.

(07:13):
So I'm actually going to spend more time in that area. I'll focus there. We'll make sure we do a little bit extra time there. We'll still address other needs as well. A typical treatment is 30 minutes and typically for just an all over rejuvenation where I want to address a little of all those things, I'll spend about 10 to 15 minutes on the labia itself. So to provide some external tightening, we'll do a little bit of heat right over the clitoris itself to help with orgasms and increased sensitivity there. And then I'll focus the rest of the time inside the vaginal wall. I do focus a little bit on each wall of the vagina, but where all the most important things are for most people in stress urinary incontinence, as well as the G-spot, is in that front anterior wall, so the one in the very front. So typically I will start there, focus some time there. I'll do a little bit all over, and then I'll end there as well so they get a little extra treatment time in that area.

Monique Ramsey (08:10):
If you could describe for people the pain or lack thereof, do you need medication during the procedure? Can you drive yourself? Tell everybody a little bit what it's like, and I think we'll have some pictures in the show notes of the device itself, and if you could just so people can picture what's happening.

Brittany Haley (08:31):
Definitely. And I just did that recording and so we got a really beautiful shot of the device itself, kind of what the treatment room looks like a little bit. We do use some ultrasound gel for the treatment, and we do have a warmer for it, so it's nice and warm. You don't have that cold splash of gel on you like when you get an ultrasound. And then you actually will get a chance to see the probe that we use for the treatment. It's a very specialized probe that is customized to do the treatment very comfortably. It has heat emitting from one side of the device where the frequency comes out. And so that's where we use to target the energy on the area that we're treating and it feels warm. I typically will start by setting our peak temperature at a little bit lower rate to kind of warm the area slowly.

(09:19):
And then once you're comfortable with that temperature, I'll usually put it up to the max temperature of 45 pretty quickly. So it's a pretty seamless transition. It feels warm, but it's not uncomfortable. Once in a while if there is, if it feels a little warm in one area, I'll move on and I'll come back, so kind of spread it around a little bit. But I've never had anyone tell me that it was just super uncomfortable that they needed anything else, so just a gentle warming sensation and surprisingly, and for the interior vaginal wall, you barely feel it.

(09:48):
So it's a warm sensation, but it's not uncomfortable. And I think one thing that we do offer here that's really nice is it's normal to be anxious, of course, for any procedure, but especially with one, you know, in sensitive as this area and this treatment. And so I have had patients in the past use our Pronox, which is a very, very light form of laughing gas that we do offer here at La Jolla Cosmetic. And you can use it for the treatment to help relieve anxiety. And this is something that it works quickly, works in a matter of seconds. It lasts about five minutes so you can drive yourself to and from the appointment. And it just helps reduce anxiety around the appointment making it a little bit smoother. I haven't had many patients really need that, but for anxiety concerns, I think that it can be really helpful.

Monique Ramsey (10:37):
That's great. And I think that it's good for people to realize that you're having this, you have it 30 minutes, but you can go home, go back to work, go out to a party, and you could even have sex the same night. Is that right?

Brittany Haley (10:52):
That is right. Yes. So the wonderful thing is that there's virtually very little downtime. There's no activity restrictions. Once the procedure is done, you can have sexual intercourse that night, if you wish. You may have a tiny bit of cramping. That can be normal and maybe once in a while, tiny, tiny bit of spotting. That's unusual as well. And I almost associate the cramping as a good thing. We know something happened. We know changes are taking place. We all remember our high school days and we had those horrible cramping periods. It's almost like you're bringing back some new life in there, that there's changes happening., So not a bad thing. And one that's not super common, I would say maybe 10 to 15% of patients do have a little bit of light cramping after that can be relieved with a little bit of Tylenol, Ibuprofen, if needed.

Monique Ramsey (11:38):
Okay. Now, who would not be a good candidate for ThermiVa?

Brittany Haley (11:44):
There are a couple of medical conditions that wouldn't make you the best candidate for ThermiVa treatment. And one of them would be something like a severe disease to the area, severe like in sclerosis would be a difficult treatment to do. Anyone who is having any sort of infection or active outbreak, a UTI, that kind of thing would not be good to do a treatment until that has fully resolved. And then anyone who had a really severe autoimmune condition where they didn't have maybe the same healing or they were taking some immunosuppressive medication wouldn't be our best candidate. But in reality, that's a very small percentage. Most people are great candidates for this procedure and there's not a whole lot of contraindications.

Monique Ramsey (12:27):
Now you said it helps with vaginal tightening and the tightening of the labia like outside, but also inside. Are there some people who might think, oh, I can have ThermiVa, and then you say, no, maybe you need surgery or how, because I know that some of our plastic surgeons do labiaplasty, do vaginal neuroplasty, do some of the other feminine rejuvenation procedures. How do you know when you're a good candidate?

Brittany Haley (12:54):
With radiofrequency treatments, we will see some tightening. We'll see some smoothing, but what it can't do is it can't remove tissue. So when you are looking at the area, if you have tissue, they're like this tissue needs to be gone, then it's something that probably you're going to be better off having that done with a surgical procedure. And so we do offer that here and we have surgeons who specialize in that here. And that's something where I would encourage them to do a consultation as well and see.

(13:23):
And maybe something where we can do some even combination treatments. And if surgery is just out of the picture, if you're not an option, it will improve a little bit. And it's something that if you're not sure of, then I can always speak with you when we have our consultation or when we actually do our first treatment. What I typically will do is I'll do a photo for you and I usually do it on your phone, so no one else has to see it, but it's on your phone so you know and we will look at it together so that way we have a really safe way to talk about it together and limitations and when you may want to consider that.

Monique Ramsey (13:56):
Okay. Okay. Now, if anybody who's been listening to our podcast or knows La Jolla Cosmetic, you know how much we love reviews, so I found a review from one of your ThermiVa patients, and here's what she said." I'm a 39 year old mother of three, and I've had problems with bladder leakage since my first born five years ago, something that I assumed was totally normal that I would have to live with for the rest of my life. I had three sessions of ThermiVa done by Brittany, and I'm extremely happy with my results. No more bladder leakage. I'm very active, so this is life changing for me." So she's happy not to be leaking anymore. What other kinds of improvements have you heard some of your patients describe after the treatment? Maybe something that they didn't even think would happen.

Brittany Haley (14:47):
I think increased lubrication is definitely something that it helps with, that sometimes patients aren't even aware that that was an issue for them, and they notice a difference with that, and that's always really exciting when they get this extra thing they weren't even that concerned. They're like, oh my gosh, wow, it's so much better. So that is one area. And then increased sensitivity. So increased sensitivity, I feel like I was saying in that study that did show that there is neurosis happening, that this has the ability to create new sensitive tissue there, so overall increase in sexual satisfaction.

Monique Ramsey (15:23):
Nothing wrong with that. That's a great bonus.

Brittany Haley (15:25):
Yeah. There's nothing wrong with that. Yeah. For a completely, non-invasive treatment with very little downtime. And I think that a lot of women feel that way. Like this is how it is. I have to live with this. And they've lost hope, that there could be something to make it better. And so I think that it's really great to get the word out there that there is something easy that will help, that's non-invasive. It doesn't involve hormone therapy. That's a big one for a lot of women these days who are experiencing those changes. They don't want to do hormone therapy and the patches and that kind of thing. There is an alternative.

Monique Ramsey (16:01):
Yeah. And I've even seen some products online that you insert everyday or every other day, and that's still. I think that gets messy and none of us want to have to do that every day. And so this is a nice way to have your series of three. You're good for six months to a year or more depending when you need it. You'll kind of know. If anybody's interested in kind of the surgical side of vaginal rejuvenation, we did do a Lady Bits podcast episode quite a while ago at the beginning of when we started, and that was really, really, it was our most popular episode at the time. So we'll put a link in the show notes to that. So lastly, what other treatments might be combined with ThermiVa?

Brittany Haley (16:47):
We are also a certified center in performing PRP for feminine and male rejuvenation here at La Jolla Cosmetic with a procedure we call the O-Shot. And they do talk about it in Lady Bits too. It's a great procedure in combination with ThermiVa though, so it can just kind of bounce upon hitting multiple things with one treatment are really maximizing results. So if someone had some problem with achieving orgasm, reaching orgasm, and they really wanted to target that, I would say, okay, let's do ThermiVa. We're going to focus on external. We're going to focus on internal vaginal wall, and then we're going to add an O-Shot too. So we're going to give that just double whammy. With O-Shot, we are doing shots of growth factors, so growth factors are stem cells that we take from your own blood. So there's very little concentrations.

(17:39):
You really can't be allergic to them. It's your own blood. And then we are injecting them in a concentrated form into three areas. So we're doing one into the back of the clitoris. We do one into the urethral border, which helps with urinary incontinence. And then we're also doing some into that anterior vaginal wall where you have the G-spot and it's as well further improvement with the urinary incontinence. So adding those two together is like a home run, really, really wonderful combination. And they can be done on the same day. So that has become increasingly popular over the last year as we're doing an O-Shot at the first ThermiVa appointment, following up with the next two ThermiVas, and then potentially for their maintenance treatment doing that ThermiVa with O-Shot once a year and once every six months.

Monique Ramsey (18:31):
Okay. Now before we wrap it up, do you have an idea of the cost of the treatment?

Brittany Haley (18:39):
I believe the price is, I think it's around 900 for a single, and we do offer a package and it's beneficial for everyone to do the package. I mean, once in a while, I do have patients who just want to try it. They're nervous. They won't do well with that, and that makes sense. But the package ultimately is what you'll want to do because you are going to want to do your three treatments and then you're going to be in maintenance mode where you will need your maintenance treatments and they never expire.

Monique Ramsey (19:01):
Okay.

Brittany Haley (19:02):
So we do offer that package pricing.

Monique Ramsey (19:04):
Yeah. I have here, on our website, we do have for everybody a list of ranges of all the procedures that we do. So ThermiVa, we have, it's $1,300 to $3,900, but for our GLAMfam members, you're going to save a minimum of 15% because that's what you save. And sometimes more when you do a package. And then the O-Shot looks like from around $1,190 to $1,400. But again, it depends on whether you're a GLAMfam member or not. So it's really, I think especially with, depending on what you need, we have financing, so it can be really affordable where you can just kind of slot in with a monthly payment and be able to enjoy your results as soon as this first night.

Brittany Haley (19:50):
Absolutely.

Monique Ramsey (19:51):
Really not maybe the first night on the first treatment, but they will build on each other, and that's something that people really love about that there's no downtime. So the last thing, when you talked about your consultation, so was that a Zoom consult you, because you were talking about photos or are you seeing them for consult in the office?

Brittany Haley (20:14):
We are doing both. So I do virtual and in-office consultations so it really would be about personal preference. If somebody had a concern when they were maybe considering ThermiVa versus a surgical procedure, I would encourage an in office so that we can really evaluate and talk about the best plan together. And then typically for ThermiVas, I will do a phone consultation, so phone or Zoom. I do think patients like to get a feel for it virtually first, talk to me a little bit, see what it's about, see if it's going to help them with their concerns, and just generally steer them in the right direction for whatever we decide the best plan is.

Monique Ramsey (20:52):
Great. Well, thank you, Brittany, for talking about this and sharing your own personal experience, and I'm assuming it was a positive help after your babies.

Brittany Haley (21:01):
Absolutely. Yes.

Monique Ramsey (21:03):
So in the show notes, we'll have all the links for scheduling and financing, and I don't know if we have any before and after photos of ThermiVa because it's not necessarily... Do we have a few?

Brittany Haley (21:16):
We actually do. Of course, it being an intimate nature, those aren't going to be on our website, but we do have some before and afters and they can be sent through our patient coordinators.

Monique Ramsey (21:29):
Okay. Okay.

Brittany Haley (21:29):
We do have those available.

Monique Ramsey (21:31):
All right. Perfect.

Brittany Haley (21:31):
And they're wonderful.

Monique Ramsey (21:33):
Oh good. Oh good. Yeah. And then lastly, if, you know, if you love our podcast, we would love to have you write us a review on Goodpods or Apple Podcasts or Spotify or wherever you watch your podcasts. And thanks again, Brittany. And we will see you all next time.

Brittany Haley (21:49):
Thank you. My pleasure.

Speaker 3 (21:57):
Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment, or mention the promo code PODCAST to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla Cosmetic is located just off the I5 San Diego Freeway in the XIMED Building on the Scripps Memorial Hospital campus. To learn more, go to LJCSC.com or follow the team on Instagram @LJCSC. The La Jolla Cosmetic Podcast is a production of The Axis, the axis.io.