Evolved Medical · Walnut Creek, CA
Patient Instructions
Male Hormone Therapy (TRT / HRT)
Direct link: evolvedmedical.com/instructions.html#service-male-hormone-therapySide Effects
- Estrogen elevation: Water retention, mood changes, breast sensitivity — managed with aromatase inhibitors.
- Elevated hematocrit: Monitored with labs; may require phlebotomy.
- Acne / oily skin: More common early; resolves with dose stabilization.
- Testicular atrophy: Expected; reversible with HCG if desired.
- Fertility / sperm suppression: Discuss HCG protocols if fertility matters.
⚠ Contact Us Immediately: Chest pain, shortness of breath, or leg swelling (blood clot) · Severe mood changes or aggression
Timeline
| Timeframe | What to Expect |
|---|
| Weeks 1–2 | Early mood and energy improvements |
| Weeks 3–6 | Libido, energy, and sleep improvements |
| Months 2–3 | Body composition changes begin |
| Months 3–6 | Full optimization through follow-up labs |
| Ongoing | Maintained with consistent adherence |
Lab Monitoring
| Timepoint | Tests |
|---|
| Baseline | Comprehensive lab panel — everything important |
| 6–8 weeks | Response assessment and protocol adjustment |
| Every 3–6 mo. | Follow-up appointments and lab testing to optimize |
Storage & Supplies
- Store at room temperature; protect from light
- Supplies: insulin syringes, alcohol swabs, sharps container
Injections (If Applicable)
Staff will train you on safe injection procedures. Rotate sites every injection.
→ Full Injection Instructions
Pellet Post-Care (If Applicable)
- Remove pressure bandage after 3 hours
- No submersion for 3 days
- No strenuous lower-body exercise for 3 days
⚠ Call Us: Increasing redness/swelling beyond day 3 · Pellet extrusion · Fever >101°F
Female Hormone Therapy (BHRT)
Direct link: evolvedmedical.com/instructions.html#service-female-hormone-therapySide Effects
- Adjustment symptoms: Breast tenderness, mild cramping in first 4–8 weeks.
- Mood fluctuations: Brief changes before levels stabilize.
- Spotting: Breakthrough bleeding common early; report persistent or heavy bleeding.
- Scalp hair loss / acne / facial hair: More common with testosterone therapy.
⚠ Contact Us Immediately: Heavy vaginal bleeding · New breast lump or discharge · Chest pain / SOB / leg swelling · Severe headaches or vision changes
Timeline
| Timeframe | What to Expect |
|---|
| Weeks 2–4 | Sleep and mood improvements |
| Months 1–2 | Hot flashes, night sweats, energy improve |
| Months 2–4 | Libido, vaginal comfort, mental clarity continue improving |
| Long-term | Bone and cardiovascular protective benefits |
Lab Monitoring
| Timepoint | Tests |
|---|
| Baseline | Comprehensive lab panel |
| 6–8 weeks | Response and adjustment |
| Every 3–6 mo. | Follow-up labs to optimize |
Topical Application (If Applicable)
- Apply to inner wrist, arm, or thigh as directed
- Allow to dry fully; wash hands after with soap
- Rotate sites daily; avoid breast tissue
Pellet Post-Care (If Applicable)
- Remove pressure bandage after 3 hours
- No submersion for 3 days
- No strenuous lower-body exercise for 3 days
⚠ Call Us: Increasing redness/swelling beyond day 3 · Pellet extrusion · Fever >101°F · Heavy/persistent vaginal bleeding · Unrelenting headache
Sermorelin
Direct link: evolvedmedical.com/instructions.html#service-sermorelinSide Effects
- Injection site reactions: Mild redness/swelling — rotate sites
- Skin flushing: Post injection, may last up to an hour
- Water retention: Mild, early in treatment; resolves
- Carpal tunnel symptoms: Wrist pain or finger numbness — contact us promptly
- Blood glucose changes: Monitored closely in pre-diabetics/diabetics
Not appropriate for: active malignancy · pregnancy/breastfeeding
Timeline
| Timeframe | What to Expect |
|---|
| Weeks 1–3 | Improved sleep quality |
| Weeks 4–8 | Energy and recovery improve |
| Months 2–4 | Body composition changes begin |
| Months 4–6 | Skin quality and vitality peak |
| Ongoing | Minimum 3–6 month commitment |
Storage & Supplies
- Refrigerate; do not freeze; protect from light
- Use within 90 days of opening
- Supplies: insulin syringes, alcohol swabs, sharps container
Administration
Inject subcutaneously at bedtime — aligns with natural GH secretion pattern. Missed dose: skip and resume next night — no double dosing.
→ Full Injection Instructions
Lab Monitoring
| Timepoint | Tests |
|---|
| Baseline | Comprehensive lab panel |
| 6–8 weeks | Response and adjustment |
| Every 3–6 mo. | Follow-up labs to optimize |
⚠ Call Us: Injection site infection (redness/warmth/discharge) · Persistent swelling · Severe or persistent headaches
Growth Hormone Peptides
Direct link: evolvedmedical.com/instructions.html#service-growth-hormone-peptidesSide Effects
- Injection site reactions: Mild redness/swelling — rotate sites
- Skin flushing: Post injection, may last up to an hour
- Water retention: Mild, early in treatment; resolves
- Carpal tunnel symptoms: Wrist pain or finger numbness — contact us promptly
- Blood glucose changes: Monitored closely in pre-diabetics/diabetics
Not appropriate for: active malignancy · pregnancy/breastfeeding
Timeline
| Timeframe | What to Expect |
|---|
| Weeks 1–3 | Improved sleep quality |
| Weeks 4–8 | Energy and recovery improve |
| Months 2–4 | Body composition changes begin |
| Months 4–6 | Skin quality and vitality peak |
| Ongoing | Minimum 3–6 month commitment |
Storage & Supplies
- Refrigerate; do not freeze; protect from light
- Use within 90 days of opening
- Supplies: insulin syringes, alcohol swabs, sharps container
Administration
Inject subcutaneously at bedtime, 2+ hours after last meal. Food raises insulin, which blunts the GH response. Missed dose: skip and resume next night.
→ Full Injection Instructions
Lab Monitoring
| Timepoint | Tests |
|---|
| Baseline | Comprehensive lab panel |
| 6–8 weeks | Response and adjustment |
| Every 3–6 mo. | Follow-up labs to optimize |
⚠ Call Us: Hand/wrist tingling or numbness (carpal tunnel — call promptly) · Significant joint pain · Injection site infection · Unusual blood sugar changes
Medical Weight Loss (GLP-1 Therapy)
Direct link: evolvedmedical.com/instructions.html#service-medical-weight-lossSide Effects
- Nausea: Most common — reduced by small meals, avoiding high-fat foods.
- Constipation: Increase fluids and fiber.
- Reflux / heartburn: Smaller meals; avoid lying down after eating.
- Hair thinning: Usually related to rapid weight loss; temporary.
⚠ Contact Us Immediately: Severe persistent abdominal pain radiating to back (pancreatitis — ER immediately) · Can't keep fluids down >24 hrs · Severe right-sided upper abdominal pain (gallstones)
Timeline
| Timeframe | What to Expect |
|---|
| Weeks 1–2 | Appetite reduction; feeling full on less food |
| Weeks 2–4 | Early weight changes (2–5 lbs) |
| Months 2–3 | 1–2 lbs/week as dose optimizes |
| Months 6–18 | Full potential: semaglutide ~15%, tirzepatide ~20% body weight |
Injection Instructions
Once weekly, same day each week. Missed dose: if >2 days until next dose, take as soon as remembered. If <2 days, skip. Never double dose.
→ Full Injection Instructions
Lab Monitoring
| Timepoint | Tests |
|---|
| Baseline | Comprehensive metabolic panel, HbA1c, lipids, thyroid, CBC |
| 3 months | Repeat labs — medical consultation |
| Every 6 months | Repeat labs — medical consultation |
⚠ Call Us: Severe abdominal pain (go to ER) · Vomiting preventing fluids >24 hrs · Infected injection site · Low blood sugar signs if diabetic
Aesthetic Consultation
Direct link: evolvedmedical.com/instructions.html#service-aesthetic-consultationHow to Prepare
- Arrive with clean skin; no heavy makeup or plan to remove it
- Bring a list of current skincare products and topical medications
- Note prior aesthetic treatments (dates and providers)
- Write down your primary concerns and goals beforehand
- Disclose all medications, supplements, and health conditions
What to Expect
Thorough review of skin history, goals, and health background, followed by a visual skin assessment. You will receive a personalized written treatment plan with specific services, realistic expectations, and clear costs.
BBL (BroadBand Light)
Direct link: evolvedmedical.com/instructions.html#service-bblSide Effects
- Temporary spot darkening: Expected — spots darken and flake off over 7–10 days. Do not pick.
- Redness / warmth: Resolves within hours.
- Post-inflammatory hyperpigmentation: More likely in darker skin tones — strict SPF reduces risk.
Timeline
| Timeframe | What to Expect |
|---|
| Days 3–10 | Spots darken then flake off; redness resolves |
| Weeks 2–4 | Clearer, more even tone |
| After full series (4) | Optimal results: clearer and brighter skin |
| Maintenance | 2 sessions/year |
Pre-Treatment
- 4 weeks before: no tanning; daily SPF 30+
- 1 week before: stop retinoids, AHAs/BHAs, benzoyl peroxide
- Day of: clean skin only — no makeup, moisturizer, or sunscreen
Post-Treatment
- SPF 30+ before any sun exposure — critical
- No heat: hot showers, saunas, exercise for 24–48 hrs
- Let pigmented spots darken and shed naturally — do not pick
⚠ Call Us: Blistering or significant skin breakdown · Signs of infection after 48 hrs · Worsening swelling beyond 2 days
CO2 CoolPeel
Direct link: evolvedmedical.com/instructions.html#service-co2-coolpeelSide Effects
- Redness and rough texture: Expected for 2–6 days.
- Peeling: Expected as treated skin sheds. Do not pick or force.
- Swelling: Mild to moderate, especially around eyes.
Timeline
| Timeframe | What to Expect |
|---|
| Days 1–4 | Active recovery — red and rough (normal) |
| Days 5–10 | Healing; peeling resolves; skin clearer |
| Weeks 2–4 | Visible texture and tone improvement |
| Months 3–6 (post-series) | Full results as collagen matures |
Pre-Treatment
- 4 weeks before: no tanning; SPF 30+
- 2 weeks before: stop retinoids, AHAs/BHAs
- Day of: clean skin only; eat beforehand
Post-Treatment: Hours 0–48
- Apply Aquaphor lightly; keep skin moist
- Vanicream gentle cleanser twice daily; apply Exo Elite serum after each cleanse
- No makeup, actives, exercise, heat, or picking
Post-Treatment: Days 3–7
- Skin may peel — do not pick
- Continue Exo Elite serum
- Begin SPF 30+ once skin tolerates
After 1 Week
- Resume actives only when cleared by your provider
- No swimming pools, hot tubs, or saunas for 1 week
- Series of 3 treatments spaced 4–6 weeks apart recommended
⚠ Call Us: Signs of infection: pus, worsening redness, swelling, or increasing pain · Delayed healing · Fever >101°F
CO2 DEKA — Ablative Laser Resurfacing
Direct link: evolvedmedical.com/instructions.html#service-co2-dekaSide Effects
- Expected healing: Redness, swelling, raw skin, oozing, crusting, peeling, prolonged pinkness, itching (3–10 days).
- Uncommon: Post-inflammatory hyperpigmentation; milia (self-resolve, do not extract).
⚠ Contact Us Immediately: Increasing redness/warmth/pus/fever after day 3–4 (infection — call immediately) · Painful blistering in/around mouth (herpes reactivation) · Picking = primary cause of scarring
Timeline
| Timeframe | What to Expect |
|---|
| Days 1–3 | Most intense — keep moist and protected |
| Days 4–7 | Crusting and peeling begin |
| Days 7–14 | New skin forms; return to activity |
| Months 3–6 | Collagen remodeling completes |
Pre-Treatment
- 2–4 weeks before: no tanning; stop retinoids and exfoliants at least 2 weeks before
- 1 week before: stop aspirin, NSAIDs, fish oil; no alcohol
- Day before: cold sore history — start Valacyclovir 500mg twice daily for 10 days
- Day of: clean skin; bring all prescribed medications
Post-Treatment Day 0
- Keep Aquaphor on skin at all times
- Sleep head elevated; do not cleanse until next morning
Days 1–2
- Cleanse 3–4x daily with Vanicream; pat dry
- Vinegar soaks if crusting (1 cup water + 1 tsp vinegar)
- Reapply thick Aquaphor after every cleanse
Days 3–7
- Use Exo Elite Serum after each cleanse
- Continue Aquaphor until weeping stops
- No sunscreen or makeup until provider confirms skin fully closed
Days 8–14
- Exo Elite serum once daily
- Begin Vanicream Facial Moisturizer with SPF 30 once healing confirmed
- Makeup OK from day 10
Weeks 3–4
- OK to restart active ingredients (retinoids, acids)
- Strict sun protection — reapply SPF every 2 hours outdoors
⚠ Call Us: ANY sign of infection after day 3 · Fever >101°F · Painful blistering in/around mouth · No new skin by day 7–8
Facial Shockwave Therapy
Direct link: evolvedmedical.com/instructions.html#service-facial-shockwaveSide Effects
- Mild transient redness: Resolves within minutes to an hour.
- Temporary sensitivity: Possible during or just after treatment.
Timeline
| Timeframe | What to Expect |
|---|
| Sessions 1–6 | Some early toning and texture improvement |
| Weeks 4–8 (post-series) | Tightening and firmness clearly visible |
| Maintenance | Sessions every 6 months |
Before & After
Arrive with clean skin. Wait 2 weeks after neuromodulator treatments (Botox/Dysport). After treatment: apply sunscreen, resume all normal activities immediately — no aftercare required.
Neuromodulators (Botox and Dysport)
Direct link: evolvedmedical.com/instructions.html#service-neuromodulatorsSide Effects
- Bruising: Common; resolves 5–10 days. Arnica or cold compress helps.
- Redness / swelling: Resolves within hours.
- Eyelid/brow drooping: Rare; temporary. Reduced by following aftercare exactly.
Timeline
| Timeframe | What to Expect |
|---|
| Days 2–3 (Dysport) / 3–5 (Botox) | Initial movement reduction visible |
| Day 14 | Full effect — follow-up to assess/touch up |
| Months 3–4 | Effect wears off |
Post-Treatment — Critical: First 4 Hours
- Do NOT lie flat
- Do NOT exercise or increase face blood flow
- Do NOT massage, rub, or press injected areas
⚠ Call Us: Significant asymmetry at 2 weeks · Eyelid drooping · Difficulty swallowing or unusual weakness · Signs of allergic reaction (rash, hives, SOB — go to ER)
HA Dermal Filler
Direct link: evolvedmedical.com/instructions.html#service-ha-dermal-fillerSide Effects
- Bruising: Very common; resolves 5–10 days.
- Swelling: Expected especially lips; resolves 1–2 weeks.
- Tyndall effect: Bluish tint if too superficial — reversible with hyaluronidase.
⚠ Contact Us Immediately: IMMEDIATELY: Skin blanching, severe/unusual pain, skin turning gray/dark = possible vascular occlusion (EMERGENCY — call us and go to ER). We maintain hyaluronidase on-site.
Timeline
| Timeframe | What to Expect |
|---|
| Days 1–3 | Peak swelling — results look exaggerated |
| Days 3–7 | Swelling subsides; shape becomes natural |
| Days 10–14 | Final results visible — follow-up scheduled |
| Months 9–18 | Results gradually fade |
Post-Treatment
- Cold compress 10 min on, 10 min off
- No pressing, massaging, strenuous exercise, heat, or alcohol for 24–48 hrs
- Lips: eat soft foods 24 hrs; avoid forceful straw use
- 2-week follow-up is important — do not judge final result before then
⚠ Call Us: IMMEDIATELY: Blanching, severe pain, gray/dark skin (vascular occlusion — call + ER) · Any vision changes
BioFiller (PRP-Based Natural Filler)
Direct link: evolvedmedical.com/instructions.html#service-biofillerSide Effects
- Swelling / bruising: Expected; resolves 3–7 days.
- Temporary firmness/lumps: Possible in first few days as fibrin matrix integrates; softens within 1–2 weeks.
Timeline
| Timeframe | What to Expect |
|---|
| Days 1–7 | Swelling and initial volume — fades quickly |
| Weeks 2–4 | Initial results visible as swelling resolves |
| Weeks 8–12 (post-session 3) | Cumulative natural-looking volume |
| Months 6–18 | Results gradually fade — maintenance recommended |
Pre-Treatment
- Stay well hydrated (easier blood draw)
- 3 days before and after: no aspirin, NSAIDs, Omega-3s
- 48 hours before: no alcohol
- Day of: eat a full meal — do not come fasting
Post-Treatment
- Cold compress; no pressing or massaging for 48 hrs
- No strenuous exercise, excessive heat, or alcohol for 24–48 hrs
PRP Facial Microneedling
Direct link: evolvedmedical.com/instructions.html#service-prp-facial-microneedlingSide Effects
- Redness: Expected and normal 1–3 days.
- Mild swelling: Common first 24 hrs.
- Temporary breakout: Brief purging in week after treatment — not infection.
Timeline
| Timeframe | What to Expect |
|---|
| Days 1–3 | Recovery — redness and mild swelling |
| Weeks 1–4 | Initial texture and tone improvement |
| After sessions 2–3 | Progressive scar fading, pore refinement |
| Months 3–6 (post-series) | Full results as collagen matures |
Pre-Treatment
- 2 weeks before: stop retinoids and exfoliating acids; no tanning
- 3 days before and after: no aspirin, NSAIDs, Omega-3s
- Day of: clean skin; eat beforehand — no fasting
Post-Treatment
- First 24 hrs: hydrating serum or plain moisturizer; SPF 30+; no makeup or actives
- Days 2–7: gentle cleansing; SPF daily; no retinoids for 5–7 days
⚠ Call Us: Increasing redness/swelling/discharge after 48 hrs · Fever · Significant blistering
PRP Hair Restoration
Direct link: evolvedmedical.com/instructions.html#service-prp-hair-restorationSide Effects
- Scalp tenderness: Expected 24–48 hrs — mild.
- Temporary shedding: Possible in weeks 2–4 — normal hair cycle shift. Not a sign of failure.
Timeline
| Timeframe | What to Expect |
|---|
| Weeks 2–6 | Reduced shedding; hair cycle shifting |
| Months 2–4 | New growth may appear; hair feels thicker |
| Months 3–6 (post series of 4) | Peak results — density, thickness |
| Maintenance (every 6 months) | Maintains results |
Pre-Treatment
- Stay well hydrated
- 3 days before and after: no aspirin, NSAIDs, Omega-3s
- Day of: wash hair normally; eat a full meal — no fasting
Post-Treatment
- No hair washing for 12 hrs; no exercise or heavy sweating for 24 hrs
- No swimming for 24 hrs
- Resume normal washing day 2; no chemical treatments for 1 week
⚠ Call Us: Significant scalp pain, increasing swelling, or discharge beyond 48 hrs · Fever
Acoustic Shockwave Therapy for ED
Direct link: evolvedmedical.com/instructions.html#service-shockwave-edSide Effects
- Mild discomfort during treatment: Most patients describe mild vibrating or tingling — well tolerated.
- Temporary soreness: Possible for a few hours after.
Timeline
| Timeframe | What to Expect |
|---|
| Sessions 4–8 | Many patients notice improved erectile quality |
| Weeks 4–8 (post-series) | Full vascular changes mature; results peak |
| Months 6–12 | Results typically well maintained |
| Years 1–3 | Results fade. Repeat treatment annually. |
Before & After
No specific preparation required. Disclose all medications, especially blood thinners. Return to all normal activities immediately — including sexual activity. Complete the full 12-session series.
⚠ Call Us: Unusual pain during or after treatment · Skin irritation or breakdown in treatment area
Penile Botox
Direct link: evolvedmedical.com/instructions.html#service-penile-botoxSide Effects
- Bruising / swelling: Mild and temporary.
- Variable response: Individual results vary based on baseline function and underlying cause.
Timeline
| Timeframe | What to Expect |
|---|
| Days 7–14 | Results begin as toxin takes effect |
| Weeks 2–4 | Full effect realized |
| Months 3–6 | Effects gradually wear off |
| Maintenance | Repeat injections as needed |
Pre-Treatment
- 1 week before: no aspirin/NSAIDs, blood-thinning supplements
- 48 hours before: no alcohol
Post-Treatment
- No strenuous activity for 24 hrs; no sexual activity for 24 hrs
- Cold compress gently if needed; do not massage injection area
⚠ Call Us: Injection site infection signs · Significant or persistent pain · Unusual muscle weakness beyond expected area
Penile PRP (Platelet-Rich Plasma)
Direct link: evolvedmedical.com/instructions.html#service-penile-prpSide Effects
- Mild swelling / bruising: Temporary; resolves within days.
- Variable response: Depends on baseline tissue health, age, and underlying cause.
Timeline
| Timeframe | What to Expect |
|---|
| Weeks 4–6 | Initial sensitivity and erectile quality improvements |
| Months 2–3 | Full regenerative response develops |
| After series of 2–3 | Optimal cumulative results |
| Peyronie's disease | Curvature improvements over several months |
Pre & Post
- Use vacuum pump for 10 minutes twice a day
- Pre: stay hydrated; eat beforehand — no fasting
- 3 days before and after: no aspirin, NSAIDs, Omega-3s
- Post: no sexual activity 24 hrs; no strenuous activity 24 hrs
⚠ Call Us: Infection signs · Significant or worsening pain beyond 48 hrs · Any concern about response or recovery
Female Sexual Wellness PRP
Direct link: evolvedmedical.com/instructions.html#service-female-sexual-wellness-prpSide Effects
- Mild swelling / sensitivity: Temporary; resolves within days.
- Variable response: Depends on hormonal status, age, baseline function.
Timeline
| Timeframe | What to Expect |
|---|
| Weeks 2–4 | Improved urine control; early comfort and sensitivity improvements |
| Months 1–2 | Improved arousal, lubrication, and sensation |
| After series of 2–3 | Optimal cumulative results |
Pre & Post
- Pre: stay hydrated; eat beforehand — no fasting
- 3 days before and after: no aspirin, NSAIDs, Omega-3s
- Post: no sexual activity 24 hrs; no strenuous activity 24 hrs
⚠ Call Us: Unusual or increasing pain beyond 48 hrs · Infection signs (fever, unusual discharge, increasing redness/warmth)
Injury Repair Shockwave Therapy
Direct link: evolvedmedical.com/instructions.html#service-injury-shockwaveSide Effects
- None for most patients.
- Soreness during sessions: Expected in the targeted area — indicates accurate targeting.
Timeline
| Timeframe | What to Expect |
|---|
| Sessions 1–2 | Stimulation begins; some patients feel more sore initially |
| Sessions 3–4 | Most patients notice meaningful pain and function improvement |
| Weeks 8–12 (post-series) | Full results as tissue repair matures |
After Each Session
- Mild soreness is normal — ice if significant (15–20 min)
- AVOID anti-inflammatory medications (ibuprofen/naproxen) for 48 hrs — they blunt the healing response. Use acetaminophen instead.
- No high-impact use for 24–48 hrs after each session
⚠ Call Us: Severe or significant worsening pain beyond 48 hrs · No improvement by session 4 — we will reassess
Peptide Therapy (NAD+, BPC-157, Skin, Glow Blend, Heal Blend)
Direct link: evolvedmedical.com/instructions.html#service-peptide-therapyBenefits
- NAD+: Cellular energy, mitochondrial support, DNA repair, mental clarity.
- Skin (GHK-Cu): Skin collagen/elastin, hair follicle support, wound healing.
- BPC-157: Tissue healing, gut mucosal repair, inflammation reduction.
- Glow Blend: Full regenerative support — skin, hair, healing, anti-inflammatory.
- Heal Blend: Recovery, inflammation, immune modulation, gut health, vitality.
Side Effects
- Injection site reactions: Mild redness/swelling — rotate sites.
- NAD+: Mild nausea or flushing early — resolves.
- Skin (GHK-Cu): More injection site redness/warmth than other peptides — not infection if resolves within hours.
Not appropriate for: active malignancy · pregnancy · sulfur sensitivity (NAD+)
Storage & Supplies
- Refrigerate; do not freeze; protect from light
- Use within 90 days of opening
- Supplies: insulin syringes, alcohol swabs, sharps container
Administration
All peptides dosed daily, 5 days per week. Preferred sites: outer buttock (most preferred), abdomen, upper outer arm.
→ Full Injection Instructions
⚠ Call Us: Injection site increasingly red/warm/swollen after 24 hrs · Fever · New cancer diagnosis — pause all peptides · Any concern