Age Management Questions

Age management is about healthy aging: living long while remaining well. It is also called longevity or anti-aging medicine. Age management medicine is a field of medical expertise, which aims to slow, prevent or reverse the physical and mental decline of aging. Think of it as advanced preventative medicine.

With age management medicine there is a paradigm shift in the underlying premise of the aging process. Often, conventional medicine views aging and age-related disease as inevitable; the loss of function and dependence unavoidable. Age management views aging as a condition which can be ” treated” with strategies to prevent or slow the aging process by addressing the underlying causes where possible. This new paradigm influences both your evaluation and the program developed for you.

The Age Management model is based on the premise that optimal health is achieved by striving for youthful benchmarks in a person’s  function, lab values and other measurements of health. The evaluation at Live Young will often take more time than what you are used to; the initial assessment visits are typically 1 hr long.  It involves a comprehensive review of your medical history, current health status, risks and exposures, family history and  past lab and other investigations where relevant  in order to assess not only how you are currently feeling and functioning but also to determine the diseases and disability you may be at risk for. Typically, lab evaluation is recommended following this initial consultation and a 2nd follow up visit  arranged once lab is reported.

 During this 2nd consultation your lab results and other investigations will be reviewed with you and Dr. Sweeney will recommend a program specifically for you that addresses your physical, mental and reproductive health ( menopause or andropause for example) for the short and long term. The goal is to help you live out your full life expectancy while maintaining youthful, resilient and optimally functioning mind and body.

This is achieved primarily by modulating or balancing hormones and making  effective lifestyle changes. The seven pillars of an anti-aging program are diet and nutrition, exercise for body and mind, nutritional supplementation, stress and sleep management, risk factor reduction, elimination of toxic exposures and hormone balancing. The goal with our treatment plans is to address the root cause for diseases, not just the diseases themselves.

A customized program will give you:

  • Better energy
  • Better sleep
  • Improved memory and concentration
  • A greater sense of wellbeing
  • Decreased body fat and increased muscle and bone mass
  • Improved physical performance and reaction time
  • Improved immune function
  • Improved sexual function
  • Skin rejuvenation
  • Less stress
  • Better mood

It will assess the diseases you may be at risk for and provide strategies for prevention. Not only will you feel better, but you will also have an accurate idea of what you need to do to maintain your health and vigour over a long lifetime.

When the levels of hormone decline our physical and mental function is impaired. Hormones decline due to age, menopause/andropause, disease or trauma. When our hormone levels fall the aging process begins to accelerate. This is because hormones are essential for normal cellular function for all organ systems. This influences not only our energy and vigour but also the body’s ability to repair and regulate itself.

As we age we often develop hormone insufficiencies – levels lower than youthful, physiological levels. The hormones that commonly decline are testosterone, progesterone, estradiol, DHEA, melatonin, growth hormone and thyroid. (The hormones cortisol and insulin tend to rise.) The symptoms can include: weight gain, loss of muscle mass, degenerative diseases (such as diabetes, heart disease and osteoporosis), compromised immune system, memory and cognitive decline, depression and stress, insulin resistance, loss of sex drive and poor sexual function, fatigue, sleep disorders, and wrinkled and thinning skin. This influences not only our energy and vigour but also the body’s ability to repair and regulate itself.

Replenishing these hormones to optimal physiological levels can address these age-related changes. Hormone modulation is beneficial to men and women at any age, but the best long-term protective benefits are achieved if they rebalanced sooner rather than later.

At Live Young, we do assessments and lab tests to assess hormones such as thyroid, DHEA, estrogen, progesterone, testosterone, insulin, cortisol, growth hormone and melatonin depending on individual patient symptoms and circumstances. When there are insufficiencies or excesses, we restore levels to normal youthful ranges.

We also provide ongoing evaluation following the initiation of hormone replacement or modulation to ensure the blood hormone levels remain in the optimal youthful ranges but never exceed what the body was accustomed to in its younger years.

Yes, we do, for many reasons:

  • It is not possible to obtain all the micronutrients we need in sufficient quantities from diet alone. For example, the vitamin C content in five serving of fruits and vegetables is about 200mg; we need 500mg/day. This is especially important as crops are often grown in depleted soil.
  • The traditional recommendations based on preventing deficiency states not on achieving optimal levels.
  • Now even the most conservative organizations are recommending people take a multivitamin/mineral.
    • Canada Food Guide
    • Harvard revised guidelines for vitamins, Lancet 2002

As we age our needs change, because there is:

  • Less efficient absorption or production of many micronutrients: calcium, Vit B12, Vit D and Vit K to name a few examples.
  • Higher demand for anti-oxidants as wear and tear accumulates
  • Higher demand for natural anti-inflammatory as chronic inflammation takes hold. (This is where Omega 3 fatty acids play an important role.)
  • Higher demand for detoxification i.e. Homocysteine metabolism and B12/B6 and folic acid
  • Increased need for the compounds needed for cellular energy production especially for optimal function of:
    • Cardiac cells
    • Brain cells
    • Immune cells

Live Young has its own line of nutritional supplements that have been developed for two primary reasons:

  • Compliance – they are put together so that they are easy, convenient to take and provide not only the baseline essentials but also additional supplements for optimized cardiac, brain, immune and bone health.
  • Safety – they are made from pharmaceutical-grade ingredients in sufficiently high doses to be useful but won’t cause toxicity through inadvertent multi-dosing. For example, I have seen several cases where patients were getting far too much selenium as it was in several of the supplements they were taking.

The terms natural and bio-identical hormone replacement are often used interchangeably. Natural hormones are chemical messengers which are manufactured usually by the body’s endocrine system . Bio-identical hormones used for hormone treatment are structurally identical to the hormones our bodies naturally create but are made in a lab. They are used to replace declining natural hormone levels. The body’s receptors  accept and metabolize these bio-identical hormones in the same way it does for natural hormones. They are not drugs in the usual sense although they are produced by pharmaceutical manufacturers or compounding pharmacies. 

In contrast, synthetic hormones are chemically altered from the natural hormones structure. Synthetic hormones can produce many desirable effects but may also have adverse side effects or unsafe long-term effects.

At Live Young, we use bio-identical hormone replacement wherever possible.

It is a bonus if you have an active job or lifestyle but everyone needs to exercise in ways that specifically target the declining cardiovascular function and lean body mass that we experience as we age. Exercise truly is the fountain of youth and reduces our risk for all known diseases of aging. Not only that, it makes us feel and sleep better and improves our appearance as it raises metabolism, builds muscle and burns fat.

At Live Young, we advocate interval training for two essential components of fitness: cardiovascular and strength training.

A little bit of stress is motivating but the problem with our lifestyles is that we often experience excessive and prolonged stress and do not know or have the time to implement stress management. A strategy to counter stress is essential because we now know that stress not only affects our sleep and makes us feel lousy, but it is also a major risk factor for cardiovascular disease, which is the leading cause of death for men and women in North America. Not only that, it raises obesity rates, causes memory problems, impairs immune function, raises the risk for osteoporosis and mood disorders, and interferes with the secretion of repair and regeneration hormones such as growth hormone and melatonin. Stress causes so many ill effects primarily through the secretion of excess cortisol and adrenalin – the stress hormones.

At Live Young, our goal is early detection or prevention of disease. Every program is developed by putting together each patient’s individual risk profile and this incorporates the risks due to family history. The wonderful thing about prevention is that we can change the course of history by intervening before disease sets in. This is true for a number of illnesses including diabetes, heart disease, stroke, Alzheimer’s, osteoporosis and some cancers. Your assessment will involve screening for these and other common illnesses and if you are at risk for less common medical problems we will explore that too. Once we have assessed your current health status Dr. Sweeney will develop a program to address the risk factors. For example, we will treat and closely monitor your weight, insulin, cholesterol, homocysteine, blood pressure and refer you for advanced diagnostic tests as needed. We use the 7 pillars framework for your treatment plan. (See question 2 above.)

If you already have diabetes or other established disease Dr. Sweeney will develop a program to control or reverse that as well.


Aesthetic medicine is an area of medical expertise which uses minimally invasive, non surgical procedures to reverse signs of aging and enhance physical  appearance caused by advancing age, the sun, smoking and other environmental factors. Typically, the procedures are more affordable than surgery and do not carry the same risks or recovery time. They are also used for many age-related changes that surgery does not address and in cases where surgery is not yet appropriate. Examples are irregular skin pigment from ultraviolet damage that is best treated with laser or sagging and loss of fullness in the cheeks where a facelift may be ineffective or premature and  1-2  treatment  sessions using dermal filler will address the problem.

Other areas where dermal fillers may be a better choice to naturally reverse years to decades of lost volume and restore a more youthful appearance are in the under-eye hollows, chin, jawline, lips and forehead.  In many cases, patients are choosing to use aesthetic  treatments as a means to prevent the changes that aging brings. Botox in the forehead and around the eyes both reverses and prevents aging changes as well as creates a more relaxed, friendlier expression. 

Cosmetic medical treatments  are often less expensive than people think, especially when you consider their effectiveness and compare their duration with other routine and discretionary treatments such as nail or lash enhancement. We can’t provide a specific price for most treatments without consultation because the available options and “dose” are highly individual. 

To give you an idea:

-A typical Botox treatment for the glabellar frown lines (those ones between the eyebrows) with an eye brow lift can range from $300-$450 depending on the age of the patient and the strength and distribution of the muscle movement.  The duration is typically 3-4 months.

-An IPL laser series to reverse years of sun damage is approximately $1000 and the results are enduring unless the area is re-damaged. 

We are used to paying for great hair every 4-6 weeks; with Botox the cost is often about the same if averaged monthly- the difference is that a larger sum is paid every 3-4 months. One of the benefits of regular Botox treatment is that it last longer when done regularly. Many of our patients who have been using Botox a year or more need to be treated 3 times per year rather than 4, a saving of 25% without compromising the fantastic result.

Request a consultation to find out about your individual aesthetic needs and to receive an accurate quote for treatment options.


No cream can reverse significant wrinkles or even deeper pores and scars, but they help with skin texture and tone and minimize fine lines,pores and some brown discoloration in the skin. At Live Young, we see them as support for the treatments we provide at the clinic. Some can help stimulate collagen and others are exfoliators. Vitamin A or Retinol/ Retinoic Acid remains the gold standard for wrinkle treatment but we also carry the peptides (Argireline and others)  for those who can’t tolerate vitamin A or who want an added boost. Vitamin C and other antioxidants can help protect the skin when applied topically.

The key is getting the right ingredients, in sufficient quantities, in a delivery system that will deliver the active ingredients into the skin’s deeper layers. Our clinic selects skincare that does all of this.  As well we carry a selection of sunscreens for optimal and safe UV protection. 

Laser or IPL is the best way to treat colour discoloration in the skin that is caused by pigment deposits or dilated blood vessels. Microdermabrasion is a superficial treatment that polishes the skin and improves the sheen but does not go deep enough to lift the brown pigment deposits that cause sun or age spots. Both can be used together to get great looking, healthy skin because they treat all the skin layers.

Photorejuvenation is a series of  IPL or BBL ( intense pulse light) treatments that improve skin texture, decrease redness and broken capillaries and lighten dark spots in the skin. It is most often used for treating the face, chest, arms and hands but can treat any skin area. The treatments should not be done if you have a tan because the light will be attracted to the melanin in the skin causing the tan and away from the problems we want to target- sun spots for example. This may lead to a less effective treatment or adverse effects from excessive heating in the skin surface which could cause a blister. Following the treatment, you need to avoid tanning for 4 weeks because your body may develop irregular pigment if exposed to tannin ultraviolet in this time period. We encourage you to give up tanning altogether as ultraviolet light is the most important accelerator of skin aging and more seriously promotes skin cancer. Additionally, sun exposure without protection against tanning may “undo” the benefits achieved from the laser treatment.

That depends on where the wrinkles are and their depth. Fine lines can be treated with collagen boosting procedures such as a microneedling series. More moderate lines addressed with fractionated CO2 resurfacing using the SmartXide Dot. The choice depends on the recovery time you can set aside: microneedling recovery is typically 1 day, The Dot is 5-10 days depending on the depth of treatment chosen.

Dynamic lines and wrinkles, those caused by movement of certain muscle groups, such as frown or squint  lines  are often best treated with BOTOX . This is especially true for those in the upper face- the number 11’s, bunny lines and crow’s feet. BOTOX relaxes the muscle causing the unnecessary movement resulting in a more smooth skin surface.

Dermal fillers such as JUVEDERM,  are used more often in lower face lines and folds. They are temporary implants made from naturally occuring substances such as hyaluronic acid, that fill in under the lines and folds to smooth and contour the from below the skin surface. Common areas for treatment are lip and Marionette lines and nasolabial folds.

Laser  treatments address the wrinkles in the upper skin layers while lines or folds at a deeper level are treated with “injectables” such as BOTOX and JUVEDERM. Beyond the focus on wrinkles these procedures have the added advantage of rebalancing facial expressions, so you do not appear tired, sad, angry or stressed.

BOTOX  has been approved for medical use in Canada since the 1990’s years for the treatment of certain medical conditions including those caused by severe muscle spasm. BOTOX was approved for cosmetic use in  Canada in 2001. BOTOX is one of 4 botulinum toxin products available in Canada all of which are purified forms and ARE NOT to be confused with botulism – poisoning from ingestion of large quantities of the neurotoxin  from a contaminated food source. When Botox is used for cosmetic and medical treatments the protein is purified from its natural source. This purification is carried out under strict quality control by the pharmaceutical company Allergan. During the treatment, very tiny amounts are delivered by injection into targeted muscle groups to relax. 

Other conditions for which BOTOX is approved in Canada are: migraine headache, urinary incontinence and hyperhidrosis ( excessive sweating) in areas such as the underarms and palms. Compared with other available products BOTOX has the widest range of indications within Canada.

Potential adverse effects of BOTOX Cosmetic include: temporary lid and brow ptosis (droop), headache, injection site discomfort and inflammation and bruising. There is a very rare possibility of muscle weakness remote to the injection site. To reduce the risk of adverse effects such as weakness of muscles that are not the target of treatment, Dr. Sweeney asks patients to remain upright and to avoid vigorous exercise and rubbing of the treated area for 4 hours following treatment.

There have been incidents where unapproved botulinum products have been used illegally in Canada with serious consequences. Ensure you are being treated by a qualified and experienced medical professional and ask about the product that will be used. Dr Sweeney has been using BOTOX since 2003 to safely and effectively treat patients for a wide variety of cosmetic and medical indications.

There are many dermal or soft tissue fillers available today. Dermal fillers are categorized as temporary, semi-permanent or permanent. Temporary or semi-permanent fillers are prefered for several reasons; as our face ages and sags due to volume loss and gravity the appearance of permanent filler in the face may become less desirable over time and most importantly if an reaction occurs it can be very difficult to remove a permanent filler. In addition,  techniques and style preferences change over time. What looks great at one age or point in time, may not be the look you want at another. Think of jean styles and materials.

Dr. Sweeney has been using temporary dermal fillers manufactured  from hyaluronic acid  since 2004 and is continually reviewing and evaluating  the prefered techniques and products in order to deliver optimal, natural looking results for men and women through their various life stages. 

Typically, dermal fillers work best in the lower face for lines and folds and are used in the cheeks, lips, jawline and under the eyes to restore the volume that’s lost with time, lift sagging and to create smooth or more defined contour. Botox can be used around the mouth and chin to help with frowning and pebbling but when advanced changes are present dermal filler will provide a better and more enduring result. Botox on the other hand is superior when used for frown lines between the eyebrows or for fine dynamic lines around the eyes and on the nose. 

Photorejuvenation refers to skin rejuvenation using light- typically using IPL or other laser treatments. The skin is the drape which over lies the deeper structures such as the muscle and fat pads- the deeper areas addressed with BOTOX and dermal filler. Skin cannot be ignored as great skin is a projection of health and vitality as well as youth. Rather than relying on any one solution it is better to combine treatments not only for a better overall global improvement but also for more integrated natural looking results.

There is a big difference. Dr. Sweeney will see you for your initial assessment and will perform most procedures or directly oversee them. Being assessed and treated by a medical doctor ensures you will be given advice with scientific backing and recommended treatments which are not only effective but also safe. Not only will your treatment have the benefit of medical expertise but you can be assured of the appropriate follow-up and post-treatment care and that you will be in the hands of a professional who can manage complications should they occur. This holds true for all treatments provided at Live Young Medical.

Be careful of facilities claiming to be medispas. To be called a medical spa they must have a medical director who is a licensed MD.

Laser hair removal in the right conditions is very effective for areas such as underarms, bikini, legs and arms. Benefit can be  constrained for several reasons such as a poor match of skin color and hair quality or an underpowered laser. The term laser is used for all light-based systems. However, not all light-based systems are created equally and, I am afraid, your friend was probably treated with a system that did not deliver enough energy to do the job. From a safety standpoint, the higher-powered medical lasers should only be used by a well-trained medical professional. In the wrong hands, even  weaker lasers have caused burns and unsightly pigment changes in darker skinned individuals. It is unfortunate that your friend had a disappointing result for which she invested both time and money.

Even under ideal circumstances, results can vary from person to person so no one can guarantee results. However, be assured you that you will receive evidenced based advice and professional treatment at Live Young Medical.

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