Unlocking Hormones: the Key to Looking, Feeling, and Living Better
Led by Kara Waskiewicz, the Women’s Health and Longevity program at Bucky Plastic Surgery and Bucky Body Center can help women thrive, shine, and own every stage of life.
When a woman reaches a certain point in her life, her body sends not-so-subtle messages suggesting she is about to undergo dramatic changes. She experiences shifts in her energy level, mood, and libido. Hot flashes and night sweats abound. The person in the mirror’s reflection begins to look like a stranger.
Louis P. Bucky, M.D., FACS, a pioneer in cosmetic medicine for more than 25 years, knows all too well how changes brought on by menopause can affect a woman’s physical health and perception of herself. Such understanding guides him in the continued evolution of his medical practice at Bucky Plastic Surgery and Bucky Body Center, which offers a comprehensive menu of solutions designed to help a woman look, feel, and perform at her very best, regardless of age.
“I’ve always been of the mindset that beauty and wellness go hand in hand, and they are both ongoing missions for all of us,” says Dr. Bucky. “Now, more than ever, we’re learning so many new ways that help us improve our longevity so we’ve integrated these tools into our practice to help our patients live a longer, healthier, happier life.”
Enter Kara Waskiewicz, PA-C, Director of Women’s Health and Longevity at Dr. Bucky’s practice. Waskiewicz is a board-certified physician assistant who specializes in internal and integrative medicine with a focus on women’s health. Her areas of expertise include bioidentical hormone replacement therapy (BHRT), nutrition, supplementation, and longevity-focused care. Known for her compassion, thoughtfulness, and personalized approach, Waskiewicz empowers women to improve their health and vitality at every stage of life, including during menopause and perimenopause.
“Kara is a key new player in this mission and I’m so excited for her to bring her expertise in hormone replacement therapy,” Dr. Bucky adds. “It truly plays an integral role in helping people reclaim their best selves.”
We spoke with Waskiewicz about the benefits of BHRT, how the treatment works in concert with other services she provides, and the practice’s collaborative and holistic approach to enhancing women’s health, appearance, and overall wellness.
Q&A
When it comes to optimizing women’s health, how do you determine each patient’s needs and which modalities will best suit her?
We employ a very personalized approach. I prioritize the needs of the person in front of me and, in combination with evidence-based data analysis, allow this to guide our decision making and treatment strategy. Evaluation includes blood work, urine hormone testing, body composition analysis and a deep dive into the patient’s history, symptoms, and goals, to determine their unique path to a higher quality of life and longevity. The approach looks a little different for everyone, based on their needs when they first meet with us, and we make ongoing adjustments to meet the patient where they’re at every step of the way.
Q&A
When it comes to optimizing women’s health, how do you determine each patient’s needs and which modalities will best suit her?
We employ a very personalized approach. I prioritize the needs of the person in front of me and, in combination with evidence-based data analysis, allow this to guide our decision making and treatment strategy. Evaluation includes blood work, urine hormone testing, body composition analysis and a deep dive into the patient’s history, symptoms, and goals, to determine their unique path to a higher quality of life and longevity. The approach looks a little different for everyone, based on their needs when they first meet with us, and we make ongoing adjustments to meet the patient where they’re at every step of the way.
For example, for patients in perimenopause (the transitional period leading up to natural menopause), methods of hormone replacement like transdermal patches or creams are typically favored, as they allow us to adjust therapy as needed to accommodate for fluctuations in endogenous hormone production. For those patients in a more stable place along the menopause trajectory, more long-term methods such as subcutaneous pellets, which are implanted under the skin to release hormones over a period of time, provide a stable, bioavailable method of delivery that doesn’t require any daily application by the patient.
Who would be a good candidate for BHRT? How often would a patient need treatment?
All women should consider the role of BHRT in their health and wellness journey. Hormones like estrogen, testosterone, and progesterone impact brain function, cardiovascular health, and bone mass density. Any changes to these hormone levels have the potential to contribute to diseases that can shorten the duration and quality of a woman’s life. In terms of symptoms, women may start to notice vasomotor symptoms impacting temperature regulation, as well as insomnia, mood changes, weight gain, hair loss, menstrual cycle irregularity, low libido, vaginal dryness, joint pain, and many more.
Who would be a good candidate for BHRT? How often would a patient need treatment?
All women should consider the role of BHRT in their health and wellness journey. Hormones like estrogen, testosterone, and progesterone impact brain function, cardiovascular health, and bone mass density. Any changes to these hormone levels have the potential to contribute to diseases that can shorten the duration and quality of a woman’s life. In terms of symptoms, women may start to notice vasomotor symptoms impacting temperature regulation, as well as insomnia, mood changes, weight gain, hair loss, menstrual cycle irregularity, low libido, vaginal dryness, joint pain, and many more.
Frequency of treatment depends on the modality. For a topical administration such as a patch or cream, this is applied anywhere from twice weekly to daily. For patients opting to go with subcutaneous pellet therapy, this is typically done every three to six months. We meet with patients every three months or so to monitor progress, review testing, and adjust therapy as needed.
What can BHRT help women achieve, and how quickly can they expect results?
BHRT is an incredibly impactful therapy when it comes to resolving the symptoms of menopause that can really rob women of quality of life. Things like hot flashes, night sweats, insomnia, and vaginal dryness are often resolved relatively quickly after starting therapy. Plus, there are additional benefits like increases in bone mass density—meaning the reversal of osteopenia or osteoporosis—and other positive changes in body composition.
Does BHRT work well with cosmetic treatments?
I love the holistic approach to wellness and aesthetics that we are able to offer at Bucky Plastic Surgery and Bucky Body Center. The more we learn about women’s hormonal health, the more we are able to understand why midlife is classically plagued with changes to body composition like increase in body fat percentage and loss of muscle mass. Our unique Medical Weight Loss Program provides a key adjunctive therapy to combat many of the changes we associate with perimenopause and menopause such as changes to metabolism, insulin resistance, and visceral fat deposition.
BHRT is an incredibly impactful therapy when it comes to resolving the symptoms of menopause that can really rob women of quality of life. Things like hot flashes, night sweats, insomnia, and vaginal dryness are often resolved relatively quickly after starting therapy. Plus, there are additional benefits like increases in bone mass density—meaning the reversal of osteopenia or osteoporosis—and other positive changes in body composition.
Does BHRT work well with cosmetic treatments?
I love the holistic approach to wellness and aesthetics that we are able to offer at Bucky Plastic Surgery and Bucky Body Center. The more we learn about women’s hormonal health, the more we are able to understand why midlife is classically plagued with changes to body composition like increase in body fat percentage and loss of muscle mass. Our unique Medical Weight Loss Program provides a key adjunctive therapy to combat many of the changes we associate with perimenopause and menopause such as changes to metabolism, insulin resistance, and visceral fat deposition.
Having a comprehensive toolkit is really important to me when working with patients. There are also significant changes to skin elasticity and quality associated with loss of estrogen, so our incredible aesthetics team offers a wide variety of therapies and tools to help women feel their best inside and out. At Bucky Body Center, modalities such as red light, compression, and cryotherapy offer additional help to support healthy resolution of inflammation, an underlying force behind many of the negative changes associated with hormonal shifts. There’s really nowhere else that offers all these services all under one roof so it makes it really seamless for our patients to get everything they need in one place, under one person’s supervision. That’s really a luxury when it comes to care.
Are there any specific tools, techniques, or technologies you consider essential to the services you provide?
One of my favorite technologies that we have is the DEXA scan, which is typically only otherwise available in medical facilities or professional athletic centers. This is an incredibly accurate body composition analysis, which is essential in optimizing health and screening for loss of bone mass density, also known as osteoporosis. Natural loss of estrogen plays a massive role in the loss of bone mass density, and subsequent fractures can lead to increased morbidity and mortality in women as we age. Monitoring these changes and adjusting therapy to optimize lean body mass and minimize loss is critical to our women’s wellness and longevity program.
Are there any specific tools, techniques, or technologies you consider essential to the services you provide?
One of my favorite technologies that we have is the DEXA scan, which is typically only otherwise available in medical facilities or professional athletic centers. This is an incredibly accurate body composition analysis, which is essential in optimizing health and screening for loss of bone mass density, also known as osteoporosis. Natural loss of estrogen plays a massive role in the loss of bone mass density, and subsequent fractures can lead to increased morbidity and mortality in women as we age. Monitoring these changes and adjusting therapy to optimize lean body mass and minimize loss is critical to our women’s wellness and longevity program.
How closely do you work with Dr. Bucky and other care providers on the Bucky Plastic Surgery team, and why is this level of collaboration important?
Bucky Plastic Surgery is all about teamwork. We help each other make recommendations and create fully individualized treatment plans between all our fields—surgery, injectables, skin care, hormonal health, weight loss, and more—so that our patients get the most 360-degree aesthetics and wellness plan.
Bucky Plastic Surgery is all about teamwork. We help each other make recommendations and create fully individualized treatment plans between all our fields—surgery, injectables, skin care, hormonal health, weight loss, and more—so that our patients get the most 360-degree aesthetics and wellness plan.
When it comes to BHRT, collaboration is especially important because awareness about perimenopause/menopause is still so low. Many patients who come to BPS for a variety of other services may not be thinking about how their hormones are affecting their health. Having a knowledgeable team to open the conversation enables us to help more people.
For more information on Dr. Bucky’s offices in Philadelphia and Ardmore, visit DrBucky.com.
For more information on Dr. Bucky’s offices in Philadelphia and Ardmore, visit DrBucky.com.
Photo by Jody Robinson
Published (and copyrighted) in Suburban Life magazine, May 2025.
