Bridget Alsup, PA-C

Can I still take hormones if I’ve had…?” is one of the most common questions I get.

We are a generation of women navigating one of the biggest reckonings in modern medical history: perimenopausal, menopausal, and post-menopausal care.

And, it is confusing because we watched the women before us, our mothers and grandmothers, navigate this path very differently.

Here’s what I want you to know:
You may spend up to 40% of your lifetime in this period.

So, it’s important to seek out care that optimizes your health during this transition. It is not too much to ask. Or burdensome. Or unreasonable.

It is taking care of yourself.

Just because you have certain medical conditions doesn’t mean you should be exempt from the HRT conversation.

A history of certain types of cancer, blood clots, migraines or autoimmune disease doesn’t automatically mean no.

It might mean you need to seek specialty care or it means we choose the right type, the right route and the right combination for you.

Swipe through to see what the most up-to-date stance is for each as of Fall 2026.

Save this for later, and send it to a friend who’s been told “hormones aren’t for you.”

Educational only, not medical advice. Book a consult via the link in bio.

Bridget Alsup, MPAS, PA-C, FMCP-M
Aesthetic Medicine + Wellness

You see a hollow, a fold, a flat spot, and filling it feels like the obvious answer. But, that area is usually the result, not the cause. Filled on its own, it can throw off the balance of your entire face.

Here’s why: Your face ages in layers, all at once.

Skin thins and loses collagen. Muscles shift how they pull. Retaining ligaments, the anchors that hold soft tissue in place, loosen. The superficial and deep fat pads deflate and descend. Even bone resorbs, especially around the eyes and midface.

Areas I would never recommend filling on a whim, and you should never have filled without a full face assessment:

1 Tear troughs. Under-eye hollows are often driven by midface volume loss and a tight tear trough ligament. Filling the thin lower lid without restoring cheek support first can lead to puffiness, a bluish cast, or swelling that lingers for months.

2 Nasolabial folds. These deepen when the deep cheek fat loses volume and tissue slides down and forward. Filling the crease adds weight to an area that’s already heavy. Support from above, and the fold often softens on its own.

3 Lips. Your lips are in constant conversation with your chin, nose, and midface. Out of that context, even a subtle syringe can make the lower face look out of proportion.

A full facial balancing assessment evaluates every layer: skin quality, muscle movement, ligament support, and the superficial and deep fat compartments. Restoration starts deep and structural, so thinner areas are ready to hold volume and look natural.

Sometimes the first step isn’t filler at all. It might be a neuromodulator to rebalance muscle pull, microneedling to improve the overall tone and texture of your skin, or a biostimulator like Sculptra or Radiesse for overall facial rejuvenation and collagen-induction.

Foundation first. Then refinement.

That’s how you end up looking like yourself, rested and balanced, not “done.”

SAVE THIS for your next consult, and ask your injector what their plan is for your whole face before filling one area alone.

Book a consultation- link in bio - and, follow along for more!

Bridget Alsup, MPAS, PA-C, FMCP-M
Aesthetic Medicine + Wellness | Winston-Salem, NC

There was a time I wouldn’t leave the house without makeup on because of the overall dull texture, fine lines, and hyperpigmentation on my face — I didn’t feel confident bare faced.

Today, while my skin is by no means perfect, I can (and do) walk out the door barefaced regularly. My skin looks and feels so much healthier than it did 2 years ago.

The interventions that have made the greatest impact in helping me age in reverse:
1) my professional-grade skincare regimen, and
2) consistent SkinPen microneedling treatments

When it comes to microneedling, I started with a series of 6, have since done a series of 3 and try to get a session in every 6-to-8 weeks.

SkinPen Microneedling is:
• Safe for all skin tones and skin types, in every season
• A true collagen and elastin stimulator, not just a surface-level treatment
• Proven to improve fine lines, wrinkles, and dull texture
• Effective at brightening pigment and evening overall tone
• FDA-cleared for acne scarring and neck wrinkles, and widely used to improve enlarged pores, mild skin laxity, and inflammatory conditions like rosacea and mild-to-moderate acne

Every series can be personalized further with add-on products targeted to your specific concerns. Downtime is minimal, and results build gradually over time.

If you’ve been thinking about starting, now is the time.

Begin your 3-to-6 session series this month and you receive a complentary ZO Skin Health accelerated serum to boost your results AND your skin will be glowing as the holidays arrive, for the parties, the photos, the moments you actually want to feel and look like the best version of yourself!

DM me to learn more about this offer!

It’s so important to have a provider who follows up on your procedural results —

like any medical procedure, tox injections carry risks / benefits / potential side effects & complications. You, as a patient, should be counseled on these pre-treatment and followed-up with post-treatment (or, at the very least, have a direct line of communication to your provider in the event that one of these does happen).

Because, while tox complications are uncommon, they DO happen. Even in the most experienced hands.

Here’s what to know if any of these happen to you:

1) SPOCK BROWS — How It’s Fixed
• A small touch-up (1–2 units) placed just above the highest point of the peak
• Relaxing those outer fibers brings the arch back in line
• Left alone, it fades on its own as the toxin wears off over a few months

2) HEAVY BROWS — What Affects It
• Some faces naturally rely on the forehead to hold the eyes open — relaxing it reveals that true baseline
• Rarely, early massage or pressure lets product spread beyond the injection site
• Usually peaks around 2 weeks, eases within 1–2 weeks if mild, up to 3–4 months if more pronounced

3) PTOSIS — Key Facts
• Timeline: usually starts 2–10 days after treatment
• Duration: temporary, typically resolves in 2–8 weeks (occasionally 3–4 months)
• Management: prescription drops (like apraclonidine) can offer temporary relief

4) ASYMMETRIC SMILE — What to Expect
• Temporary: no reversal agent exists, but it resolves on its own in 8–12 weeks
• A small counter-injection on the opposite side can help balance it sooner

Have you ever experienced any of these?

Does your provider appropriately counsel you, follow up with you, and talk through how they manage potential complications?

Do you have a direct line of communication to your provider?

Let me know in the comments!

Bridget Alsup, MPAS, PA-C, FMCP-M
👩🏼‍⚕️Aesthetic Medicine + Wellness Practitioner
💉Advanced Cosmetic Injector
📍Winston-Salem, NC