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SottoPelle Hormone Replacement Therapy

SottoPelle Hormone Replacement Therapy (HRT) replenishes the hormones lost in the aging process and is a safe, effective, and natural solution to hormone replacement.


Should You Consider SottoPelle Hormone Replacement Therapy?

Aging and Hormones.

You don’t have to live with it!

Remember how easy it was to stay in shape in your early 30’s? A big reason why is because of powerful chemicals in your body called hormones.

As you get older, your hormone levels drop. When your hormone levels drop, the signs and symptoms of aging such as decreased energy, weight gain, and loss of libido are accelerated.


Are You A Candidate?

Our SottoPelle Hormone Replacement Therapy Self Evaluation can help you decide if SottoPelle is the right treatment for you.




Aging & Hormones

Hormones are powerful chemicals secreted by your body into your bloodstream around the clock that serve as vital messengers to affect cells in other parts of your body. Hormones play a vital role in regulating your body’s physiological systems including the body’s metabolism, temperature, mood, reproduction, growth, aging, and immune system.


As you get older, your hormone levels drop. This hurts the performance of cells and organs that require hormones to function efficiently. Your brain, heart, internal organs, immune system, metabolism, muscle mass, and bone density all rely on adequate levels of functioning hormones. When your hormone levels drop, the signs and symptoms of aging are accelerated, including:

  • Fatigue and decline of energy and motivation
  • Weight gain and loss of muscle mass
  • Degenerative diseases (diabetes, cancer, heart disease, osteoporosis)
  • Thinning and wrinkling of the skin
  • Stress and depression
  • Weakened immune system (leading to frequent infections)
  • Decline in memory and overall cognitive function
  • Loss of sex drive and performance
  • Sleep disorders

SottoPelle Biologically Identical Hormone Therapy: For The Physical & Functional Signs of Aging

The supplementation of biologically identical hormones in order to achieve levels of young adults has been shown to reverse the physical and functional signs of aging and to lower the risk of age related illnesses including cancer and heart disease.

The benefits of bioidentical hormone replacement therapy include:

  • Enhanced libido and/or increased sexual desire
  • Decreased body fat & greater capacity to get in shape
  • Reduced fatigue & increased energy levels
  • Increased focus, mental clarity, and concentration
  • Improved memory
  • Consistency in moods — reduction in feelings of anger, nervousness, and irritability
  • Relief from anxiety and depression
  • Increased sense of overall well-being


Women and Men Who Are Bothered By The Signs and Symptoms of Aging

Sotto Pelle biologically identical hormone replacement therapy can be an excellent treatment if you are bothered by the signs and symptoms of aging including:


Hormonal imbalance from early menopause, premenopausal symptoms, perimenopausal weight gain, adrenal fatigue, menopause, or premenstrual symptoms (PMS) have been affecting millions of women worldwide for years. In many cases, bioidentical hormone therapy is the solution.

Don’t suffer from hot flashes, night sweats, trouble sleeping and weight gain if these symptoms can be controlled. The Age Management Institute at 77 Plastic Surgery has been helping women control these undesirable aging symptoms naturally, making the process more manageable and enjoyable.

If one or more of these symptoms are a concern for you, call us at 415-655-7546 (SKIN) or contact us online here for a consultation and learn more about a personalized treatment plan:

  • Weight gain
  • Hot flashes
  • Night sweats
  • Mood swings
  • Depression
  • Low libido
  • Insomnia
  • Fatigue
  • Memory loss
  • Fibroids
  • Endometriosis
  • Premenstrual symptoms
  • Vaginal dryness


Hormone therapy programs aren’t only for women. Men experience a gradual loss of hormones as they age, mainly testosterone. The result, andropause, can make daily life feel like an uphill battle, and because men are living longer, they are seeking more active lifestyles and looking for solutions to manage these symptoms.

If one or more of these symptoms are a concern for you, call us at 415-655-7546 (SKIN) or contact us online here to learn more about a personalized treatment plan:

  • Muscle loss
  • Weight gain
  • Fatigue
  • Sleep problems
  • Gynecomastia
  • Hot flashes in men
  • Night sweats in men
  • Lower sex drive
  • Irritability
  • Depression
  • Hair loss
  • Erectile dysfunction
  • Urinary problems
  • Memory loss

The Treatment

Sotto Pelle HRT is the most convenient, hassle-free, and scientifically based bio-identical hormone therapy available

Sotto Pelle hormone replacement therapy is a unique treatment method based on prescribing the right kind of hormone (biologically identical), in the correct amount (determined through testing and proper analysis of the results), using the right delivery method (pellets). The hormones used in the Sotto Pelle therapy are biologically identical, meaning that they are natural, derived from plant compounds that have the same molecular structure as those made by the human body.

Sotto Pelle uses an exclusive, science-based approach to your hormonal well being developed by the late Dr. Gino Tutera — an internationally recognized bio-identical hormone therapy expert. Unlike other treatments, Sotto Pelle therapy delivers small doses of testosterone and estradiol directly into your bloodstream at the level your body needs around the clock for up to 6 months. This makes this treatment the most convenient and hassle-free bioidentical hormone therapy available.

How It Works

It’s actually pretty simple.  During your initial consultation, Dr. Fan will conduct a detailed history and physical examination. Blood will be drawn to determine the baseline levels of your body’s own hormones and based on your symptoms we will determine the optimal bio-identical hormones that will be prescribed for you. The hormones are administered using pellets that are inserted beneath the skin in a simple, 5-minute office procedure. Periodic re-evaluation of your hormone levels will be required until all of the levels are “optimal” and then annual follow-ups to monitor your therapy and optimize your treatment plan.

Why The Sotto Pelle Method is Superior to Other Forms of Hormone Replacement

Hormonal balance is a sensitive state of being to achieve and vital to your overall well-being. Many physicians prescribe hormones without understanding the full importance of the differences in modalities, testing the interpretation of those tests, the quality of the prescription and how to achieve hormonal balance. Other hormone pellet therapies may rely on experimentation, guesswork and incorrect information and are comfortable with the one-size-fits-all, smallest-dose-for-the-amount-of-time approach.


No Downtime

There is little to no downtime after Sotto Pelle bio-identical hormone replacement therapy; in fact, you should be able to return to work and normal activities immediately after your treatment. We recommend that you wait three to seven days to resume exercise.


Choosing A Provider

Why Dr. Larry Fan

Dr. Larry Fan, Board Certified Plastic Surgeon and Director of 77 Plastic Surgery, is a wellness and age management expert. Dr. Fan developed an interested in wellness at an early age while growing up in sunny Southern California. These interests were further developed early in his medical career at UCSF, where he performed anti-aging research. He subsequently was hand-selected to train with Dr. Gino Tutera, M.D., a world respected age management expert and pioneer and founder of Sotto Pelle hormone replacement therapy.

Dr. Fan has been voted One of America's Top Plastic Surgeons for the past 5 years by the Consumers Research Council of America. He is also an accomplished scientist and has received national awards for his research in medicine and surgery. He has been a speaker at the American Society of Plastic Surgeons and the American College of Surgeons. Dr. Fan has been featured on national media outlets such as NBC, ABC, and Us Weekly. He is an avid reader, design aficionado, and athlete.

At most practices, the Sotto Pelle treatment is administered by a nurse practitioner or physician’s assistant. At 77 Plastic Surgery, all Sotto Pelle treatments are personally administered by Dr. Fan himself, so you can be certain that you will receive the most safe, effective, and physiologic treatment.  



Cost is As Little as $3 Per Day

The cost of Sotto Pelle hormone therapy ranges from $800 to $2,500 per year.

Feel Your Results

Look Younger. Feel Younger. Live Younger.



Sotto Pelle hormone replacement therapy can help maximize your health, vitality, and wellness throughout life. Patients who use Sotto Pelle therapy report benefits of:

  • Enhanced libido and/or increased sexual desire
  • Decreased body fat & greater capacity to get in shape
  • Reduced fatigue & increased energy levels
  • Increased focus, mental clarity, and concentration
  • Improved memory
  • Consistency in moods – reduction in feelings of anger, nervousness and irritability
  • Relief from anxiety and depression
  • Increased sense of overall well-being

*Individual results may vary


Sotto Pelle Hormone Therapy

What is SottoPelle® bio-identical hormone therapy?

It is the most convenient and effective method of hormone replacement available. Thoroughly documented and researched in medical journals, the therapy involves the simple and painless insertion of bio-identical hormone pellets under the skin. Once the pellets are inserted, a steady, low dose of natural hormone flows directly into the bloodstream whenever the body needs it. This gives the body the ability to control the release of the hormone just as it did when the ovaries and testicles were working working normally.

SottoPelle was developed by Dr. Gino Tutera, widely recognized as a pioneer and leader in the field of bio-identical hormone therapy and who specializes in the treatment of hormone deficiency. Dr. Tutera developed SottoPelle Hormone Therapy based on the use of subcutaneous pellets – the most effective hormone delivery system available. 

Dr. Fan is a SottoPelle® Trained Physician who was hand-selected and personally trained by Dr. Tutera. Dr. Fan has obtained from Dr. Tutera’s company both the same sourcing of the hormone pellets and the tools to customize the therapy to each patient’s hormone needs.

What are the pellets used in SottoPelle® bio-identical hormone therapy made of?

The pellets are compounded according to the highest industry standards, using the best quality botanical ingredients available.  They are derived from a natural plant source of yam and hand compounded to be biologically compatible to the human form of estradiol and testosterone. The body is given what it can no longer produce through hormone replacement therapy.

What are some of the benefits pellet hormone replacement therapy offer?

The quality of life given back to every man and woman is second to none. Our patients have reported:

Increased energy levels
Restored or increased sexual drive
Consistency in moods (no more roller coaster effect)
Relief from anxiety and depression
Increased mental focus and clarity
Decreased body fat
Greater capacity for getting the body in shape

I get horrible headaches; will pellet hormone therapy help me?

Yes! Sottopelle has had great success with hormone-related headaches.

Can men benefit from hormone replacement therapy?

It is a common misconception that women are the only ones who need hormone replacement as they age. However, more research is coming out showing that men too can benefit from receiving hormone replacement therapy. Hormonal balance from hormone replacement therapy can provide critical protection against osteoporosis, heart and prostate disease, among other health issues that can either kill you or drastically reduce your quality of life.

Many men are led to believe by their physicians that feeling constantly tired, having the inability to gain muscle mass and lose fat, decreased libido and foggy thinking is all a part of growing older.

Accepting these symptoms as a part of aging can negatively impact your ability to perform at work, relationship with friends and family and most importantly, how you enjoy your life. You’d be amazed at how impactful hormones and hormone therapy are to your well being. And when they’re out of balance, so is everything else in your life.

How often will I need to come back to the office to receive pellets?

It depends on the person, but anywhere from four to six months.

What about other types of bio-identical therapies?

Other bio-identical hormone delivery methods - creams, pills, injections and even miniscule capsules - do not provide the balanced hormones that factor into good health. Subcutaneous pellets on the other hand, can deliver a constant stream of hormones into your bloodstream twenty-four hours a day, seven days a week.

Not all hormone replacement therapy pellets are created the same either. Some hormone therapy pellets use fillers or more pure ingredients and compounding methods. The physician’s experience and training in diagnosis and pellet insertion procedures can also make a significant difference in the efficacy of your treatment.  Years of research went into developing our SottoPelle method.

In the end, it was uniquely formulated to work with your body's chemistry to support individual hormonal balance and optimum health. SottoPelle only uses the right kind of natural hormone (biologically identical), using the proper delivery system (quality pellets placed under the skin), in the proper amounts (through accurate testing, analysis and individualized to your hormonal needs) that will work for three to six months, and for some, even longer!

Why doesn't my doctor suggest natural hormone replacement therapy as an option?

The great majority of physician training is on synthetic hormones. More than likely they were never trained on the use of biologically identical hormone therapy.

How long will it take for the hormones to get into my system and work?

Most female report that they begin to experience improvement within several days of receiving their pellets.  Testosterone pellets may take two weeks to express their benefits for men and women.

As a woman, do I still need estrogen in my hormone replacement therapy?

Estrogen is the most important hormone for a woman to protect her against heart attack, stroke, osteoporosis and Alzheimer's. Synthetic estrogen taken orally does not offer the universal benefits or the same benefits as being on bio identical estrogen.

Are there any side effects or complications?

Side effects in both men and women are rare. In women, transient breast tenderness lasting 7-10 days may occur with the first insertion, but rarely with repeat treatments. Acne and hair loss are rare occurrences from testosterone therapy.  The growth of facial hair is also rare and occurs no more frequently than what happens in post menopausal women on no hormones. 

In men, the side effects are also rare, but may include decreased sperm count, decreased testicular mass and possible prostate enlargement.  These side effects occur much more frequently with the use of synthetic hormone replacement therapy.

Dr. Fan is a SottoPelle® Trained Physician who was hand-selected and personally trained by Dr. Gino Tutera, the pioneer of Sotto Pelle hormone replacement therapy.

For more information visit the sites below:


Related Procedures

Skin Care

Our skin care programs involve the use of medical grade skin care products that can brighten, smoothen, and even out aging skin. Our skin care programs are frequently used to enhance the results of facelift surgery.

Learn More About Skin Care


Between not sleeping well, having frequent mood swings, and always feeling tired, I stopped feeling like myself after menopause. I heard about Sotto Pelle from a girlfriend, and I have to see that it has been a life changer for me. I feel so much more energetic and vibrant. Even my husband gushes how his wife has returned."*

— Ms. A

Why Dr. Larry Fan & 77 Plastic Surgery


Larry Fan, MD


Dr. Larry Fan is an award winning, Harvard educated, and nationally recognized plastic surgeon. He is a progressive, compassionate thinker who is committed to achieving the highest levels of excellence and the very best aesthetic results. Dr. Fan is an expert facelift surgeon who is known for achieving natural beauty, never “overdone.”

Meet Dr. Fan

Harvard Trained & One of America's Top Plastic Surgeons

Dr. Fan is known for his elegant sense of artistry and refined surgical skills. He will perform your surgery with expert, world-class execution and has the results to prov


Exceptional Results & Award Winning Care

Dr. Fan and his team are committed to providing you with exceptional care, counseling, and support before, during, and after surgery. We take pride and joy in caring for you and have received numerous awards for our compassionate care.


State-of-the-Art Office & Private Surgery Center

Come relax in our beautiful office and enjoy the comfort, safety, and privacy of our fully accredited onsite private surgery center.

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"Beauty for Life"

In this feature length book, you will learn:

  • How to look great at any age
  • How to find a beauty team that you can trust
  • How to choose the right skin care products for your skin type
  • How to choose between The Needle and The Knife

This book was written by top plastic surgeon, Dr. Larry Fan.



Sotto Pelle Biologically Identical HRT Can Help You Look Younger, Feel Younger, & Live Younger.

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