Louisiana Via Research Day Book 2026

Case Studies: Section 1

Case Studies: Section 1

Brenden Larson, MS 1 ; Sabeen Wazir, BS 1 ; Kyra Salinkas, MS 1 ; Sophie Qui, BS 1 ; Hawk Cambron, MD 2 1 VCOM-Louisiana; 2 Department of Family Medine, Acadiana Medical Center, Eunice, Louisiana 76 TREATMENT OF INSULIN-RESISTANT, METFORMIN-RESISTANT POLYCYSTIC OVARIAN SYNDROME UTILIZING TIRZEPATIDE

Kendyl Berry, OMS-II 1 , Shohreh Ghasemi, MD, DDS, PhD 2 1 VCOM-Louisiana; 2 Advisory Board of Oklahoma University, Faculty of AUSOMA, Dental Faculty of RCSI 75 NON-SURGICAL FACIAL RECONTOURING THROUGH RADIOFREQUENCY-INDUCED COLLAGEN REMODELING

Background: Age-related facial laxity occurs as dermal thinning results from the loss of collagen, elastin, and hyaluronic acid. With aging, collagen-rich structures undergo fragmentation with age, leading to the loss of skin integrity. Radiofrequency (RF) therapy is an office-based, non-surgical procedure that uses controlled thermal energy to induce immediate collagen contraction and fibroblast-mediated neocollagenesis and collagen reorganization to result in tissue tightening. Case Presentation: A 55-year-old female presented with concerns of skin sagging, loss of facial volume, and wrinkles. Physical examination of the face demonstrated mild to moderate facial laxity. The patient declined surgical intervention and was seeking a non surgical treatment option. She underwent four RF treatments sessions over two-week intervals. A handheld RF device was used to target areas of concern to stimulate collagen production and tissue tightening. Results: Following the completion of her RF sessions, the patient reported satisfactory outcomes, with noticeable improvements in

facial tightness and jawline definition. The progressive nature of improvement was consistent with collagen remodeling rather than volumetric change. No adverse events were reported. Conclusion: This case highlights RF therapy as an effective non-surgical alternative for facial recontouring. Unlike surgical interventions, which primarily provide immediate structural change, RF treatment promotes ongoing dermal improvement through neocollagenesis and allows for precise, targeted treatment of areas of concern. Observations from this case supports the role of RF as a safe and effective non-surgical modality for patients with mild to moderate facial laxity seeking gradual, natural appearing improvement.

Context: Insulin resistance with compensatory hyperinsulinemia affects approximately 44-70% of women with polycystic ovarian syndrome (PCOS). Current first line management includes lifestyle modification and metformin; however, treatment resistance is common. Glucagon like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists have emerged as effective therapies for obesity and metabolic disease, but data in metformin-resistant PCOS remain limited. We report one of the first cases of metformin resistant, insulin-resistant PCOS successfully treated with tirzepatide. Report of Case: A 33-year-old woman with a past medical history of polycystic ovarian syndrome (PCOS) with insulin resistance presented with fatigue, weight gain, and episodic palpitations, shakiness, and diaphoresis despite treatment with metformin ER 500 mg. Laboratory evaluation demonstrated persistently elevated 1- and 2-hour insulin levels with normal hemoglobin A1c (5.0%), consistent with metformin-resistant, insulin-resistant PCOS. The physical examination was unremarkable. Given persistent symptoms and obesity, weekly

subcutaneous tirzepatide was initiated. At the one-month follow-up, the patient experienced significant weight loss (BMI decreased from 28.9 to 27.8) and complete resolution of symptoms. Tirzepatide dosage was increased, with continued follow-up planned. Conclusion: We searched PubMed using “PCOS” OR “polycystic ovary syndrome” AND “tirzepatide” AND “insulin resistant” prioritizing human studies and systematic reviews. While prior studies show GLP-1 receptor agonists can improve weight and insulin-resistance measures in overweight/obese patients with PCOS as an adjunct therapy. This patient’s case is among the earliest clinical reports describing successful use of tirzepatide in metformin resistant insulin resistant PCOS. Our patient demonstrated a metabolic response consistent with GLP-1 therapy, including rapid BMI reduction and complete symptom resolution. This case suggests tirzepatide may represent a promising therapeutic option for metformin resistant insulin-resistant PCOS, warranting further metabolic follow up and larger controlled studies.

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2026 Research Recognition Day