For more information and before and after photos, go to the product websites for Botox®, Dysport®, Juvederm®, Restylane®
Pain is minimal to moderate- all fillers contain anesthetic. A dental block is free for lip injections. Most patients skip anaesthetic cream, but if you wish to apply, please arrive at least 30 minutes early. You can also buy Ebanel on Amazon for around $20 and numb on your way over. Apply a thick layer wherever you think we might inject.
Bruising from injections around the mouth is common. It may be difficult to cover a dark bruise for a week or more. Laura Mercier makes a good concealer called Secret Camouflage.
Because they increase bruising, aspirin, ibuprofen, naprosyn, fish oil, and vitamin E should be avoided for at least 48 hours prior to injection (aspirin actually thins the blood for 2 weeks!). Tylenol® is ok. IF you take aspirin because your doctor wants you to for heart or neurologic disease, then please continue taking it. The bruises are temporary.
Aftercare for filler: Keep injection sites clean, avoid makeup for 1 hour after Botox and 6 hours after lower face filler, 12 hours for cheek/eye area filler. Avoid hot baths and exercise the night of the filler, and gently apply cold compresses for 10-15 minutes every hour for a few hours. Alcohol probably doesn't matter, but minimize for best results. Sculptra must be massaged, but other fillers should not be massaged. Sleeping with head up helps minimize the first morning swelling, which is sometimes dramatic. If you can't take the day off work, a pair of glasses hides swelling around the eyes well. Dermagen patches also help undereye swelling- available at Amazon. For lower face bruising and swelling, hiding out for a few days may be your best plan.
If you are having lip injections and tend to get cold sores, you may wish to take prophylactic antiviral medication to prevent a recurrence. Contact me with your pharmacy of choice and date of birth for the prescription.
Frequently asked questions
I have a surprised look or "Spock" brow from Botox®- If eyebrows arch up too high, this is easy and free to fix- a tiny dose of Botox above your brow(s) will balance your forehead. Too much lift is better than "droop" or heavy brow. In the future we'll try to get it right the first time, but sometimes a touch up is the only way to make it perfect. This kind of touch up is free.
I had Botox®, but I still have wrinkles! Botox® and Dysport® take 4-7 days to take effect. If you have waited 10 days and you still have muscle activity that creases the overlying skin, you may need a slightly higher dose. The dose that is effective for a certain area varies from person to person, and can change over time. I encourage follow up visits so that I can fine tune your treatment. Touch up treatments are usually inexpensive, around $60-100 depending on how many units we add. Another reason for persistent wrinkles is that they are too deep to resolve with Botox® alone. We can use an injectable dermal filler, and it is very helpful to apply Frownies at night for the "scowl" lines (available at Amazon).
I have a lump or bump. Lumps that are felt and not seen don't need any treatment, but I'm happy to take a look. If you can see the filler through the skin, I can help. Please come back for a free touch up. The undereye area is particularly difficult due to thin skin, and often requires a minor touch up (or even two) for the best results.
If anything hurts more than expected or seems discolored in a way other than a usual bruise, or if you have any concerns at all, please contact me immediately.
Your safety is the highest priority. All procedures carry some risk. Problems are rare, but these procedures are common. That means every so often, something unpleasant (or worse) can happen. I encourage you to do your research ahead of time and weigh your options. This is an inexact science. Results cannot be guaranteed.
Below are links to sample consent forms and an article about dermal filler complications. You will need a PDF Reader to view these documents available at Adobe Reader.