Botox/Filler Care Instructions

Dermatologists located in Marin County

We’re thrilled to be part of your journey to look and feel your best! To ensure optimal results, follow these guidelines for both before and after your treatment.

Pre-Treatment Care

Minimize Bruising and Swelling for Your Next Appointment

• Avoid blood-thinning medications and supplements • Stop taking aspirin, ibuprofen, naproxen, or other NSAIDs at least 7 days before your appointment (if medically safe to do so). Let us know if you are on migraine medications or other prescriptions that may thin your blood. • Avoid supplements such as fish oil, vitamin E, and ginkgo biloba, which can thin the blood. • Skip Alcohol: Avoid alcohol for 24–48 hours before treatment, as it can increase the likelihood of bruising. • Use Arnica Gel: For people who are easy bruisers or feel strongly about avoiding bruises, apply Arnica gel twice daily for 3 days before treatment to reduce bruising. • Plan Ahead: Schedule your treatment at least 2-3 weeks before any important events.

Post-Treatment Care

Immediately After Treatment

• Avoid Touching the Treated Areas: Don’t massage, rub, or apply pressure for 24 hours to prevent displacement. • Use Arnica Gel: Apply Arnica gel twice daily for 3-7 days after treatment to reduce swelling and bruising. Especially for the lips, which can swell out of proportion to the other areas of the face for three days. Oral Arnica or bromelain supplements can help. • Skip Makeup: Avoid applying makeup for 12 hours to reduce the risk of infection. This is an exceedingly low risk, so if you need it, go for it. For extra caution, apply some antiseptic OTC Briotech before and after.

For the First 24 Hours

• Avoid Alcohol and Exercise: Alcohol and vigorous activity can worsen bruising and swelling. It can also potentially diminish the duration of Botox results. • Cold Compress for Swelling: Gently apply a cold pack for 10 minutes at a time to reduce swelling. • Avoid Heat: Steer clear of hot showers, saunas, and tanning beds, as heat can exacerbate swelling.

For the First Week

• No Facials or Massages: Avoid professional facial treatments or massaging the treated areas. • Minimize Sun Exposure: Protect the skin with sunscreen (SPF 30+) to prevent bruising and discoloration. • Stay Hydrated: Drink plenty of water, especially after filler treatments.

What to Expect

Botox

• Botox/Xeomin/Daxxify takes 2 weeks for full effects to be seen and lasts around 3 months. Results typically start in 5-7 days. Daxxify has a quicker action of onset, and results typically start within 2-3 days. • It is normal for it to kick in faster in some areas. This may result in mild asymmetry that typically normalizes by 2 weeks. If an adjustment is needed, please come in for a 2 week follow up. • Every patient metabolizes neuromodulators differently. For patients who only get 2 months duration, some studies have shown Zinc 50mg for 2 days prior to treatment and 2 days after treatment may increase longevity! These patients would also benefit from switching to Daxxify. • If deeper visible lines are present at rest prior to treatment, one treatment may not fully eradicate these lines. Deeper set lines can take up to 6-9 months of consistent treatments every 3 months to remodel and improve. Other adjunct treatments like microneedling and Rx Tretinoin can help soften these lines faster.

Fillers

• Provide immediate volume and last 6–18 months depending on the injection location and product. • Mild redness, swelling, tenderness, or bruising is normal and should subside within a few days. • Expect to feel (but not see) lumps under your skin surface after filler. These will begin to soften and feel normal after two weeks. • Lips swell dramatically after treatment. If your lips were treated, we recommend that you ice this area for 5-10 min 2-3 times immediately after your treatment, as ice prevents swelling (not bruising). Ice is optional for other areas treated with filler. • For the first two nights after filler, try not to sleep on the areas that have been treated. If you are a bellysleeper, place a few hair clips near your temples before bed so that if you happen to roll on your belly, the clips will encourage you to naturally roll back.

When to Contact Us

Call us immediately if you experience

• Gray or dusky or lace-like discoloration after filler, like an unusual bruise. • Severe swelling or bruising that worsens after 48 hours. • Signs of infection, such as fever, redness, or warmth.

Specific Considerations

Dermal Fillers

Lumps or Elevations: • If you notice any lumps or elevations after your filler treatment, please wait two full weeks as these typically soften and fully resolve on their own. • If they are still visible after 2 weeks, please call and come in for reevaluation. While persistent lumps are exceedingly rare, they can easily be dissolved with Hylenex (hyaluronidase enzyme) injections

Botox Treatments

• Temporary asymmetric onset of results for the first 7 to 10 days. If your Botox results appear uneven or unusual, understand that different areas may respond at varying times. Wait two full weeks to allow the treatment to fully take effect, as it typically resolves within this period. If you are still seeing an issue at two weeks, which is very rare, please call us and we will get you in right away for a touch up. • Botox touch up policy: 1st time Botox patients are eligible for up to 5 complementary touch up units at the 2 week follow up.

TMJ Botox Treatments

Post-Treatment Bulges: After TMJ treatment, if you observe any masseter bulges when you chew, please wait two weeks as they typically resolve. If they don’t, please contact us. Reduction of tension, clenching, and grinding typically occur within 2 to 3 weeks and last 6 to 12 months.

Botox Lip Flip

Expected Side Effects include temporary functional adjustments. You may experience difficulty with certain oral functions, such as: whistling, using straws, rinsing your mouth. These effects are usually temporary, most common with only the first lip flip treatment, and should improve within 2 weeks.