Injectables Pre- and Post-Care

TOXIN & FILLER: TREATMENT INSTRUCTIONS Pre-Treatment Instructions

2 WEEKS BEFORE INJECTIONS

• Medications to Avoid: Two weeks before your appointment try to avoid nuts, seeds, fish, fish oil, NSAIDs, supplements, and anything that prolongs bleeding. This will significantly help minimize bruising, bleeding and swelling.
• Arnica Supplements: You can start Arnica supplements a week prior to injection to help with post injection bruises. Arnica helps to speed up the fading away of bruises.
• Medication and Supplements: Talk to your primary care doctor or physician specialist. If you are on blood thinners you may need to stop these a few days to weeks prior to your treatment. Speak to your prescribing physician regarding safety of stopping and restarting these medications. We do not recommend patients that are on life saving medications stop their medications in order to have any cosmetic procedures performed.
• Prevention of Cold Sores: Patients prone to cold sores may need to start a prophylaxis dose of an antiviral medication prior to their injection treatment. Your physician provider will prescribe this medication prior to your treatment if they feel it is necessary.

DAY OF INJECTIONS

• Minimize makeup and lotions: Minimize make-up, in and around areas where you would like to get injections performed. Our medical assistants will remove make-up prior to treatment. You can bring make-up with you to apply immediately after your treatment.
• Topical Numbing: We recommend numbing cream application prior to dermal injections. The cream needs at least 20-30 minutes to exert its full effect, hence we ask all our filler injection patients to come a little earlier to allow for numbing time.
• Eat and drink before your treatment: It is not uncommon for patients to “pass-out” or get lightheaded during their injection. Having a good blood sugar and being hydrated will make it less likely that you will feel queasy during your treatment. 

Post-Treatment Instructions

After your filler injection it is normal to have some swelling, pinpoint bleeding and bruising. If numbing cream was applied for your procedure you will still feel numb for another 1-2 hours after your procedure. Please be sure to follow our post procedure instructions in order to minimize swelling, bruising and decrease downtime.

• Ice: Use a small bag of frozen peas in a sandwich bag or crushed ice to gently ice the area. No heavy ice bags. Ice for 20 minutes every hour while awake. Continue the icing for 48 hours if possible for filler injections. 
• Minimize Strenuous Exercise: We recommend no strenuous exercise for 48 hours in order to reduce swelling and bruising from filler injections. 
• Do not manipulate or massage or rub or poke the area: Unless specifically advised by your physician, do not massage or manipulate your face. For one week avoid facials or rough scrubbing of the face. You can wash your face gently. 
• Use make-up and concealer to cover up bruises: You can use makeup and concealer the day of your injections to cover up any bruising. 
• Do not over-evaluate your face the first two weeks: The first two weeks after injections it is normal to have bruises, swelling and asymmetry. We recommend waiting two weeks for swelling and bruising to be completely gone before you can appreciate your final results. 
• Take Tylenol for Pain: It is normal to experience some pain and sensitivity in the injection area. Most patients find that Tylenol can help relieve this post-injection pain. Avoid NSAIDs such as Motrin and ibuprofen as these can make swelling and bruising worse.
• Toxin/Dysport® Effects: Toxin/Dysport® take up to 2 weeks to fully work. You may start to notice the effect as soon as 3 days but do not be surprised if you have to wait the full 2 weeks. Toxin/Dysport® wear off in 3- 4 months on average and must be repeated 3- 4 times a year. 
• Bruising: Bruises may last 1-2 weeks. Bruises can show up several days after the treatment. Bruising can be covered with full coverage concealers. Tear troughs and lips are more likely to bruise because these areas are more vascular than other parts of the face. 
• Swelling: Swelling may not always be even from side to side depending on pre-existing facial asymmetry, volume of filler injection and bleeding at each injection site. Initial swelling takes 2 weeks to settle. Sleeping propped up and icing can minimize this side effect. Avoid exercise for the first 48 hours or longer as swelling increases when working out. Do not manipulate or massage areas as this can aggravate swelling.

WHAT TO EXPECT

• Ice: Use a small bag of frozen peas in a sandwich bag or crushed ice to gently ice the area. No heavy ice bags. Ice for 20 minutes every hour while awake. Continue the icing for 48 hours if possible for filler injections.
• Minimize Strenuous Exercise: We recommend no strenuous exercise for 48 hours in order to reduce swelling and bruising from filler injections.
• Do not manipulate or massage or rub or poke the area: Unless specifically advised by your physician, do not massage or manipulate your face. For one week avoid facials or rough scrubbing of the face. You can wash your face gently.
• Use make-up and concealer to cover up bruises: You can use makeup and concealer the day of your injections to cover up any bruising. Do not over-evaluate your face the first two weeks. The first two weeks after injections it is normal to have bruises, swelling and asymmetry. We recommend waiting two weeks for swelling and bruising to be completely gone before you can appreciate your final results.
• Take Tylenol for Pain: It is normal to experience some pain and sensitivity in the injection area. Most patients find that Tylenol can help relieve this post-injection pain. Avoid NSAIDs such as Motrin and ibuprofen as these can make swelling and bruising worse.
• Toxin/Dysport® Effects: Toxin/Dysport® take up to 2 weeks to fully work. You may start to notice the effect as soon as 3 days but do not be surprised if you have to wait the full 2 weeks. Toxin/Dysport® wear off in 3- 4 months on average and must be repeated 3- 4 times a year.
• Bruising: Bruises may last 1-2 weeks. Bruises can show up several days after the treatment. Bruising can be covered with full coverage concealers. Tear troughs and lips are more likely to bruise because these areas are more vascular than other parts of the face.
• Swelling: Swelling may not always be even from side to side depending on pre-existing facial asymmetry, volume of filler injection and bleeding at each injection site. Initial swelling takes 2 weeks to settle. Sleeping propped up and icing can minimize this side effect. Avoid exercise first 48 hours or longer as swelling increases when working out. Do not manipulate or massage area (s) as this can aggravate swelling.
• Asymmetry: Asymmetry can be related to swelling. We advise waiting 2 weeks to see if asymmetries are due to swelling or from filler. Please keep in mind that once you start to analyze your face it is not rare to “notice” new asymmetries that have been there your entire life.
• Lumps and Bumps: Filler will feel firmer than your own tissue. Do not massage or manipulate the area. The feeling of lumps and bumps will usually improve within 2 weeks. 
• Subtle Results: A 1 cc syringe of filler is the equivalent of 1/5th of a teaspoon in volume. After swelling subsides there may be a need for additional filler injections if you desire increased volume. Dr. Cox is very conservative and does not over inject patients. Dr. Cox prefers to add volume slowly with time to achieve your desired results. The first time getting injections the results tend to go away faster. With repeat treatments results last longer as you build your own collagen around the injection sites. 
• Dry Lips: Lips will also be more dry post injections. Ice the areas and keep lips lubricated with Vaseline or Aquaphor. No more than 20 minutes of ice at a time.

WHEN TO CONTACT US

Please notify our office immediately if you feel that you may be experiencing any of these possible complications after your filler injections:

• Hypersensitivity or allergic reactions
• Cold sore or herpes simplex virus outbreak
• Acne breakout
• Changes in skin sensation or ability to move parts of the face
• Signs of infection: fever, redness and warmth.
• A white or blue hue to skin indicating possible blood flow obstruction