After Care

Botox works by relaxing muscle. It blocks a chemical your muscle needs to contract, so if they cannot contract, they relax. In your face, Botox works best from the cheekbones up on your dynamic wrinkles – the ones formed when you contract your muscles – like your frown line, smile lines, and forehead lines. If you can’t contract those muscles, they relax, and your wrinkles disappear.

Botox takes anywhere from 2-14 days to work and is different for each person, each time. Don’t worry if you do not see anything in a couple of days – it will come. I would like to see you back in a couple of weeks to make sure that you achieved your desired outcome.

Botox Aftercare Instructions:

• Do not touch or rub your face for 4 hours after you have been treated.

• Do NOT have a facial, nor rub or massage the treated area for 24 hours after your treatment

• Avoid lying down for 4 hours after your treatment.

• Avoid strenuous exercise and excessive sweating for 24 hours after treatment.

• Avoid any exposure to a sauna, hot tub or tanning for four hours.

• Avoid sun exposure or tanning until any redness or swelling has subsided. Always wear SPF 30 (or greater) sunscreen.

• Avoid any skin care products that have high amounts of acid over the injected areas for 24 hours.

• “Frown, Raise, Frown, Raise” 30 times or so over the next hour, as it helps the muscle pick up the Botox and give a better effect.

Normal Side Effects:

Most people experience little to no side effects after Botox treatments. Below is a short list of the most commonly occurring ones. All of which are minor and resolve on their own in a matter of hours to a few days.

Small raised, red bumps where Botox was injected are normal, and applying ICE or a cold gel pack to the treated areas will help reduce these symptoms faster

Slight pain or discomfort at injection site

Possible bruising at injection site. If this occurs, do not worry since it will only be temporary and can easily be covered up with makeup. Any little bit of bruising may last up to one week. Make sure you are using NEW, CLEAN makeup applicators to avoid infection of the injection sites

Slight headache lasting 2-3 days, you may take Tylenol to help with this for pain relief

It is important to follow instructions about dermal filler aftercare.

Immediately after your dermal filler treatment you may notice a few of the following things:

• Swelling

• Bruising

• Red needle puncture marks

• Asymmetry

• Tenderness

• Itching in the area

These issues above are common with dermal filler aftercare, and should resolve over the next few days to weeks. Your final result will be seen at about 4 weeks after treatment, and you can be reviewed to see if further treatments are required to achieve the planned results.

Immediately after the injections, your face will be cleaned. You should not touch your face for 6 hours. After this you may clean your skin with water and a gentle cleanser.

It is ideal to avoiding makeup on the day of the procedure

Things to avoid:

Do not expose the area to intense heat (eg solarium or sauna)

Avoid pressure on the treated areas for the first few nights (i.e. sleep on back of possible)

Avoid strenuous exercise for 24 hours.

Do not use AHA, Retinols/Vitamin C therapy or oil based make-up for 24 hours

Avoid facials, facial waxing, Glycolic or AHA peels, IPL or energy based treatments and microdermabrasion for two weeks after treatment

AVOID: Alcohol, caffeine, niacin supplement, high-sodium foods, high sugar foods, refined carbohydrates (you may eat fruit), spicy foods, and cigarettes 24-48 hours after your treatment.

No dental procedures for 2 weeks preceding and following treatment

Pain relief

Pain is usually mild and sometimes moderate after filler injections. There are areas which can be quite painful like the chin and the lips. Pain relief such as tylenol may be taken

Swelling relief:

Apply a cool compress for 10 minutes every hour on the day of treatment (do not apply ice directly on your skin). A cool compress applied regularly for the first 24 hours after injections may help to reduce the amount of swelling. Some patients use arnica before and after treatment to reduce the swelling.

Bruising:

Patients on aspirin, fish oil or other drugs associated with increased bruising may find their risk increased. Arnica gel may be used to help minimize bruising.

Lumps and Bumps:

After any treatment with fillers, you may FEEL lumpy and/or bumpy for a few weeks or even months afterwards.  This is normal.  The key is not to SEE the lumps. Massage of the treated areas is typically not recommended. Follow up with me if you have concerns about lumps or bumps 4 weeks or more after your treatment.

Cold sores and dermal filler:

There may be a small chance that a treatment may induce an outbreak of facial cold sores in patients with a previous history.

Some patients take preventative antivirals to help reduce the risk of cold sores. If you get cold sores after a treatment, you should see your doctor.

Aesthetic review:

Reviewing the results of dermal filler should be performed at 4 weeks (except for cosmetic emergencies like infection or vascular occlusions, which should be reviewed immediately)

Reviewing prior to 4 weeks is not useful as there is often a small amount of swelling still present, so the results cannot be judged until this has resolved. This is particularly important with regards to symmetry. Symmetry should not be reviewed prior to 4 weeks.

Complications:

Cosmetic complications include vascular occlusion and infection. Vascular occlusions mostly occur in the treatment chair, and doctors are able to see that they are happening and treat them. An area may go white, or there may be an area of skin that looks like fishnet stockings, or there may be skin discoloration in a distant area where the skin wasn’t injected. After an occlusion, there may be an area that has small blisters on the skin. If the doctor is concerned then they will need to check the capillary return of the skin. If patients see any of these things on their skin, they should call their prescribing doctor immediately.

Early infections may occur after a few days after the treatment. The patient might notice increasing redness, tenderness, swelling, pain, heat, nodules or pus. Patients should see their doctor if this occurs.

Lip filler After care:

Lip dermal filler aftercare needs a special mention: When the lips are injected, the upper lip tends to swell much more than the lower lip and often patients think that their upper lip has had too much filler injected into it. Once the swelling calms down, they realize this is not the case. The typical ratio that most people choose for their lip proportion is 40% in the upper and 60% in the lower, so most likely the upper lip is going to be smaller than the lower lip once the swelling resolves (unless the patient has asked for a less natural-appearing lip).

Juvederm gradually dissolves.  The correction does not last forever.  Many people choose to be treated again within 1 year for routine maintenance, and as early as 4-6 months of the original treatment.

How to care for yourself after your IV Vitamin Therapy infusion:

• Apply pressure to site for 2 minutes after IV has been removed

• Keep Band-Aid in place for 1 hour

• Cold packs and elevating your arm can be used for any bruising at the site

• Cold packs can also be used for pain relief and to decrease any swelling at the site

• Any swelling should be significantly reduced in 24 hours

• Post IV infusion symptoms are uncommon.

Most patients experience significant overall improvements:

• Better energy

• Better mental clarity

• Improved sleep

• Improvement of their complaints

• Overall feelings of well being

Patients commonly report one of two patterns after an IV Vitamin Therapy infusion:

• Patients generally feel better right away. Due to a busy lifestyle, many people are chronically dehydrated and deficient in vitamins and minerals causing them to not feel well. Once the patient is hydrated and the nutrients are replaced, their symptoms improve quickly.

• Patients sometimes feel tired or unwell. These patients are generally in the process of detoxifying. When toxins are pulled out of tissues, they re-enter the blood stream. They remain poisons, but they are now on their way OUT instead of on their way IN. Even when patients do not feel well at this stage, the process is one of healing and cleansing. After this period, an overall improvement in one’s sense of well-being is generally reported.

PRE-TREATMENT INSTRUCTIONS:

• This injection is provided to you for treatment of conditions not related to pernicious anemia. If you have been diagnosed with Pernicious Anemia (a condition wherein the body cannot absorb the B12 Vitamin from dairy products or other foods) you will be referred to your primary care physician for treatment.

• Be aware that aspirin, aspirin-containing medications (ie: Motrin), fish oil, flax seed, high doses of Vitamin A or E, Ginko Biloba, or Garlic may cause undue bleeding which may result in bruising. If you wish to minimize the risk of bleeding be advised that we recommend you avoid these substances for a minimum of  three days prior to injection.

• Eat a meal or light snack prior to treatment. Notify clinician if you have a needle phobia, prior to treatment. This allows the clinician to take the appropriate precautions to ensure your treatment is as comfortable as possible.

• Optimal results are achieved with clients who continue treatments routinely. Frequency will depend on your individual needs/goals as well as your medical history.

• It is normal for the injection site to burn for just a few minutes immediately or shortly

• After the injection. This will dissipate once the muscle is used and the product diffuses into the muscle. B12 injections do not directly help with losing weight but since B12 vitamins is often nicknamed the “energy vitamin” it does stay true to its name in that it should promote those who take a vitamin B12 injection into doing more exercise.

• Please call to reschedule if you experience flu-like symptoms or a respiratory infection the day prior to treatment. Also call to reschedule if you notice any type of skin condition on the area to be treated.

POST-TREATMENTINSTRUCTIONS:

• Effects will start to be apparent within several hours to days after treatment.

• Side effects can occur but are often very mild. The most common symptoms are: pain/redness or itching at the injection site & mild diarrhea. These side effects will pass as time goes by.

• Itching or a feeling of swelling all over the body may occur. If any of these effects persist or worsen, tell your doctor promptly. Many people using this medication do not have serious side effects.

• This medication may cause low potassium levels in the blood (hypokalemia). Tell your doctor immediately if any of these unlikely but serious side effects occur: muscle cramps, weakness, irregular heartbeat.

Wash your face with cool water. Warm or hot water might not feel as good as cool or cold water, which can help soothe post-peel sensations. 

Moisturize and hydrate. Since peels can temporarily compromise your skin’s protective barrier, it’s important to reinforce that barrier with a medium-to-thick moisturizer. Also, drink more water to help avoid dehydration, which could make your skin feel tight.

Apply sunscreen with SPF30 or more. Your skin is more delicate after a peel, so avoid direct sun exposure, which can lead to even more visible signs of skin aging. If you must be exposed, use a Broad Spectrum physical sunscreen.

Avoid strenuous workouts, dry saunas and steam rooms. Increased blood circulation to the face can intensify warming, tingling, itching, redness or other uncomfortable side effects on freshly peeled skin. Skip such activities on the day you use a peel.

Wash your face with cool water. Warm or hot water might not feel as good as cool or cold water, which can help soothe post-peel sensations.

Moisturize and hydrate. Since peels can temporarily compromise your skin’s protective barrier, it’s important to reinforce that barrier with a medium-to-thick moisturizer. Also, drink more water to help avoid dehydration, which could make your skin feel tight.

Apply sunscreen with SPF30 or more. Your skin is more delicate after a peel, so avoid direct sun exposure, which can lead to even more visible signs of skin aging. If you must be exposed, use a Broad Spectrum physical sunscreen.

Avoid strenuous workouts, dry saunas and steam rooms. Increased blood circulation to the face can intensify warming, tingling, itching, redness or other uncomfortable side effects on freshly peeled skin. Skip such activities on the day you use a peel.

Don’t over-exfoliate. Peels are maximum-strength exfoliants, so you don’t need to use a separate exfoliant (like a scrub, brush or exfoliating cleanser) within 3-4 days of your peel. Over-exfoliating can lead to more redness or sensitivity, so wait until your skin feels up to it.

Once your skin feels “back to normal” after a peel, it’s generally considered OK to resume your normal skin care regimen.

 Peels are maximum-strength exfoliants, so you don’t need to use a separate exfoliant (like a scrub, brush or exfoliating cleanser) within 3-4 days of your peel. Over-exfoliating can lead to more redness or sensitivity, so wait until your skin feels up to it. 

Once your skin feels “back to normal” after a peel, it’s generally considered OK to resume your normal skin care regimen.

There’s no significant downtime with this minimally invasive procedure. You may experience some mild redness and irritation for 2 – 3 days after Microneedling, but this will subside quickly.

A post procedure kit from Epicutis will be sent home with you and will help decrease inflammation and aid in recovery. It’s vital you follow the post-treatment home care routine provided to you by your professional skin therapist – this is as important as the treatment itself for maintaining and enhancing your results.

Results will be visible within two weeks. It’s recommended to book a series of PRO Microneedling treatments 4-6 weeks apart for optimal improvements and skin maintenance.

Continue gentle cleansing and moisturizing over the next few days

Apply sunscreen with SPF30 or more. Your skin is more delicate after microneedling, so avoid direct sun exposure, which can lead to even more visible signs of skin aging. If you must be exposed, use a Broad Spectrum physical sunscreen. 

Avoid strenuous workouts, dry saunas and steam rooms. Increased blood circulation to the face can intensify warming, tingling, itching, redness or other uncomfortable side effects on freshly microneedled skin.

Morpheus8 Post-treatment:

• Immediately after treatment, most patients will experience erythema (redness) for 1-3 days, however for more aggressive treatments this may last longer. Slight to moderate edema (swelling) and a mild to moderate sunburn sensation are also common post treatment and may last 1-3 days. Skin may crust and peel for 2-7 days depending on treatment settings.

• Before discharge a topical ointment may be applied to the face, no bandages or wraps are necessary.

• There are no restrictions on bathing except to treat the skin gently, avoid scrubbing or trauma to the treated area.

• Avoid sun exposure to reduce the chance of hyperpigmentation.

• The use of a zinc oxide sun block SPF 30+ at all times after 24-48 hours.

• Avoid applying any product to the treated area that would not be suitable for an open wound. If possible, do not apply any products for the first 12-24 hours. The treatment creates open channels in the skin, which can inadvertently serve as an entry point for such products. If this occurs, medication/active ingredients can penetrate the skin and lead to an allergic reaction, prolonged healing time, excessive swelling and granulomas. Ensure that any products applied to the treated area are specifically recommended for use in this context.

• As soon as the craters close (1-3 days), apply moisturizer and sunscreen, and may use make-up. • Downtime is minimal and ranges from 1-5 days, a longer time for superficial treatment and higher energy levels. Some patients hardly show any skin surface response despite future good results.

• Number of sessions varies from 1-4 with intervals of 3-6 weeks, and maintenance as needed.

The side effects may include:

• Discomfort

• Excessive skin redness (erythema) and/or swelling (edema)

• Damage to natural skin texture (crust, blister, burn)

• Change of pigmentation (hyper- or hypo-pigmentation)

• Scarring.

Lumecca Post-treatment:

• Sun block should be used for 3 weeks following the treatment.

• Moisturizer may be applied after each treatment.

• Make-up may be applied immediately after the treatment.

The side effects may include:

• There may be some discomfort (like rubber band snaps) during the treatment and is transient.

• Excessive skin redness (erythema) and/or swelling (edema)

• Damage to natural skin texture (crust, blister, burn)

• Change of pigmentation (hyper- or hypo-pigmentation)

• Scarring

Diolaze Post-treatment:

• Sun block should be used for 3 weeks following the treatment.

• Moisturizer may be applied after each treatment.

• Make-up may be applied immediately after the treatment.

• Treatment requires a number of sessions. The exact number of sessions is individual, typically 6 sessions will give great reduction.

What to Expect During Treatment: Your treatment provider will begin treatment by completing a consultation to assess your individual needs and any contradictions you may have to your desired treatment. To reduce your risks of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. After receiving Semaglutide or Tirzepatide injections patients may feel tired, nausea, vomiting, diarrhea, or constipation.

Common side effects include, but are not limited to:



• Gastrointestinal: Nausea/vomiting, abdominal pain, Diarrhea/constipation, dyspepsia, abdominal distension, eructation, flatulence, gastroenteritis, GERD, gastritis, lipase increase, amylase increase


• Neurological: Headache, dizziness


• Cardiac: Heart rate increase, Hypotension


• Endocrine: Fatigue, hypoglycemia (diabetic patients), alopecia


• Ophthalmic: Retinal disorder (diabetic patients)


• Skin: redness or pain at injection site



Serious Reactions include, but are not limited to:



• Thyroid C-cell tumor (animal studies)


• Medullary thyroid cancer


• Hypersensitivity reaction


• Anaphylaxis


• Angioedema


• Acute kidney injury


• Chronic renal failure exacerbation


• Pancreatitis


• Cholelithiasis


• Cholecystitis


• Syncope

Contraindications to Semaglutide/Tirzepatide:

• Diabetic Retinotopy


• Low blood sugar


• Gull bladder disease


• Acute inflammation of the pancreas
• Decreased kidney function


• Medullary thyroid cancer


• Multiple endocrine neoplasia type 2
• Family history of medullary thyroid carcinoma


• Kidney disease with decreased kidney function

Possible Drug Interactions:

Beta-blocker medications (such as metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia).

Tirzepatide may decrease the efficacy of oral hormonal contraception due to changes in gastric emptying; contraceptives administered by a nonoral route are not affected. Because the changes in gastric emptying are largest following the first dose, patients using an oral contraceptive should add a barrier method for 4 weeks after starting tirzepatide treatment and for 4 weeks after each dose increase. Alternately, patients can switch to nonoral contraceptive methods.