NEUROTOXIN Pre and Post-Treatment Instructions

Our office wants to provide you with the absolute best care.  You can help to minimize the risk of complications by carefully reading and following your pre and post-care instructions.  Ask us to clarify any item about which you have questions.

Pre-Treatment

• Consuming alcoholic beverages 24 hours prior to treatment may thin the blood and increase the risk of bruising.
• Schedule your appointment at least 2 weeks prior to a special event which you may be attending, such as a wedding or a vacation.
• Reschedule your appointment at least 24 hours in advance if you have a rash, cold sore or blemish on the area.
• If you have a history of cold sores please let your provider know, they may put you on an anti-viral medication prior to treatment.
• You are not a candidate if you are pregnant or breastfeeding.

Post-Treatment

• Do NOT massage or manipulate the treated area for 4 hours following treatment.
• Following injections DO exercise and use the facial expression muscles that were injected for the next 2 hours.
• Do NOT lie down for 4 hours after your Botox treatment.
• Do NOT perform activities involving straining, heavy lifting, or vigorous exercise for 6 hours after treatment. This will keep the Botox in the injected area and not elsewhere.
• It can take approximately 4 to 7 days for results to be seen. If the desired result is not seen after 2 weeks of your treatment you may need additional Botox. You are charged for the amount of product used. Therefore, you will be charged for a product used during any touch-up or subsequent appointments.
• If you suffer any allergic responses, prolonged generalized symptoms, discomfort, discoloration or any lumps/unevenness that persists after 5-7 days, please call the office at (859) 266-5483, or 859-266-0117 (after-hours) if you have any questions or concerns.

Botox/Xeomin/ Dysport are prescription medications that have FDA “on label” approval for various medical conditions and cosmetic applications.  However, they are also sometimes used “off-label” for the other indications. Because they have similar profiles and are made of clostridium botulinum they are often used interchangeably.  Botulinum toxin is a neurotoxin derived from Clostridium botulinum, a gram-positive bacterium discovered more than 100 years ago. It blocks nerve signals when injected into a muscle, thus preventing muscle contractions. There are numerous non-cosmetic therapeutic uses of botulinum toxin, including: blepharospasm (involuntary eyelid contractions), strabismus (crossed eyes), cervical dystonia (involuntary contraction of neck muscles), hyperhidrosis (excessive sweating), urinary incontinence, and migraine headaches. Botulinum toxin injections are also commonly performed to address the following aesthetic concerns: crow’s feet, forehead lines, frown lines, neck bands, radial lip lines, chin dimpling, wrinkles around the corners of the mouth, shape of the jaw line,  gummy smile and other areas. Botulinum toxin cannot stop the process of aging; however can temporarily diminish the look of wrinkles caused by muscle groups. Botulinum toxin injections may be performed as a singular procedure or as an adjunct to other procedures. This response is usually seen 2-6 days after injection. It is common that the muscle action along with its associated wrinkles will return in 3-6 months. At that time repeat injections will be necessary to maintain desired effects. Side effects experienced by patients who have had Botulinum toxin treatment include, but are not limited to: headache, bruising, pain during injections, scarring, infection, nose and throat irritation, upper respiratory tract infection, eyelid swelling sinus inflammation, nausea, asymmetry, twitching, numbness, and in a small percentage of cases, drooping of the eyelids or eyebrows (ptosis). Ptosis usually resolves within several weeks but may take longer. Dysport may contain cow’s milk protein, human albumin and lactose, patients who are allergic to any of the components should choose an alternative neuromodulator.  Patients should inform the medical provider: if they have received any other botulinum toxin product in the last four months, if they have had reactions to botulinum toxins in the past, if they have recently received an antibiotic by injection, if they are currently taking muscle relaxants, an allergy or cold medicine,  sleep medicine,  or blood thinners. Patients receiving cosmetic neuromodulators should not be pregnant, nursing an infant, or have any neurological diseases such as myasthenia gravis, Eaton-Lambert syndrome, or Lou Gehrig’s disease. Neuromodulators are also used to treat serious conditions which may require larger doses than in the cosmetic population. For this reason, the FDA requires the following warning be included when a neuromodulator is presented. “Post-marketing reports indicate that the effects of all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have underlying conditions that would predispose them to these symptoms. In unapproved uses, including spasticity in children and adults, and in approved indications, cases of spread of effect has occurred at doses comparable to those used to treat cervical dystonia to lower doses.”

In case of emergency, contact your MD, call 911 or go to closest Emergency Room   

I have read and understand the post-treatment instructions above and acknowledge that my failure to adhere to the instructions provided to me may increase the risks of an adverse reaction.