Skin filler treatment involves the injection of highly purified, individualized doses of hyaluronic acid (Juvederm®) into unwanted skin folds, creases, lines, and wrinkles. The skin filler acts by superficially “filling” in and simply smoothing out unwanted skin lines with a biologically natural product.

Pre-Treatment

•   For one week before treatment, start taking Arnica to help prevent bruising. Please avoid the following medications: Aspirin, Advil, Motrin, Ibuprofen, Aleve, Naprosyn, Excedrin (all OTC pain pills except Tylenol), Vitamin E, Vitamin A (RetinA, Renova, Tretinoin, Tazorac, Differin, Triluma), Gingko Biloba, Omega-3 fatty acids (fish oils), cod liver oil, CoQ10, garlic, and ginger.

• If you are taking any blood-thinning medications as per doctor’s orders (such as Coumadin, Warfarin, Plavix, Lovenox), do not discontinue without first consulting the prescribing physician. If you continue to take these medications the chances of developing an injection-related hematoma (blood clot) which can leave a dark spot if it becomes entrapped in the filler implant is higher. The dark spot may remain until the filler is naturally dissolved.

• To decrease bruising you can apply ice to the face for about 10-30 minutes before injection.

• Do not schedule any social events for the next 3-7 days as you may have bruising and/or swelling from your treatment. If you take Arnica and ice the treated area, bruising will be decreased.

• Arrive for your appointment wearing no makeup if possible. You will be able to apply makeup after your treatment although we recommend waiting at least 24 hours.

Post-Treatment

1.    Keep the treated areas clean. Light make-up coverage is acceptable if desired. Again, best practice is to wait 24 hours before applying makeup.

2.    You may apply ice for 5 minutes every ½ hour if there is any pain or swelling. Any bruising will eventually resolve on its own, typically within one to two weeks.

3.    If post-injection bruising is noticed, consider using Arnica, which has been shown to rapidly relieve and even prevent bruising. Arnica is available for purchase or at a health food store and is safe.

4.    As always, wear at least SPF 30 sun block when appropriate and try to avoid exposure to intense, direct sunlight and heat (example: sun lamp, steam, sauna) for at least two to three days from treatment day.

5.    Do NOT take aspirin containing products or the medications listed in the pre-treatment for the next 24 hours. These agents may increase bruising/bleeding at the injection site. Tylenol may be taken.

6.    Avoid alcohol intake beyond a single drink, glass of wine, or beer for approximately 24 hours after treatment. You may sleep with an extra pillow if desired to minimize swelling overnight.

7.    As always, tobacco and illicit drugs are discouraged.

Discontinue Retin-A (Tretinoin) for 5-7 days after treatment. It is best to wear no makeup or lipstick until the next day. Earlier use can cause pustules.

1.    One side may heal faster than the other. You may have bumps or nodules of filler under the skin that can last 4-8 months after the injection. If they are particularly troublesome you can massage them, we can also give a small injection to help dissolve them faster.

2.    If there is any leftover product, it must be used within 2 weeks of opening to avoid contamination.

3.    Keep in mind that evidence shows that having a follow-up treatment before the product has fully dissipated tends to enhance the lasting effect of skin fillers.

4.    Wait at least a week (preferably 2-3 weeks) after your injection before having other procedures done in the same anatomic area: example: microdermabrasion, laser treatment, chemical peel, etc.…

5.    Please notify us with any further concerns/questions. Note that you can optionally schedule a follow-up visit to evaluate results after the initial swelling has dissipated. Typically, hyaluronic fillers can be reshaped for up to two weeks post-injection.

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