After Cosmetic Treatment

• Do NOT lie down for the first 3 hours following a treatment.
• Do NOT engage in rigorous exercise or yoga for the day of treatment.
• Do NOT massage or manipulate the injection sites for 48 hours after injection.
• Do NOT undergo facials or massages for the first 48 hours after treatment.
• DO feel free to use the muscles treated (frown, smile, or raise your forehead) as this may help improve the onset of treatment.
• Avoid alcoholic beverages on treatment day.
• If bruising occurs, it may be covered up with makeup. Bruises usually resolve in just a few days.
• It will take 3 days for you to see improvement, and peak effect at 3 weeks.
• After 3 weeks, DO call us if you are not completely satisfied with your results.

Follow-Up Treatment Botox®appointments are ideally scheduled 3 months apart for the first 3 treatments. After that, the interval between appointments can be gradually lengthened depending on the individual. Try to have your next treatment before the results return completely to baseline. This will help you maintain your results longer. We want you to have an outstanding result. If you have any questions or unexpected concerns, please call the office for assistance.

• Do NOT take hot showers, use saunas or jacuzzi for 24 hours. This may cause the blood vessels to dilate and cause more bleeding and bruising.
• Do NOT exercise for 24 hours after the procedure. This may raise your blood pressure and pulse causing more bruising and swelling.
• Do NOT drink alcohol for 24 hours after treatment. Alcohol may cause the blood vessels to dilate and cause more bruising.
• Do NOT drink from a straw or smoke immediately after your treatment and for 2 weeks.
• Do NOT apply Make-up after the procedure for 12 to 24 hours.
• Swelling is most prominent 1-2 days after the procedure. Sleep with an extra pillow to minimize this.
• DO apply cold compresses or ice to the treatment sites to reduce swelling and bruising.

Note you may feel some bumps or firmness in the treated area, the material will soften over the next week. If you do develop a bruise it will resolve like any other bruise. If there is a visible bump, excessive swelling, severe bruising, rash or anything irregular, please call the office for assistance. Treatment lasts between 6-12 months and can be re-done 1 month after prior treatment.

• Do NOT pick or scratch at your skin, as this could cause scarring.
• Do NOT spend extended periods of time in the sun or tanning beds for 6 months. If you must go outside, wear a sunscreen of at least SPF 35.
• Do NOT participate in strenuous activities. This includes any form of working out for at least 1 week. You do not want to break a sweat as this could increase risk of infection and complicate healing.
• Do NOT wear make up or use any other form of face skincare products unless directed by us for at least a week.
• Do NOT shave the treated area for 10 days.
• DO drink plenty of water and apply healing ointment several times a day for optimal skin hydration.

Initial Wound Care:

The Lumenis laser produces a second degree burn and vaporizes a layer of your skin. Depending on the setting it either does this in a contiguous area, or in separated narrow columns (fractional treatment). In order to optimize your healing, you must follow some basic steps of skin care. It is imperative that you do not substitute your own products, devices or care regimen. The post-op care is just as important as the actual treatment in obtaining the best result; the better you do, the better your outcome.

The first 7 days after your laser treatment are the most crucial. Your face will be red, swollen, and possibly weeping. Your body may produce a yellowish exudate that is totally normal. Do not be alarmed by this as it is a nutrient containing portion of your own circulation. After the first 24 hours you will begin to clean your skin twice daily. Use lukewarm water and simple cleansers such as Cetaphil or Vanicream cleanser (bar or liquid), then pat your face to dry. When washing your face do NOT use anything other than your clean hands. Do NOT scrub or use a mechanical device. Following each wash, and as needed throughout the day, re-apply a layer of healing ointment (Aquaphor or Vaniply Ointment). It is important to not let your skin dry out.

White vinegar soaks are highly recommended and very soothing. They can be done every few hours, and are most effective after washing and before re-application of ointment. Mix 1 teaspoon of white vinegar with 1 cup (8 oz) of water. If the soak burns excessively, you can use less vinegar, but not more. Soak gauze in the solution and apply the gauze to the face for 10 to 15 minutes. These soaks help with the pain, dissolve residue, and are anti-microbial.

For mild to moderate discomfort NSAID pain medications (ibuprofen, motrin, advil, aleve) are the mainstay of pain control. You can take 600 mg of ibuprofen/motrin every 6 hours. For Additional pain control, or if you cannot take NSAID paid medication, you can take 1,000 mg of Acetaminophen/Tylenol every 8 hours. Opiate narcotics are occasionally prescribed and these can be used in addition to NSAIDs and Tylenol. Please be cognizant as the prescribed narcotic may have Tylenol in it. You should never exceed more than 3,000 mg of Tylenol in 24 hours. If an antibiotic has been prescribed, finish your antibiotic as prescribed.

After Skin Regrows:

The subunits of your face will recover at different rates. This typically occurs starting 4-9 days post treatment, and depends on the depth of your resurfacing. Once our skin is no longer raw (but will still be pink), you will stop using ointment on those areas, and transition to a fragrance-free moisturizer. We recommend Cetaphil or VaniCream (moisturizing skin cream). You should only use our recommended products as they avoid ingredients that are skin irritants in some people. Dry skin will delay healing so it is very important to apply the moisturizers every few hours. Be sure to stay out of the sun and use products with SPF. Two weeks after your treatment you can ease back into your normal skin care routine. Avoid any laser hair removal treatment on treated area for at least 6 weeks.

You generally will have a post laser follow up appointment in our office 1-2 weeks after your treatment. This is for us to check on your healing and answer any questions or concerns you may have.

Post laser conditions:

Acne:This is uncommon, but some people may have a minor breakout. Do not be alarmed. This will clear on its own by continuing to follow the previously defined post-treatment instructions.

Redness/Erythema: Post-laser redness is the most common complaint of post laser patients. This look is expected and part of the normal healing. Healing requires increased blood flow, and the skin thickness takes time to normalize. Redness varies between patients and even between areas of the face. It can last several weeks to several months. It is generally accepted that the longer the erythema, the more drastic the improvement as the treatment reached the deeper layers of the skin and will generate more collagen. Aggressive cleaning can also prolong the redness so it is important to be gentle when performing your skin care routine.

Post laser hyperpigmentation usually presents between 20 and 30 days after laser. It varies from patient to patient and is the result of normal pigment cells (melanocytes) in our skin becoming overactive following inflammation (from the laser treatment itself, and post-operative insults). Don’t be alarmed, 40% of patients can experience this and it will resolve on its own. This is NOT permanent and will clear up in several weeks.

Infection: Post laser infections are rare, but can occur. It is important to wash your hands frequently, and follow our wound care instructions closely. After several days, the pain of the laser treatment should improve. Increasing pain, severe itching, localized swelling, ulcers or new lesions may signify infection and if you are concerned, call our office for evaluation.

Milia: Milia are small white bumps that represent clogged pores. They can be solitary or form in groups. The usually resolve with time and continued hygiene.