Pre/Post-Procedure Info

Use the buttons below to download pre/post-op instructions (PDF format) for each procedure.

Video Instructions

Day 1 Post Treatment

If you have any discomfort begin applying open wet dressings to the treated areas 2-3x per day.

INSTRUCTIONS FOR OPEN WET DRESSINGS

Use thin, clean cloth (sheet, pillow case, etc.). Towels are too thick.
Wet with cool water and ring out well until damp.
Apply to affected area(s) and leave on for 10-15 minutes.
Dry area well, then apply prescribed cream and recommended moisturizer as directed.

Swelling will be most evident around the eyes and is usually more prominent in the morning.
Sleep on 2-3 pillows for the first few nights.
Remain indoors and avoid direct sunlight.
Apply Rx Desonide cream 2-3x per day followed by the recommended moisturizing cream. This can be continued for the first few days as well.
Take analgesics such as Advil/Aleve if necessary.
Take OTC Claritin or Zyrtec (if tolerated) the day of the procedure

Days 2-7

For female patients, you may begin applying make-up once any crusting has healed. The area may be slightly red for over a week.
Swelling will be most evident around the eyes and is usually more prominent in the morning.
Sleep on 2-3 pillows for the first few nights.
Avoid direct sunlight for at least 48 hours after treatment. After 48 hours, use sunblocks containing zinc oxide or titanium dioxide. We recommend Elta MD sunblocks, Cetaphil moisturizer SPF 50.

If you have any concers/quesYons, please call the main office at 203-792-4151

Botox is a purified protein which is injected through the skin to decrease or eliminate facial lines and wrinkles. It works by temporarily relaxing the muscles that cause lines of expression. The main areas of the face which can be treated are the glabellar area between the eyebrows (frown lines), the forehead horizontal lines, and the area lateral to the eyes (crow’s feet). Other areas which may be treated are lines under the eye and on either side of the nose, lines above the upper lip and the corner of the mouth. Botox may also be used to treat excessive chronic sweating of the armpits, hands, and feet. Botox has been used safely for decades for the treatment of various eye muscle conditions.

WHAT TO EXPECT

Photos may be taken prior to treatment. The area to be treated will be cleaned with alcohol and you will be asked to sit up so that your physician can administer the treatment. The Botox injections sting for a few seconds. You may notice some redness and mild swelling at the sites of the injection which will resolve in a few hours.

Usually, 3 to 7 days after treatment patients will notice a decreased ability to move the treated muscles. Within several weeks, the wrinkles in the treated areas should appear to soften. The effects of a Botox treatment last approximately three to four months. After this time, your ability to move the treated muscles will gradually return. It is important to note that the effectiveness of the treatment will vary. Rarely, there will be minimal to no effect at all. Most patients find that the effects of Botox last longer after having a series of injections due to a cumulative effect.

PRE-TREATMENT PERIOD

Avoid products containing aspirin or ibuprofen for ten days prior to treatment with Botox in order to minimize any change of bruising.

POST-TREATMENT PERIOD

After treatment, you must remain upright for four to six hours. Keep your head as erect as possible during this time and avoid bending down. Also, for six hours after treatment do not rub the injections sites, do not exercise, do not wear a hat or headband, and do not wash or style your hair. In addition, do not fly on an airplane for two days after treatment. Photos will be taken in follow-up to evaluate the effectiveness of the treatment.

SIDE EFFECTS

Weakness of affected muscles may be more than desired but is entirely reversible over time.
Asymmetry or drooping of the eyelids and eyebrows may occur. This side effect is rare and also completely reversible over time.
Headaches or tightness may follow the treatments but generally are mild and last less than 24 hours.
Local swelling, redness, and bruising may occur.

WHY YOU MAY NOT BE A CANDIDATE FOR BOTOX

Botox may not be administered to patients who are pregnant, nursing, allergic to albumin (eggs), taking certain antibiotics, affected by any neuromuscular or collagen vascular disease, or that have had any recent eye surgery. In addition, if you have previously received Botox and have had difficulties following the injection you should notify your physician.

BOTOX FEES

• $18.00 per unit

Usually treating the glabellar area requires 20 to 25 units, the crow’s feet 18 to 30 units, and the forehead 20 to 30 units. At your follow-up appointment 10 to 14 days after your Botox treatment a touch-up may be necessary and you will be charged based on the number of units of Botox needed.

A mild sunburn-like sensation is expected. This usually lasts 2 to 24 hours but can persist up to 72 hours. Mild swelling and/or redness may accompany this and usually resolves in 2 to 3 days. In rare cases, prolonged redness or blistering may occur. Gently cleanse and apply an antibiotic ointment if needed.
The lesion(s) may initially look raised and/or darker with a reddened perimeter. In the first 4 hours after treatment, apply cool compresses or ice packs to the treat areas for 10 to 15 minutes every hour to reduce discomfort and heat sensation. If a full facial treatment is required, sleep with your head elevated for 1 to 2 nights to minimize the possibility of swelling.
Pigmented lesions will gradually turn darker over the next 24 to 48 hours. They may turn dark brown or even black and will progress to a scab or crust. These will start to flake off in 2 to 3 days. Do not pick, scratch or remove these crusts. This will prevent impaired healing.
Treatment for vascular lesions will cause the vessels to immediately turn gray or blanch. In some cases, only a slight purplish color change will be noted. The vessels either partially or fully resolve in about 10 to 14 days. If the area treated had extensive flushing the redness will gradually fade leaving the skin with a normal appearance.
Avoid sun exposure to treated areas. Apply a sunscreen with an SPF 30 or greater daily to sun-exposed skin for the duration of treatment and continue for 4 to 6 weeks after treatments are complete.
If you received photodynamic therapy with your IPL treatment, you must avoid exposure to natural and synthetic light for 48 hours after treatment. You must apply sunscreen to the treated area and wear sun protective clothing or a hat to prevent sun exposure.
A steroid cream will be applied with your IPL treatment. Reapply this cream twice more on the day of treatment and possibly longer if you are instructed to do so.
Until redness had completely resolved, usually 2 to 3 days, avoid the following:
- Applying cosmetics on or near the treated area
- Swimming, especially in pools with chemicals
- Hot tubs or Jacuzzis
- Activities that cause excessive perspiration

Please observe the following after treatment with Restylane, Juvederm, Volbella, Vollure, and/or Voluma:

Immediately after the treatment, the most common side effects are temporary redness and swelling at the injection site. These effects typically resolve within 2 to 3 days. Cold compresses may be used immediately after treatment to reduce swelling. If the inconvenience continues beyond that time period or if other reactions occur, please contact your physician.
Avoid touching the treated area within six hours following treatment. After that, the area can be gently washed with soap and water.
If you have previously suffered from facial cold sores there is a risk that the needle puncture could contribute to a recurrence. Speak to your physician about medications that may minimize a recurrence.
Avoid taking aspirin, non-steroidal anti-inflammatories (such as Advil, Aleve, Motrin or any medicines containing ibuprofen or naproxen), St. John’s Wort, and high doses of vitamin E supplements for one week after treatment. These agents may increase bruising and bleeding at the injection site.
Avoid exercise and alcohol for six hours post-treatment.
Research shows that having a follow up treatment before the product has full dissipated will enhance the lasting effect. Please be sure to consult your physician about recommendations for follow-up treatments.

Liquid nitrogen is made from nitrogen gas which has been cooled and pressurized to form a liquid. Dermatologists use it to freeze and destroy superficial skin growths, such as warts and keratoses.

Liquid nitrogen causes stinging and a moderate amount of pain while the growth is being frozen and subsequently, thaws. Two to three freeze-thaw cycles are required to treat most growths. The initial discomfort subsides significantly within 10 to 15 minutes.

Some hours after liquid nitrogen treatment you skin will become swollen and red. Later, it may become blistered and a scab or crust may form. This will fall off by itself in 1 to 2 weeks and the skin growth should come off with the scab, leaving healthy skin behind.

If your growth required deep and extensive freezing to remove, there may be considerable blistering and swelling, especially if you hands or the area around your eyes were treated. Often, the blister will contain blood and may appear dark to bluish in color. If the blister becomes tense and very painful, you may puncture the blister with a sterile needle, which we will supply. If you do puncture the blister, cleanse the area once daily with mild soap and water, and cover it with a thin layer of Polysporin or Bacitracin ointment and a small bandage. Avoid using ointments containing neomycin (Neosporin) because they may cause itching and redness in some people. The blisters and swelling are part of the treatment and will gradually heal by themselves.

No special care is needed after liquid nitrogen treatment. You can wash your skin as usual and use makeup or other skin care products. If clothing irritates the area treated, cover it with a small bandage.

Depending upon the size and location of the skin growth you may need to have more than one liquid nitrogen treatment. This will be determined at your initial appointment or at a follow-up appointment.

Wash once daily with mild soap and water.
Pat dry.
Apply a generous layer of Vaseline ointment twice daily.
Apply a new bandaid with each dressing change.
If the dressing becomes wet replace it with a dry one.
Continue application of Vaseline until the wound is healed, this may require up to 14 days.

If any problems or questions arise please call the office.

Avoid taking aspirin or products containing aspirin for 7 to 10 days prior to treatment.
If using topical numbing cream (LMX 4%), begin applying to areas to be treated at least 15 minutes prior to your scheduled appointment. You may purchase the cream either in our office or at the pharmacy.
Apply ice to the treated areas for 10 minutes every hour for the first 24 hours after the treatment and as needed after that.
Keep head elevated on 2 pillows for the first 48 hours during sleep or when lying down.

PRE-OP INSTRUCTIONS

Areas being treated should not be tan; therefore prolonged U.V. exposure prior to treatment is not advised.
Wear loose pants to your appointment.
Bring shorts to wear at your appointment for comfort and ease of treatment.
Do not apply creams or lotions to your legs the day of your appointment.
Please arrive 15 minutes prior to your scheduled appointment time.

POST-OP WOUND CARE

After treatment, spot compression will be secured with tape on the injection sites. An ace bandage or compression stocking may be used for added compression. These should remain in place until the following morning. Soak off spot compressions the next morning with warm water (Keri oil or bath oil may be added to bath water).
Continue normal activities, walking is encouraged. Refrain from strenuous exercise for 7-10 days. Avoid hot baths, saunas, hot tubs, and long-distance travel during this time.
Wear compression stockings for 7-10 days after spot compressions are removed. It is okay to take stockings off at bedtime.
It is common to experience mild itching along the treated vein sites as well as mild to moderate swelling or bruising at the injection sites. There may also be discoloration along the treated vessels and some mild discomfort at injection sites. You may use moisturizers and sunscreens on your legs after the dressings are removed. In addition, you should apply Bacitracin or Polysporin to any crusted areas.
Use broad spectrum sunscreen.
Please contact our office immediately at (203) 792-4151 if you notice any redness, tenderness, or open sores in any of the treated areas.

BEFORE LASER TREATMENT

Purchase a tube of Polysporin or Bacitracin ointment prior to the procedure. Do not purchase ointments with neomycin (Neosporin) since they may cause itching or redness in some people.
When exposed to the sun, apply sunscreen with an SPF of 15 or higher to the lesion(s) which will be treated.
Tell your physician if you have a history of herpes simplex virus (cold sores or fever blisters) occurring on the lips or on other areas of the face. This is especially important if you are having laser treatments on the mouth or face.
Do not take medications containing aspirin or ibuprofen (Advil, Aleve, Motrin, etc.) for 1 week prior to your laser treatment. If these medications are taken regularly for medical reasons, discuss this with your physician prior to the procedure. Anticoagulants (blood thinning medications such as Coumadin) must be discontinued at least 3 days prior to treatment.

AFTER LASER TREATMENT

Do not rub, scratch, or pick at the treated area while a blue-gray bruising is present.
If the treated area becomes tender, reddened, or shows signs of infection (discharge) please call the office immediately.
If you apply make-up to the treated area, be sure to remove it gently.
Avoid swimming and contact sports while bruising is present.
Avoid rubbing or pressure on the treated areas caused by clothing or jewelry. Apply a dressing to the treated area to prevent irritation.
For 1 to 2 months following treatment, apply a sunscreen of SPF 15 or higher to the lesion(s) whenever exposed to the sun.
Do not take medications containing aspirin or ibuprofen (Advil, Aleve, Motrin, etc.) for 1 week following treatment.

CARE OF THE TREATED AREA:

Apply Polysporin or Bacitracin ointment to the treated area twice a day while bruising is present.
Showers are permitted, but dry the area gently. Do not rub the treated area with a towel or washcloth while bruising is present.
If the area develops a crust or scab allow it to fall off on its own and do not pick at the area. Keep the area moist with ointment.
Any discomfort that you may have will usually subside after several hours. You may use acetaminophen (Tylenol) as needed.
If swelling occurs, you may apply an ice pack. Wrap the ice pack in a soft cloth and apply to the treated area for 10 to 15 minutes several times daily.

After the bruising disappears the treated area will look as it did before. A few weeks after the disappearance of the bruising complete fading of the lesion(s) should occur.