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A Guide to Preparing for and Recovering from Botox and Filler Treatments: Tips from an Aesthetic Nurse

By Brigid McKee, RN



As an aesthetic nurse with the American Academy of Facial Esthetics, my primary goal is not only to provide top-notch injectable treatments to my patients but also to empower other healthcare providers with the knowledge and skills needed for safe and effective procedures. One common set of questions I frequently encounter revolves around the pre and post-care routines for Botox and filler treatments. In this comprehensive guide, we’ll explore essential steps to take both before and after these aesthetic procedures.

Before Botox and Filler Treatments:
Preparing for Botox and filler treatments is crucial to ensure optimal results and minimize potential side effects. Here are some key recommendations to share with your patients:
  1. Avoid Alcohol and NSAIDs:
    • Alcohol and non-steroidal anti-inflammatory drugs (NSAIDs) can increase the risk of bruising. Advise patients to refrain from consuming alcohol and NSAIDs for a few days leading up to their appointment. Encourage the use of acetaminophen for any discomfort.
  2. Avoid Caffeine:
    • Caffeine is known to increase heart rate and blood pressure, potentially contributing to a higher risk of bruising. Encourage patients to limit their caffeine intake in the days leading up to their Botox or filler appointment.
  3. Avoid Wearing Makeup Prior to your Appointment

Botox Post-Procedure Care:
After receiving Botox injections, patients should follow specific guidelines to enhance the treatment’s effectiveness and reduce the risk of complications. Here’s what they need to know:
  1. No Touching for 4 Hours:
    • Stress the importance of refraining from touching the treated area/face for at least four hours post-procedure to prevent the migration of Botox into unwanted muscles.
  2. Avoid Laying Flat:
    • Patients should avoid lying flat for the first four hours after treatment to ensure the proper distribution of the injected Botox and reduce the risk of uneven results.
  3. Avoid Raising Body Temperature/Exercise:
    • Instruct patients to avoid activities that raise body temperature, such as intense exercise or hot baths, for the initial four hours following the Botox injections.

Filler Post-Procedure Care:

Filler treatments require a slightly different set of post-care instructions. Educate your patients on the following recommendations:

  1. No Exercise for 24 Hours:
    • Encourage patients to refrain from vigorous exercise for at least 24 hours to minimize the risk of swelling and ensure the even distribution of the filler.
  2. Sleep with Head Elevated and on Your Back:
    • Sleeping with the head elevated and on the back can help reduce swelling and promote proper settling of the filler.
  3. No Makeup for 24 Hours:
    • Advise patients to avoid applying makeup to the treated area for the first 24 hours post-procedure to prevent potential infections.
  4. Avoid Touching Your Face:
    • Stress the importance of not touching the treated area for the rest of the day to minimize the risk of infection and disturbance of the filler.

Filler Vascular Event Awareness:

One critical aspect of post-filler care is being vigilant about potential vascular events. A vascular event occurs when filler material either enters or compresses a blood vessel, leading to compromised blood flow. This is considered a medical emergency in aesthetics, and prompt action is essential. I ensure to educate all of my patients on this matter while signing consent for the procedure.
  1. Signs of Vascular Events:
    • Educate patients on the signs of vascular events, including sudden pain, blanching/whitening or dusky/mottled appearance of the skin, or any other unusual discoloration.
  2. Immediate Action:
    • If a vascular event is suspected, timely action is crucial. For hyaluronic acid-based fillers, immediate reversal is necessary if heat application and massage do not improve tissue color. Hyaluronidase will need to be injected in the same plane as the filler to dissolve.
  3. Capillary Refill Test:
    • Instruct patients on how to perform a capillary refill test. Press on the treated area and observe how quickly the color returns. Delayed capillary refill could indicate compromised blood flow. Your patient needs to know when to reach out! Most necrotic issues related to filler occur due to the patient not knowing when to reach out to their injector.

As an aesthetic nurse, providing comprehensive pre and post-treatment care instructions is an integral part of ensuring the well-being, safety, and satisfaction of your patients. By following these guidelines, patients can enhance the effectiveness of their Botox and filler treatments while minimizing the risk of complications. A well-informed and prepared patient is a key partner in achieving successful aesthetic outcomes.


Start your facial esthetics journey by registering for the Botulinum Toxins & Dermal Fillers Level I Course! Register here today:

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