Botox and Dysport

Seven days before

• Stop over-the-counter anti-inflammatories. Ibuprofen, naproxen, fish oil, vitamin E and flaxseed oil all increase bruising.
• Stop alcohol. It dilates blood vessels and increases bruising.
• Stop high-dose vitamin C above 1,000 mg a day.
• Do not stop prescribed blood thinners or anticoagulants such as aspirin taken for cardiac reasons, apixaban, rivaroxaban, warfarin or clopidogrel. Do not stop any of these without speaking to the doctor who prescribed them. Contact us instead and we will plan around them.

Three days before

• Avoid vigorous facial massage and facial treatments, including microcurrent and gua sha.

Tell us before your appointment

• Any new medications, particularly muscle relaxants and aminoglycoside antibiotics, which can potentiate the effect.
• If you are pregnant or breastfeeding. This treatment is not performed during pregnancy.
• Your previous treatment history: when, where, how many units, and anything that did not go as expected.
• For migraine: your current frequency, what you have already tried, and any previous treatment.
• For masseter: whether the goal is slimming, relief from clenching, or both. It changes placement and dosing.

The day itself

• Arrive with a clean face, nothing on the treatment area.
• Eat something beforehand. Low blood sugar makes people lightheaded.
• Bring a list of your current medications.

This window matters more than anything else afterwards.

• Stay upright. Do not lie down for four hours. This keeps the product where it was placed.
• Do not touch, rub or massage the treated areas. That includes facials, facial massage devices, and resting your face in your hands.
• No tight headband, hat or helmet over the treated area.
• No vigorous exercise for the rest of the day.
• Avoid heat. Hot showers, saunas and steam rooms.
• No alcohol for the rest of the day.

Days 1 to 3

• Mild tenderness, swelling or small bumps at the injection sites are normal and settle within 24 to 48 hours.
• Bruising can appear, particularly around the crow's feet and lower face, and resolves within 5 to 10 days. Arnica can help.
• Do not massage the area even if it feels uneven. The product is still settling.
• Gentle skincare is fine. Avoid aggressive exfoliation and actives on the area for 24 hours.
• Slight asymmetry at this stage is normal and usually resolves.

Days 3 to 14

• Results keep developing. Most people see significant change by day five to seven.
• Avoid facials, chemical peels and microneedling for two weeks.
• If at day fourteen the result is uneven, weaker than expected, or an area has not responded, contact us. Touch-ups are assessed at two weeks.

• Some jaw soreness or fatigue in the first few days is normal while the muscle adjusts.
• Avoid very hard foods for a few days if the jaw is tender.
• The slimming effect appears gradually over four to six weeks as the muscle softens, with full results at six to eight weeks. It is not immediate.
• For clenching and bruxism, a noticeable reduction in clenching and morning jaw pain is typical within two weeks.
• Results last about three months, with retreatment on a consistent three-month schedule.

• A temporary headache or mild neck soreness in the first 24 to 48 hours is common and settles on its own.
• Preventive effect builds over two to four weeks as the treatment takes full effect across all injection sites.
• Keep a simple headache diary in the weeks afterwards. It is what allows dosing to be adjusted properly at the next session.
• Full effect is typically reached by week four. Retreatment is every three months.