Facial Aesthetics · Botox & Fillers
What to prepare, what to avoid, and what to expect — a practical guide from a plastic surgeon.
Getting a toxin (Botox, Dysport) or dermal filler treatment is not complicated — but how you prepare for it, and how you care for yourself after, directly affects the result. We see patients who have had poor outcomes or are unhappy not because the injection was wrong, but because they didn't know what to avoid or what to expect in the days after.
This is the straightforward guide I give my patients before every session. Read it, follow it, and your results will be better and last longer.
Botulinum toxin (commonly called Botox) relaxes overactive muscles. It is used to reduce dynamic wrinkles — lines that form from movement, like forehead lines, crow's feet, and frown lines (the "11s"). It does not fill volume; it reduces movement.
Dermal fillers (typically hyaluronic acid-based — Juvederm, Restylane, Belotero) add volume and structure. They are used for lips, cheeks, nasolabial folds, tear troughs, jawline definition, and nose reshaping (non-surgical rhinoplasty). They do not stop movement; they restore or add volume.
Both are injectable procedures. Both require planning.
Tell your doctor about everything you are taking — prescription, over-the-counter, and supplements. The most important ones to flag:
This is not about what sounds good — it is about your safety and your result.
Alcohol dilates blood vessels and acts as a blood thinner. Even one drink the night before significantly increases bruising risk and post-treatment swelling, especially for fillers.
Book 3–4 weeks before any important event — wedding, function, photoshoot, major occasion. Toxin takes 7–14 days to show full effect. Filler swelling, particularly in the lips and under-eyes, takes 7–14 days to fully settle. Do not leave it to the week before.
On the day of your appointment, arrive with no makeup, no moisturiser, and no skincare products on the treatment area. Clean skin means faster, more hygienic treatment.
Hyaluronic acid fillers bind to water in your tissue. Being well-hydrated before and after treatment supports filler integration and longevity. Drink water normally in the days leading up to your session.
Do not come fasting. A light meal before your session stabilises blood sugar and reduces the likelihood of lightheadedness, which some patients experience with injections.
Come with a clear idea of what concerns you want addressed — not a collection of celebrity photos. I can work with your anatomy, your proportions, your face. I cannot make your face into someone else's. Patients who come with specific, personal goals get better outcomes than those who come with trend-driven requests.
If you have had fillers placed elsewhere — at another clinic, abroad, or a long time ago — your doctor needs to know. Layering filler without knowing what's already present is a leading cause of complications. Be specific about what was used and where.
Unless prescribed for a medical condition, stop aspirin, ibuprofen, and naproxen at least one week before your treatment. If you are on these for a medical reason, discuss with your treating physician before stopping.
Dental work — especially invasive procedures — introduces bacteria into the bloodstream. Filler creates a microenvironment where bacteria can seed and cause delayed infection. Maintain at least a two-week gap on either side of filler and any dental procedure.
If you have an active cold sore (oral herpes), do not proceed with lip filler. The trauma of injection can trigger a severe outbreak. If you are prone to cold sores, discuss antiviral prophylaxis with your doctor before any lip treatment. No treatment should be done over actively inflamed, infected, or broken skin.
Aesthetic treatments done well cost money. Toxin and fillers are not places to find the cheapest option. The risk of under-treatment (not enough product, wrong placement) or complication (vascular occlusion, infection, migration) is higher when cost drives the decision. Know what you are paying for: the product, the technique, and the aftercare.
Stacking multiple aesthetic treatments — laser, peels, microneedling, toxin, filler — in the same week or even the same two-week window is not safe or effective. Each treatment needs recovery time. Space treatments appropriately and work with your doctor on a sequenced plan.
Cold compresses (not direct ice on skin) can reduce swelling and bruising in the first few hours, especially after filler. Do not press hard on the treated area.
After filler, avoid sleeping face-down or on the treated area for at least one night. Pressure can displace freshly injected product, especially in softer areas like lips and cheeks.
After botulinum toxin injections, remain upright for at least 4 hours. Do not lie down or bend forward for extended periods. This reduces the risk of toxin migration to unintended muscles.
Most toxin and filler results are assessed 2–4 weeks after treatment. This is when small corrections, top-ups, or dissolving can be done if needed. The review appointment is part of the treatment — not an afterthought. Do not skip it.
Increasing pain, blanching (white or pale patches in the skin), vision changes, severe or worsening swelling, or skin colour changes in the hours to days after filler. These may indicate vascular occlusion — filler compressing or entering a blood vessel. This is rare but time-sensitive. Do not wait and see.
Increased heart rate and blood flow after strenuous exercise can worsen bruising and swelling, and may affect filler integration. Gentle walking is fine. Gym, running, and high-intensity workouts should wait at least 24–48 hours.
Any manipulation of the treated area — massage, facial, dermaplaning, laser — should be avoided for at least two weeks after filler. Touching, pressing, or rubbing the area can move the product.
Avoid saunas, steam rooms, very hot showers, and direct sun exposure for at least 48 hours after treatment. Heat increases swelling and can affect product placement.
Fillers take time to integrate, hydrate, and settle. Toxin takes 7–14 days to show full effect. Judging your results at 24 or 48 hours — when bruising and swelling are still present — is premature and often anxiety-inducing for no reason.
If you are unhappy with your result in the first few days — wait. Most early concerns (swelling, asymmetry, firmness) resolve on their own in 1–2 weeks. Dissolving with hyaluronidase before the filler has settled can lead to over-correction. Wait for your review appointment.
| Do | Don't | |
|---|---|---|
| Before | Disclose all medications | Take aspirin / NSAIDs |
| Before | Stop alcohol 48 hrs prior | Book close to an event |
| Before | Eat a light meal | Come with active infection |
| Day of | Arrive with clean skin | Wear makeup |
| After | Ice gently if needed | Exercise hard for 48 hrs |
| After | Sleep on your back | Get facials or massage |
| After | Attend review appointment | Judge results in 24 hrs |
Book your appointment 3–4 weeks before any important event. Toxin takes up to 14 days to show full effect. Filler swelling, particularly in the lips, can take 7–14 days to resolve.
Wait at least 4–6 hours before applying makeup over injection sites. Avoid pressing or rubbing the treated area.
Yes, combination sessions are common and safe when done by an experienced doctor. In fact, a combined approach often gives better aesthetic results than either treatment alone.
Ibuprofen thins the blood and increases bruising risk. It will not ruin your treatment, but you are more likely to bruise. Avoid it where possible.
Botulinum toxin typically lasts 3–5 months. Hyaluronic acid fillers last 6–18 months depending on the product used and the area treated. Lip filler generally metabolises faster than cheek or jawline filler.
Pregnancy and breastfeeding are absolute contraindications for both toxin and fillers. Certain autoimmune conditions, active skin infections, and some neurological conditions also preclude treatment. A thorough medical consultation is necessary before every first treatment.
The most serious complication is vascular occlusion — filler inadvertently injected into or compressing a blood vessel. This is rare but can cause tissue damage if not treated immediately. This is why choosing an injector with medical training, an understanding of vascular anatomy, and access to hyaluronidase (the antidote) is non-negotiable.
Botox injections use very fine needles and are generally well-tolerated without topical anaesthesia. Filler injections, especially in the lips, are more uncomfortable — topical numbing cream is applied before treatment.
A good result is only 50% technique.
Patients who follow these guidelines get a better outcome, fewer complications, and longer-lasting results. If you have questions specific to your situation — medications, timing, a previous treatment elsewhere — bring them to your consultation. That is what it is for.
Ask it directly. Online consultations available across Kerala — no commitment, no pressure.