Patient Instructions

Botulinum Toxin A (BTA) and Filler Injections: Overview and Guide to Care


BTA procedures aim to enhance your facial appearance by addressing frowns and wrinkles. On the other hand, fillers target facial lines, creases, wrinkles, and areas of hollowness to improve aesthetics. The following details provide insights into what you can anticipate, post-procedure recovery, and aftercare instructions. Please note that some information in this guide might not be relevant to your specific situation.

BTA And Filler Injections

You’ve opted for Filler and/or BTA injections to align your external appearance with your inner self. We’re committed to ensuring your experience is seamless. Filler and BTA treatments enhance your skin’s appearance by minimizing wrinkles, giving you a rejuvenated and youthful look.

Differences Between BTA and Fillers

Injectable treatments aim to diminish the appearance of facial wrinkles, but they employ different methods to achieve this. Wrinkles can result from the natural aging process, leading to a decrease in collagen and skin structure, or from underlying muscle movements. Fillers are designed to smooth out persistent wrinkles, regardless of facial movement. In contrast, Botox, Dysport, and Xeomin target the underlying muscle activity, reducing wrinkle formation. While fillers can also enhance facial volume and fullness, Botox, Dysport, and Xeomin don’t offer this benefit. Both types of injectables serve important purposes, and a combination might be necessary for the best results.

What to Expect Before Your Procedure: Pre-Treatment Instructions

To minimize the chances of bleeding and bruising from both BTA and Filler injections, please refrain from the following two days before your treatment:

  • Alcoholic Beverages
  • Anti-inflammatories
  • Aspirin
  • Ginkgo Biloba
  • Vitamin E

**If you have a history of oral herpes simplex, it’s advisable to undergo pre-treatment before undergoing filler procedures.

What to Expect During Your Procedure

During your appointment, a medical expert will assess your face and discuss your desired outcomes. A tailored treatment plan will be presented to you, and once you agree, the procedures will begin. We might need to remove some of your makeup to prepare for the treatment. While you might experience mild discomfort from the injections, most patients find them quite bearable. Although rare, there’s a possibility of bruising post-procedure. Using cold compresses after the treatment can help reduce swelling (especially for filler treatments) and prevent potential bruising. Any bruising that does occur typically fades within a few days and should not persist beyond a week.

BTA Post-Treatment Instructions: What to Expect

The effects of BTA typically become visible between 3-7 days post-injection, so patience is key. By the end of the first week, you should observe a noticeable enhancement in your wrinkles and overall facial appearance. Some initial redness around the injection areas is normal and isn’t indicative of an allergic reaction. There might also be minor swelling, which usually subsides within the first few days. While rare, minor bleeding or bruising at the injection sites can occur. If you observe this, apply pressure for fifteen minutes and use cold compresses briefly. Here are some additional guidelines to follow post-procedure:

  • Stay upright for four hours; avoid bending or reclining.
  • Refrain from massaging or scratching the treated area.
  • Activate the treated muscles by moving them every 15 minutes for the next four hours.
  • Wait at least two hours post-injection before applying makeup.

Filler Post-Treatment Instructions: What to Expect

The results from your filler procedure can be seen either immediately or shortly after, depending on the type of filler used. For most fillers, you’ll likely observe a marked improvement in wrinkles and facial contours by the end of your appointment or within the first week. It’s normal to experience some redness around the injection sites on the first day; this isn’t an allergic reaction. Mild swelling might also be present but typically recedes within a day or two. While rare, minor bleeding or bruising can occur at the injection sites. If this happens, apply pressure for fifteen minutes and periodically use cold compresses over the next few days. Any bruising should fade within a few days and shouldn’t persist beyond a week. Here are some additional post-procedure guidelines:

  • Use ice as needed throughout the day to alleviate swelling.
  • If any nodules form, gently massage them over the next 24 hours.
  • Steer clear of prolonged sun or UV exposure for two weeks.
  • Refrain from visiting saunas or steam baths for two weeks.
  • Wait at least four hours post-injection before applying makeup.

BTA Post-Treatment Instructions: What to Expect

Neuromodulator Post Treatment Instructions:

  • Do NOT massage or apply pressure on the treated area for 6-8hrs after treatment since Botox may migrate to areas of undesirable effectiveness.
  • Do NOT lie down for 4 hours after treatment. Keep your head UPRIGHT for at least 4 hrs after injection.
  • Avoid yoga or other rigorous exercise activities, extensive sun or heat exposure, and alcoholic beverages for the 1st 24 hours after treatment. This may cause temporary redness, swelling, and/or itching at the sites of the injection.
  • Avoid certain facials for approximately 2 weeks
  • Try to exercise your treated muscles for about 2 hours after treatment (e.g. practice frowning, raising your eyebrows or squinting)
  • Headaches are a common side effect. However, if you have a headache we recommend you avoid aspirin or aspirin containing products within 24 hours. You may opt instead to use Motrin, Tylenol, and/or cool compresses. If headaches continue or worsen after a few days, contact your physician.
  • Avoid taking Advil, Vitamin E, Ginger, Ginko biloba, Ginseng, and Garlic for 2 weeks since this may increase the risk of bruising. You may shower and do most other regular daily activities.
  • Note that any bumps or marks will go away within 30 min to a few hours. Do not massage it awa. If you do develop a bruise it will resolve like other bruises you have had in about a week. There is occasionally some mild pain, swelling, itching, or redness at the site of injection similar to most other injections. Redness may last for 1-2 days, rarely longer. You may apply cold compresses or acetaminophen (Tylenol) to reduce swelling or discomfort.
  • Results of your treatment may take up to 14 days to take full effect although many people will recognize the benefits in 3-7 days after treatment.
  • Neuromodulator injections is a temporary procedure. In most people the benefits of neuromodulators last about 3-6 months. Sometimes a few wrinkles may start to return in 2-3 months depending on your activity level, and how fast you metabolize the product. The effectiveness of neuromodulators will last longer with successive treatments.
  • Schedule a follow up appointment in 2-3 weeks for any touch ups.
  • Makeup: It is recommended that you wait 12 hours after the treatment before applying make-up.
  • Cold compresses may be used 10 minutes on 10 minutes off to reduce swelling 2-3x per day during the 1st 1-2 days if needed.

Filler Post-Treatment Instructions: What to Expect

Dermal Post Treatment Instructions:

  • Swelling, bruising, tenderness, numbness, and areas of firm nodules may occur.
  • Hyaluronic acid fillers are long lasting, but not permanent. Longevity depends on the areas treated and your body’s metabolism.
  • Do not apply cleanser, moisturizer, or makeup for at least 12 hours after your procedure.
  • DO NOT massage, touch, or manipulate the injection site.
  • Avoid heavy exercise the day of your treatment.
  • Ice packs may be used to the treated area during the first 12 hours. Ice for 15 minutes on every hour.
  • Avoid dental work for 3-4 weeks after filler injections.
  • Avoid sleeping on your side or stomach for 24 hours post-treatment to prevent dispersing the product.
  • If you experience any swelling, sleep with head elevated for 2-3 days to decrease swelling.
  • You may take acetaminophen/Tylenol if you experience any mild tenderness or discomfort.
  • Wait a minimum of four weeks (or as directed by your provider) before receiving any skin care or laser treatments.
  • For most patients, the benefits of dermal fillers can be enhanced by using a medical-grade skincare system.
  • Please contact your provider or a member of the staff for product recommendations.
  • If you experience bruising, Arnica (a natural supplement) can be taken to help bruising to resolve at a faster rate, take 5 tablets three times per day (this can be started 1 week prior to injections). Consult with your doctor first if you are on any blood thinners.
 If you experience any of the following symptoms, contact our office immediately:
  • Dusky or white discoloration of injected areas, mottling or unusual bruising, severe or increasing pain, redness, increasing warmth or coolness to touch, severe swelling, itching, blisters, difficulty swallowing or smiling, fever, or chills. If you notice onset of any of these symptoms, call our office immediately at 973-570-9312 to speak with a provider.


A typical BTA treatment takes between 3 and 7 days to begin working, and the effects usually last between 3 to 4 months.

A wide variety of filler products exist, each having its own longevity. Typically, temporary fillers have effects lasting anywhere from 3 months to 2 years, based on the specific product. During your appointment, we can discuss this in detail to tailor a treatment plan that suits your needs.

BTA is generally safe and well-received when used for non-invasive cosmetic procedures. While there have been instances of complications following BTA treatments, these typically involved the use of large doses. For cosmetic purposes, the quantity of BTA administered is very minimal. Although BTA temporarily “paralyzes” facial muscles, its effects are not permanent and don’t lead to lasting issues.

Although injectable treatments come with certain risks, most fillers are safe and well-tolerated when used for cosmetic purposes. In general, most fillers have minimal associated risks.

BTA is effective in treating facial wrinkles resulting from underlying muscle movements. Commonly treated areas include the forehead, glabella (often referred to as the “elevens”), around the eyes, and lip lines. Additionally, BTA can elevate the eyebrows, lift the corners of the mouth (giving a more smiley appearance rather than a frown), and diminish the appearance of “bands” in the neck.

Filler injections are versatile in addressing facial wrinkles, catering to both superficial and deep-set lines. Beyond wrinkle treatment, fillers are widely employed to enhance facial volume, particularly in the cheeks and lips, bestowing a rejuvenated and youthful look.

In the United States, when injectable products receive approval, the Food and Drug Administration (FDA) specifies particular uses for those products. Most injectables are “approved” for designated facial areas, and these authorized treatment zones are indicated on the product’s label. However, the primary effects of the product might be consistent even when applied to other facial regions. Using a product in a manner not explicitly mentioned on the FDA’s package insert label is termed “off-label” use.

For instance, while Botox Cosmetic® might be FDA-approved specifically for treating glabella wrinkles (the “elevens”), leading to their reduction or softening, the same product might produce similar cosmetic outcomes when injected around the eyes, even if the FDA hasn’t officially endorsed this application. In the U.S., medical professionals can administer products in an off-label fashion, but it’s crucial for patients to be informed and aware of such practices.

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