Neuromodulators

Following injections with neuromodulators (Botulinum A) such as Botox, Jeuveau, Xeomin, Dysport or Daxxify, it is important that you observe the following guidelines in order to keep the medication in the precise areas in which it was placed:

​

1. No strenuous exercise for 16 hours following injections. Avoid saunas and hot tubs as well.

​

2. Do not rub, massage, or otherwise apply pressure to the treated areas, as this may displace the medication dosage and result in relaxing a muscle that was not intended to be treated.

​

3. Do not apply pressure to the treated areas, such as lying in a face cradle for a massage.

​

4. Localized bruising is always a possibility when an injection is performed in living tissue, though it will likely be minimal if any. We make every effort to prevent bruising, but it may happen despite our best efforts. Gently apply a cold compress or ice if desired. A list of medications you may choose to avoid prior to treatment to decrease this possibility was provided in your pre-treatment instructions which can be found in your client portal.

​

5. Temporarily, you may see small wheals or bumps at the injection sites. This is the result of a fluid medication in a small space. Your tissue will absorb the fluid within a few hours, though pinpoint needle sites may remain visible.

​

6. You may continue with your usual skin care routine and make up application, but avoid hard scrubbing or massage to the areas injected and use a light touch. 

​

​

How does Neuromodulator/Tox work?

Neuromodulators do not erase wrinkles, they temporarily limit muscle contraction which reduces the degree of repetitive movement. Repetitive movement leads to tissue damage which over time, along with volume loss, creates wrinkles. 

 

During the 3-4 month period of decreased movement, your skin is allowed more time to heal, restore, and turnover. Over time, this will lead to the reduced appearance of wrinkles. You will see and feel a change in your muscle movement within days, but the smoothing of lines may take weeks or even several repeat treatments, depending on your muscular anatomy, goals, and degree of existing line formation.

​

When will I see my results?

Tox takes 14-21 days to fully evolve. If you are noticing some unevenness or areas that still have more movement than others, it will likely correct itself within this timeframe. We want to avoid injecting additional units until at minimum day 14 to avoid the risk of overshooting the dosage. Refinement may be needed, and it is better to add more than to have more relaxation than you need to meet your goals.

​

Just like you have a strong arm and a strong leg, we each have a strong side of our face and an area may take a little more time to settle evenly. An additional 1-2 units may be required to achieve your ideal dosage.

It is helpful for us to have photos of your concerns in order to provide guidance, planning, and treatment. Please feel free to send photos to us at 573.222.0158. We are happy to schedule you for a refinement if needed, somewhere between days 14-21.

​

How long will this last?

Neuromodulators function at the neuromuscular junction of the skeletal muscle. These molecules adhere to a portion of the nerve terminal that sheds every 3-4 months, which is the duration of action for most individuals. If you want to continue to improve the appearance of lines and maintain your results, regular treatments are indicated. If you choose to stop treatments for any period of time, all that will happen is a return to your baseline movement. The decision about when and if to continue treatment is entirely yours!

​

One of my eyebrows is sitting higher than the other when I raise my brows. What can you do about that?

 

As mentioned above, it does take 21 days for neuromodulator to take its full effect. During this period, it is not uncommon for some aspects of your musculature, particularly the upper part of your forehead, to become more obvious as they contract against the adjacent areas of relaxed/non-moving muscle. This is usually most obvious during your first treatment or your first treatment after a hiatus as your musculature is more dynamic because it has been allowed to contract freely for a long period of time.

​

This dynamic muscle movement can look like: brow asymmetry, a slight ridge, or line formation.

 

There is an adjustment period, and refinement may be indicated. I welcome and appreciate feedback on this issue so that I can provide you with a treatment that leaves you feeling your best. Typically, this concern will resolve itself between days 14-21 as the muscle acclimates to its degree of block and settles down. If additional units are needed, this is a quick fix, and we appreciate your patience with the process, as it is in YOUR best interest to wait it out for a bit to ensure you don’t feel too “heavy” when the full dosage takes effect. Hang in there! 

​

I still have wrinkles. Why?

Remember: we are not erasing wrinkles. We are creating a period of muscular relaxation that allows your skin to smooth over time. You may reach your goals for smoothing during the weeks after your first treatment. For deep lines, it may take a year of regular treatments to reach the degree of smoothing you desire. The key to making sure we have set you up to meet that goal is optimizing your dosage and confirming that muscle movement has been blocked to such a degree that smoothing can occur.

​

I want more/less movement. Is that possible?

 

Please let me know! Typically, I am able to take information from our consultation about your stated goals, muscular anatomy, and line formation and create a plan of care that is in line with your goals, comfort, and budget. 

 

From time to time, adjustments may be needed because treatment is very personal and what looks “perfect” to one client may be too much or too little movement for the personal preference of another. Dosage is a dial, not a switch –we can turn it up or down as needed. Even for longstanding clients, goals sometimes change, and dosage and/or placement may be adjusted accordingly. If I know that adjustment is needed, I can plan accordingly for your care.