Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Ensuring patient comfort is the first step in any procedural protocol. For injectables, a high-potency topical anesthetic cream is applied to the treatment areas for 15 to 30 minutes. This numbs the skin’s surface, making the needle entry virtually painless.
Many dermal fillers also contain lidocaine within the gel itself, providing internal anesthesia as the product is injected. For more intensive energy treatments, such as Ultherapy or CO2 lasers, practitioners may use nerve blocks (injections of numbing medication into specific nerves) or offer oral anxiolytics and analgesics to manage discomfort.
Practitioners utilize different tools depending on the safety profile and the desired outcome. Sharp needles are used for precise, deep placement of filler onto the bone or for intradermal work. They allow for accurate bolus deposition.
Blunt-tipped microcannulas are increasingly favored for soft-tissue volumization. Because they are blunt, they slide through the tissue rather than cutting it, significantly reducing the risk of bruising and, more importantly, accidental injection into blood vessels. Cannulas are ideal for broad areas like the cheeks, temples, and jawline.
Neuromodulator treatments involve a series of quick, small injections into specific muscles. The practitioner marks the injection points based on the patient’s unique muscle movement patterns. The toxin is placed directly into the muscle belly to inhibit contraction.
The procedure is rapid, typically taking less than 10 minutes. The depth of injection varies; deep placement is used for strong muscles like the glabella, while superficial “micro-tox” techniques target skin texture and pore size without affecting deep muscle function.
Filler injection is an artistic sculpting process. The practitioner injects the product in layers. High G-prime (stiffer) fillers are placed deep on the periosteum to mimic bone and provide structural lift. Softer, more flexible fillers are placed more superficially to smooth transitions and hydrate the tissues.
The practitioner constantly assesses symmetry and contour during the procedure, massaging the product to ensure smooth integration. The goal is to build volume gradually to avoid overcorrection. This layering technique restores the face’s natural three-dimensional topography.
For energy-based devices, the protocol is defined by the wavelength, fluence (energy level), and pulse duration. The skin is cleansed and often covered with a coupling gel. The device handpiece is moved over the skin in a systematic pattern to ensure uniform coverage.
Cooling mechanisms are critical during these procedures to protect the epidermis while heat builds up in the deeper dermis. The practitioner monitors clinical endpoints, such as immediate skin tightening or mild erythema (redness), to ensure the therapeutic temperature is reached without causing burns.
Immediately following the procedure, the patient is assessed for any adverse reactions. Cold packs are applied to minimize swelling and vasoconstrict vessels to reduce bruising. The skin may appear red or slightly swollen, a normal inflammatory response to trauma or heat.
For injectable patients, the treated area is cleaned, and a barrier repair cream or sunscreen is applied. Patients are given a mirror to see the immediate results of volume restoration, although the final result will settle over time.
Swelling and bruising are the most common side effects of non-surgical rejuvenation. Swelling is a natural response to physical trauma and the hydrophilic (water-loving) nature of hyaluronic acid fillers. It typically peaks within 24 to 48 hours.
Bruising occurs if a needle nicks a small blood vessel. To manage this, patients are advised to keep their head elevated, avoid strenuous exercise for 24 hours, and avoid heat (saunas, hot showers). Arnica Montana and Bromelain supplements may be recommended to accelerate bruise clearance.
The most serious risk with fillers is vascular occlusion, where filler enters a blood vessel and blocks blood flow. Practitioners remain vigilant during and immediately after the injection for signs of compromise, such as skin blanching (whitening) or unusual pain.
If occlusion is suspected, the protocol involves immediate cessation of injection, flooding the area with hyaluronidase (an enzyme that dissolves HA filler), application of warm compresses, and massage to restore circulation. This rapid response capability is a hallmark of a qualified medical injector.
The recovery timeline varies by modality. Neuromodulators have virtually no physical downtime, though results take days to appear. Fillers may involve “social downtime” of 3 to 7 days due to potential swelling or bruising, though patients can usually work during this time.
Laser resurfacing and deep chemical peels require more significant recovery, often involving 5 to 7 days of redness, peeling, and skin shedding. During this time, the skin barrier is compromised, and strict adherence to gentle skincare and sun avoidance is mandatory.
To ensure optimal product settling, specific restrictions are enforced. Patients are instructed not to massage the treated areas (unless specifically told to) to avoid displacing filler. Lying down flat for 4 hours after Botox is discouraged to prevent migration.
Makeup application is usually restricted for 12 to 24 hours to prevent bacterial infection of the injection ports. Dental work should be avoided for 2 weeks after fillers to minimize the risk of bacterial seeding and displacement from facial manipulation.
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Most fillers contain lidocaine, which numbs the area from the inside as it is injected. Patients typically feel a pinch at the initial needle entry and a sensation of pressure as the gel is deposited, but it is generally well tolerated. Cannulas are often less painful than needles.
If you bruise, you can apply Arnica cream or take Arnica tablets. Avoid blood-thinning medications and alcohol. Laser treatments (like IPL) can sometimes be used a few days later to break up the bruise and speed up healing. Cover-up makeup can be used after 24 hours.
It is generally safe to fly, but changes in cabin pressure can slightly increase swelling. It is usually recommended to wait 24 to 48 hours after treatment before flying, mainly to ensure you are near your provider in the unlikely event of a complication.
Botox is not immediate. You may start to see a softening of lines around day 3 or 4, but the full effect typically takes 10 to 14 days. Do not judge the results or ask for a touch-up until the whole two weeks have passed.
It is normal to feel some firmness or lumpiness for the first week or two as the filler integrates with your tissue and swelling subsides. However, if you notice visible lumps or experience pain, contact your provider.
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