When is the best time to get cosmetic procedures such as Botox and filler injections done? How long does it take for a procedure to take full effect?

Recently, I have been flooded with inquiries on cosmetic procedures such as Botox and Juvederm/Restylane… and the best times to have them done. There are many different aspects to consider when having a cosmetic procedure. Generally speaking, these are considered “lunchtime procedures” – meaning they can not only be performed quickly, but offer an immediate return to a regular lifestyle afterwards.

There is minimal swelling, discomfort, bleeding etc. and patients do not need to take time off of work to recover. We call these “little or no downtime” procedures. I recently saw a patient on a Monday who was on the Today show on Wednesday. Another patient left the office and went straight to a cocktail party she was hosting.When speaking about “time” in terms of age, the earlier you start for prevention, the better off you are in avoiding more invasive procedures down the road. If someone does not receive Botox injections and lines deepen, it is possible they will not be 100% correctable with Botox alone. Usually, then a combination of Botox and filler can achieve 100% correction and with subsequent Botox injections, Botox alone can do the trick. Someone who starts at a younger age and prevents deep lines from ever forming will continue to have optimal results later in life. Similarly, the deeper one’s nasolabial folds become, the more volume of filler is required to optimally correct. The 60 year old never before treated sun soaker will have deep, deep lines, possibly requiring 3-4 syringes of filler, whereas the 60 year old who began fillers 20 years ago or so would require much less maintenance at 60 and would likely do well with one or two syringes. Everyone has their own threshold. Early 20’s is the optimal age to visit your dermatologist and get a consultation regarding the procedures. My youngest patient to date was an 18 year old model.

With regards to timing and maintenance – Botox typically lasts 4-6 months. If you regularly use Botox and stay on time with your follow-up injections, chances are you have weakened your muscles enough to create a longer results time period. I cannot stress enough that you should not wait for your Botox to wear off completely. Schedule your calendar the way you would any other business meeting or doctor’s appointment and be sure to stay on top of your Botox upkeep. When working with fillers, the results tends to be a bit longer – 7 -10 month result (Radiesse lasts 12-15 months – but should not be used by beginners – patients or doctors!).

With your wedding, 10 year reunion or fashion show on the horizon, you need to plan out your cosmetic procedures with enough time to see results. You never want to book yourself too close to an important event for a number of reasons. The first and foremost is optimal results. Botox can take up to 2 weeks and fillers 2-3 weeks to achieve the desired end outcome. You also want to be careful and give yourself ample healing time – though minimal, there is a risk of bruising or swelling. You don’t want your first portrait of husband and wife with a puffy face, so plan accordingly.

The last key is patience for my patients. Like a good haircut or fine wine, time brings about the best. Allow 2-3 days to see improvements, as in the case of Botox, where an actual physiological effect needs to occur. Fillers are immediate, but take 2-3 weeks for full results to really kick in. You may find that your lines are completely filled when you leave the office and then (to your dismay, no doubt) they return. Don’t panic…the initial “filling” effect you see immediately is a combination of swelling and filler. As the swelling reduces, it will appear as though some lines have not been corrected. Be patient as the filler starts to work its magic. The hyaluronic acid fillers such as Restylane and Juvederm work by attracting water. This takes time for full effect.

As said before – these are both referred to as “lunchtime procedures”…generally they can be done as quickly as 5 minutes and up to ½ hour, depending on the patient, doctor, and area(s) to be treated.

Most important, these days especially (See Fox Business Channel clip on media section of my website) you should have these procedures done by a true specialist – a board-certified Dermatology Surgeon or Plastic Surgeon would be ideal. BEWARE of ads that state “board-certified laser surgeon.” There is no residency in “laser surgery.” These docs are likely board-certified in family medicine or internal medicine – far from advanced aesthetic training.


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