medSPA by milk + honey
Pre and Post Care Instructions

• Photoaging, sun-damage, and sun-induced brown spots, redness, rosacea, unwanted blood vessels
• Fine wrinkling, coarse, crepey, dull, rough skin, stretch marks
• Acne scarring, irregular pigmentation, uneven skin tone

• The skin should not be irritated or peeling (such as may occur with topical retinoids, exfoliants, and other skin treatments) and should not have any active areas of infection (herpes/cold sores, bacterial, other infections) prior to treatment.
• Make-up and sunscreen should be removed and the skin should be gently cleansed prior to treatment.
• Sometimes a topical anesthetic will be applied before treatment.
• BBL + Moxi: Retinol should not be used 3 days prior to your treatment
• BBL + Moxi: No sun exposure 2 weeks prior to your appointment. You must be at your baseline color.

• Apply a cold compress or an ice pack for comfort for approximately 10 – 20 minutes each hour as needed for the first 12–24 hours.
• BBL + Moxi: No sun exposure 1 week after treatment.
• Wear a sunblock of SPF 30 or greater daily, during, and for 3 months after treatment sessions to help reduce the risk of pigmentary changes.
• Apply Aquaphor (OTC at local drug store) 3-4 times daily to any areas that develop blistering or open sores.
• While there may be some degree of swelling immediately post-treatment, if you have excessive swelling or pain, or develop fever, blistering, extreme itching, or any other concerns, contact our office immediately.

• Avoid herbal supplements such as Ginkgo, green tea, and anti-inflammatories of any kind for 1 week before treatment to limit bruising.

• We encourage patients to use the muscles more for the first hour or so after injection as this may help maximize the effects of the medication.
• For the first 4 hours following neurotoxin treatment, remain upright, do not lie down.>
• Do not participate in activities that include heavy lifting, vigorous exercise or straining for the first 24 hours.
• Do not rub, touch, or manipulate Botox/Dysport/Xeomin for 6 hours.
• Avoid irritating products for 24 hours following Neurotoxin treatment.
• Make-up may be applied gently before leaving the office, remember to wipe up and away from your eyes or brows.
• Bruising in the area injected is normal and often expected, especially if treated around the eyes. Bruising can last up to several weeks. Using/taking Arnica may help diminish bruising.
• It may take up to 14 days for neurotoxin to take full effect. A follow-up visit at 10 days to 2 weeks is suggested; As results vary, if full correction is not achieved, you may need to purchase additional neurotoxin at that time.
• Re-treatment is typically needed between 2-6 months. Regular injections usually yield a longer-lasting neurotoxin result.
• If your upper lip was treated you may not be able to drink through a straw, whistle, or enunciate some words for approximately 2 weeks.
• Although rare, infection in the injected area is possible. Signs of infection may include redness and tenderness in the infected area and fever. Should you develop an infection, antibiotics may be necessary.

• Do not consume alcoholic beverages at least 24 hrs prior to receiving injections. Alcohol thins the blood and may result in increased bleeding and/or bruising.
• Avoid using aspirin (unless instructed by a physician), nonsteroidal anti-inflammatory medications (such as ibuprofen), St. John’s wort, or vitamin E supplements or fish oils as these agents may increase bruising.
• If you are currently taking anticoagulation medications (Warfarin, Coumadin, Heparin, Lovenox, Enoxaparin, Lepirudin, Refludan, Ticlopidine Ticlid, Clopidogrel, Plavix, Tirofiban, Aggrastat, Integrilin, Eptifibatide), discuss the use of these medications with your healthcare provider prior to your treatment. You may or may not be a candidate for treatment with cosmetic soft tissue fillers.
• Notify your care provider if you have previously suffered from facial cold sores, as medication may be prescribed to minimize the risk of recurrence.
• It is not recommended to have filler injection within two weeks before or after a dental procedure.
• Many soft tissue fillers contain an anesthetic, so supplemental pain medication is typically unnecessary. Occasionally, our team employs topical or local anesthesia to make the procedure more comfortable, especially when treating the lips.

• Avoid dental work for 2 weeks before and 2 weeks after filler treatment.
• Avoid massages where positioning would compress the treatment area for 2 weeks after filler treatment.
  You may experience swelling, redness, pain, bruising, and tenderness at the injection site. This is typically mild and normally lasts no more than several days.
• Use cold compresses/ice to reduce swelling for up to 10 – 20 minutes each hour.
• Avoid using aspirin (unless instructed by a physician), NSAID medications (such as ibuprofen), St. John’s wort, or vitamin E supplements for one week after treatment.
• You may apply make-up over the treated region, but avoid rubbing the area to prevent the filler from moving unless instructed by your treatment provider.
• Avoid intense heat (hot tubs, saunas, exercise, hot bath/shower) until redness and swelling dissipate.
• Avoid strenuous exercise, exposure to sunlight, and drinking alcohol during the first week after treatment.
• Please contact us immediately if you experience pain after your filler treatment as this could be a sign of a dangerous complication like blood vessel obstruction due to filler injection. Additionally, contact us with unexpected or increasing swelling, warmth, redness, or drainage in the treated area or should any other questions arise.

• Shave the full treatment area on the morning of your appointment.
• Do not tweeze or wax or use other techniques of hair removal besides shaving for six weeks prior to treatment sessions.
• Stay out of the sun and tanning beds for four weeks before treatment and for the duration of your treatment course.
• Do not apply self-tanners to areas to be treated two weeks prior to treatment.
• If you have a history of herpes (“cold sores”) inform your doctor as you may benefit from antiviral medications prior to treatment.
• You may take Tylenol on your treatment day to help minimize discomfort.
• You should not have any hair removal treatments if you are pregnant or think you might be pregnant.

• Redness and swelling may last from two hours to a few days.  Applying ice during the first few hours after treatment will reduce any discomfort or swelling.
• Avoid sun exposure and use a broad-spectrum UVA/UVB (SPF 30 or greater) sunblock daily during the duration of the treatment series.
• No exercise, hot showers, saunas, hot tubs, or hot baths until redness and swelling resolve.
• Avoid applying retinol (such as Retin-A), glycolic acid, and other alpha hydroxy acids to the treatment area for three to five days after the procedure.
• Avoid picking and scratching the treated skin.
• Do not use any other hair removal methods other than shaving during the series
• After underarm treatments, do not use a deodorant or antiperspirant for 1-2 days.
• Do not exfoliate for the first three days after your treatment.  After three days, exfoliating is recommended to help remove the dead hair beneath the surface.
• Hair may start to fall out 2-21 days after treatment.  You can clean and remove this hair by washing, wiping, or shaving the treated area.
• If you experience blistering, pain, extreme itching, or any other concerns, please contact us immediately.

• Incomplete improvement or worsening. The outcome of treatment will vary among patients, with multiple treatments typically necessary to achieve desired outcome.  Improvement may be temporary or nonexistent.  Some patients may observe an increased amount of loose skin, bands, or laxity with treatment.
• Numbness.  The patient may develop diminished sensation or numbness in the treatment area which may persist for months after treatment.
• Bruising, Redness, Swelling, Itching, and Pain.The patient may experience pain during and after the procedure, as well as substantial bruising, redness, swelling and itching after treatment. These symptoms typically last a week or longer in some cases. Patients using medications that can prolong bleeding, such as aspirin, warfarin, or certain supplements may experience increased bruising or bleeding at the injection site.
• Induration. The patient may develop areas of hardness or “lumps,” which may be tender and persist for months after treatment.
• Ulceration.  Rarely, injection may lead to sores and ulceration of the skin.
• Nerve Damage. Many patients will experience numbness in the treatment area that may last weeks to months and could be permanent.  Cases of marginal mandibular nerve injury, manifested as an asymmetric smile or facial nerve weakness, have been reported with Kybella® injection.  These have resolved spontaneously in time, but potentially could be permanent.
• Future inability to have cosmetic surgery or complications from cosmetic surgery.  Use of Kybella may be a contraindication to future cosmetic surgeries such as facelift or necklift.
• Hair Loss.  Permanent hair loss in or around treatment area(s) may also result.
• Infection. As with all transcutaneous procedures, injection of Kybella® carries a risk of infection.
• Dysphagia. Difficulty swallowing has been reported with Kybella® injection.  These have all spontaneously resolved in clinical trials but could potentially be permanent.
• Keloids and Scarring. Formation of keloids or scarring is a rare but possible side effect.

• The patient should avoid blood-thinning medications and supplements (unless recommended by a physician) for two weeks before and one week after treatment when possible.  Included in medications to avoid for at least one week prior to treatment are NSAIDs (Non-steroidal anti-inflammatory agents such as Ibuprofen, Advil, Aspirin, Naproxen), Fish Oil, and Vitamin E supplements.
• Avoidance of alcoholic beverages is recommended for 48 hours prior to the treatment.
• Plan your treatment well in advance of any special events. At least a 4 week lead time to any events such as parties, weddings, etc. should be considered.
• Swelling can be camouflaged with use of a scarf or turtleneck after 24 hours.

You should rest and intermittently ice the treated region and otherwise care for the treatment region as per the instructions given at milk + honey.  Visible swelling, redness, bruising, and tenderness typically persist for 1-3 weeks after each treatment, so the patient should plan accordingly.

• • • Apply ice every hour for at least 15min. You make apply it for 5 min intervals with 10 min breaks, but avoid prolonged icing to avoid developing frostbite.
    • Avoid massaging or manipulating the swelling area.
    • Over the counter tylenol may be used for any discomfort as recommended on the label.
    • Sleep with your head slightly elevated, preferably on 2-3 pillows for 2-3 nights.
    • You may shower and wash your face as you regularly do.
    • You may apply moisturizer or sunscreen to the treated area the next day.
    • You may apply Arnica gel if you develop any bruising to expedite the healing process.
    • Avoid any gym activity for 3 days as exercise is known to worsen swelling.
    • It is absolutely normal to feel and see mild to moderate swelling, numbness, hardness to touch, tingling, redness and tenderness at the site of injections. You may occasionally see bruising or small bleeding that should resolve spontaneously.
    • Some men might see an area of no hair growth after Kybella injection, which is temporary and will return to normal in 4-6 weeks.
    • Most swelling happens immediately and the following day after treatment and will start improving by day 5.
    • If you develop any skin discoloration or scabbing, notify your medical provider immediately.
    • If you develop difficulty breathing or difficulty swallowing you must immediately call 911.

No current usage of Retin A®, or other retinol derivatives, products containing Alpha Hydroxy Acids (AHA) or Beta Hydroxy Acids (BHA). You should be off of these products at least 3 days prior to treatment.

• In order to see significant results these treatments need to be done in a series and in combination with using active ingredient skin care products.
• Avoid sun exposure as much as possible. Direct sun exposure, including tanning beds, is not recommended while undergoing treatment and the use of daily sunblock protection is mandatory.
• Delay exposure to excessive heat, heavy workouts, steam rooms, and sauna for 24 hours post-treatment.
• Wait 7 days before waxing. Waxing may be done prior to dermaplaning.
• Schedule appointments every 4-6 weeks for optimal results.
• Call your provider with any questions, concerns, or complications.

Skincare after Dermaplaning

• Cleanse – Use a gentle cleanser, warm water (not hot), and NO abrasive cloths or cleansers for 48 hours after treatment.
• Moisturize- Apply a hydrating moisturizer twice daily as it is common for the skin to feel mildly tight, and/or mild dryness and peeling may occur.
• SPF – Your skin is more vulnerable to UV rays. Sunscreen with SPF of 30+ is essential to protect your skin, even on cloudy days.
• Makeup – Makeup can be irritating to skin. Make sure your brushes are clean to minimize risk of irritation and/or infection.

• Avoid Accutane in the six months prior to beginning your treatment sessions.
• Do not use topical agents that may increase the sensitivity of your skin such as retinoids, exfoliants, topical antibiotics or acids 5-7 days prior to your treatment.
• Do not take anti-inflammatory medications such as ibuprofen, Motrin, or Advil for at least 3 days prior to your microneedling session. These will interfere with the natural inflammatory process that is critical for your skin rejuvenation.
• Avoid IPL/Laser procedures, unprotected sun exposure, or sunburn for at least 2 weeks prior to your procedure.
• No waxing, depilatory creams, or electrolysis to the area being treated for 5-7 days prior.
• Do not shave the day of the procedure to avoid skin irritation. If there’s dense hair present in the treatment area, shave the day before you arrive for your appointment.
• If you’re prone to cold sores, notify your physician/practitioner so that antiviral therapy can be considered and/or initiated.
• Avoid blood thinning agents for one week prior because bruising is a common side effect of microneedling.

• Wash your face with gentle soap and warm water 4 hours after the procedure.
• Only use a gentle foaming cleanser and moisturizer for 3 days.
• No makeup for 24 hours.
• Strict sun precautions. No use of chemical SPF (zinc) for 24 hours, use physical SPF (wear a hat).
• No prolonged sun exposure for 10 days.
• No swimming for 2-3 days.
• Only use clean sheets and towels.
• No exercise for 24 hours post-treatment.
• Do not sleep with animals.

You can expect to observe a gradual improvement in overall skin texture, with improvement in the appearance of your treated concern area.  Patients with visible aging can expect to see their skin become smoother, with diminished fine wrinkles and more uniform pigmentation.  Even after the first treatment, the skin will often feel smoother and have a more even tone. Multiple treatments, scheduled and performed several weeks apart, are recommended for optimal results.

While there may be some degree of swelling immediately post-treatment, if you have excessive swelling or pain, develop a fever, blistering, extreme itching, or any other concerns, contact our office immediately.

• If you are taking any blood thinners, please let the doctor know immediately, as they may represent a contra-indication to this treatment. These medications include Plavix, Coumadin, and Heparin.
• You may use Tylenol (acetaminophen) as needed prior to the treatment.
• If you are taking broad beta-blockers such as Inderal (Propranolol), please contact the doctor as this medication may need to be changed to a select beta-blocker in advance of the treatment.
• If possible, please refrain from, or minimize, smoking three days prior to and one day after the treatment. Smoking may impact healing and oxygen delivery to the scalp, therefore, your results may be improved the longer you are able to stop smoking before and after the treatment.
• Prescription medications (including heart and blood pressure medication) should be taken as prescribed right up to, and including, the day of and the day after your treatments.
• Minimize alcoholic consumption the day prior to your PRP treatment.

The Morning of Your Treatment

• Shower the morning of your treatment and wash your hair very thoroughly using your regular shampoo.
• Do not apply sprays, gels, or any other styling products to your hair. If you wear a hair system, please remove it prior to shampooing and do not wear it before your PRP treatments.
• Eat regularly the morning of your treatment and please drink approximately 16 oz of water at least 2 hours prior to your treatment.
• Sedation is NOT required for PRP treatments.

• DO NOT touch, press, rub or manipulate the treated area(s) for at least 8 hours after your treatment.
• Avoid Advil, Aleve, Aspirin, Ibuprofen, Motrin, Naprosyn, (all non-steroidal antiinflammatory agents), Vitamin A, Vitamin E, Ginkgo Biloba, Garlic, Flax Oil, Cod Liver, Essential Fatty Acids (EPA, DHA), for at least 1 week prior to and 2 weeks after your treatment.
• Remember, our goal is to create inflammation. These listed medications will limit or prevent inflammation, which can diminish your results.
• If you must take Aspirin for cardiac reasons, you certainly may do so, but this may limit your results.
• It is normal to experience bruising, redness, itching, swelling and/or soreness that may last from 2-5 days following your procedure.
• If you experience any pain or discomfort you may take Tylenol or other Acetaminophen-containing products as directed.
• We would prefer if you could refrain from applying ice to the injected area as ice acts as an anti-inflammatory.
• Do not wet your hair for at least 3 hours after your treatment.
• For the first 3 days, use shampoo that is pH balanced.
• Do not use any hair products for at least 6 hours after your treatment.
• Avoid saunas, steam rooms, swimming for 2 days after your treatment.
• Avoid vigorous exercise, sun and heat exposure for at least 2 days after your treatment.
• Avoid alcohol, caffeine, and cigarettes for 3 days after treatment. Smokers do not heal well and problems recur earlier and results may take longer.
• Avoid resuming Minoxidil (Formula 82M, Rogaine®) or hair coloring or straightening for 3 days.
• Continue increased water intake the first week after your treatment.

• Local swelling and bruising may occur at the injection site and along the vessel. Swelling usually lasts no more than 24 hours; bruising fades within several weeks. Brown discoloration may infrequently develop. This usually lasts approximately three months, slowly fading away.
• Tenderness may occur at the injection site and along the vessel, and may persist for a few days.
• Immediately following injection, an allergic reaction, typically a local hive-like reaction may develop at the site, usually lasting no longer than several hours.
• Following injection of the ankle or calf, mild cramping may occur.
• Scarring is exceedingly rare but may occur if ulceration develops at the injection site.

• Refrain from using moisturizers/lotions on the day of treatment.
• Do not take Vitamin E, NSAID medications, (such as Advil® or Motrin®), or aspirin unless instructed by your doctors for at least one week prior to treatment. Tylenol is often a good substitute.
• You may also want to consider bringing comfortable shorts to wear during treatment and/or loose-fitting pants or a long skirt to wear home.
• Make sure to have compression stockings ready for use after your procedure.  Our team can coordinate with you to ensure these are available and appropriately sized.

• Immediately after the injection session is completed, apply compression with a stocking and walk for 15-20 minutes in order for blood to circulate.
• For three to four days post-treatment, avoid heavy exercise, long plane flights, sunbathing, hot baths or showers, or use of the hot tub/sauna.
• Minor discomfort or mild itching is common. An ice pack or Tylenol may help. Avoid anti-inflammatories for one week (Advil, Motrin, Nuprin) as these can blunt the desired response to treatment.
• Notify your physician if you experience allergic reactions to the medication or if you experience worsening pain, swelling, or any other symptoms.