Pre/Post Treatment Instructions

Dermal Fillers Pre/Post Instructions

Before Treatment

• Avoid taking aspirin or other non-steroidal anti-inflammatory drugs such as Ibuprofen, Advil®, Motrin®, Nuprin®, Aleve®, Celebrex®, Fish oil, Gingko Biloba, St. John’s Wort and high doses of vitamin E for at least 7-10 days before your appointment, unless medically necessary.
• You may take Tylenol® (if not contraindicated) one hour before your appointment to prevent any discomfort you may experience. If you have concerns about discomfort.
• If you are taking prescription blood thinners such as Coumadin or Plavix, you should check with the prescribing doctor to see if you are able to stop these medicines for 7-10 days before your appointment and at least 2 days after the procedure has been done.
• If you have any history of Herpes Simplex (cold sores) on your face, make sure you inform the healthcare professional that you have made your appointment with, one week prior to your appointment; this will allow us adequate time to prescribe a medication to prevent an outbreak.
• Avoid dental procedures (including cleaning) 2 weeks pre filler and 2 weeks post filler.
• Come to your appointment with a clean face. **This means NO MAKEUP or MOISTURIZER**
• Eat a small meal or a snack before your appointment.
• Bruising and swelling will be worse for the first 24-48 hours after you receive your dermal filler injections. Refrain from exercising for the remainder of the day following your injection(s). You may want to refrain from going to any special events during this time.

After Treatment

• The majority of reactions to dermal fillers are redness, swelling, bruising and tenderness after the injections. These usually subside a few days after the treatment, but can last up to a week. If any of these symptoms persist longer than a week, or if you develop other symptoms, please contact our office.
• Cold compresses may be used after the treatment to reduce swelling and decrease soreness. You may take Tylenol (if not contraindicated) every 4-6 hours after the treatment to help with any discomfort you may have.
• No make-up for 12 hours post injections.
• In the first 24 hours following treatment, limit exposure to sunlight or UV lamps. Extensive sun or heat exposure and alcoholic beverages may cause a temporary increase in redness, bruising or swelling at the injection sites. If there is persistent swelling or redness after the injections, you should limit exposure to sunlight or UV lamps until these symptoms subside (for at least 5-7 days). If sun exposure is unavoidable, use a sun block with an SPF of 30 or greater, combined with zinc oxide and/or titanium dioxide.
• Patients should avoid strenuous exercise for 48 hours to prevent moving the filler or increasing blood flow to the face.
• Avoid taking aspirin (unless medically necessary) or other non-steroidal anti-inflammatory drugs such as Ibuprofen, Advil®, Motrin®, Nuprin®, Aleve®, Celebrex®, Fish oil, Gingko Biloba, St. John’s Wort and high doses of vitamin E for 5 days after the treatment, as these may cause an increased risk of bleeding or bruising at the injection sites.
• Avoid excessive touching or massaging the treated areas for about 6 hours after the injections. The treated areas can be washed with a gentle cleanser such as Cetaphil® Cerave® or Dove® unscented.
• Avoid dental procedure (including cleaning) 2 weeks post filler.
• Your satisfaction is important to us! We would like you to return to the office in 2 weeks to see whether a touch-up is necessary. If follow up treatments are necessary, there will be additional charges at the regular rate. Additional costs of medical treatment would be patients’ responsibility would complications develop after dermal filler procedure.
• Studies have shown that having a follow-up treatment before the product has fully dissipated will enhance the lasting effect. Consult your healthcare professional about recommendations for touch-up or follow-up treatments.
• Remember your sunscreen daily.

When to contact us:
Serious complications are rare, but it’s vital that you seek urgent review if anything like this occurs:

• Swelling, puffiness or lumpiness which does not fade in the first week with a gentle massage.
• The filler changes texture and becomes hard, nodular or lumpy, especially if there is redness or tenderness after 48 hours. All these symptoms may indicate a need for medical assistance from your clinician or family doctor if you are unable to see us, but please contact us so we can advise.

IMPORTANT: Contact us immediately if you have symptoms of a blocked blood vessel.

If you develop increasing pain near or above the site of injection which is getting worse over time, especially if associated with a pale area of skin indicating a lack of blood flow you should contact us straight away. In rare cases, an urgent reversal or other medical interventions may be required immediately to prevent scarring. If you are having any of these symptoms, please call the office. If on the weekend or after hours, go to the nearest ER to be seen.

Pre and Post Care Instructions for Kybella

Pre Care Instructions

• Take Ibuprofen such as Motrin or Advil about 1 hour before your appointment if not allergic.
• Please inform your nurse or physician if you have a history of DIFFICULTY swallowing, medication allergies, history of anaphylaxis, and any other medical problems.

Post Care Instructions

• Post treatment, gently apply ice packs on the areas that have been treated with Kybella for a few times that day.
• Treated areas may be red, inflamed, swollen and bruised for the next 2-7 days.
• Normal for area injected to feel slightly firm as the Kybella is working. It will slowly soften but usually takes approximately 8-10 weeks as it is shrinking and tightening the area.
• May resume all normal activities including exercise as long as it is comfortable to you.
• Take Ibuprofen such as Motrin or Advil or Tylenol if needed for discomfort after the treatment.
• If bruising occurs, apply topical Arnica gel or drink fresh pineapple juice to help bruising resolve faster.

Schedule your next appointment in 8-12 weeks. Kybella requires 2-6 sessions for optimal treatment.

PDO Thread Lift

What happens during the treatment?
Lidocaine topical cream is applied to the area following which threads are introduced into the skin through a fine needle–into either the skin itself, the muscle, or subcutaneous fat. The treatment results in an immediate improvement in appearance but the results will improve over ensuing days and weeks as the PDO stimulate neocollagenesis, increasing the amount of collagen in the skin. The appearance of the skin improves in terms of overall texture, becoming thicker, tighter and firmer as fine lines and wrinkles are reduced.

Which areas can be treated?

• Forehead and brow
• Upper and lower cheeks
• Jawline
• Nasolabial folds
• Marionette lines
• Neck
• Arms
• Abdomen
• Thighs

What results can I expect?
Thread lift treatments result in an instant and natural looking improvement in the appearance of the skin. A process of natural protein synthesis then begins after about 10-14 days. Over the following weeks, results will continue to improve, peaking at around 6 months and lasting for up to 2 years as your own body produces collagen, elastin and hyaluronic acid. The thread itself is completely biodegradable and dissolves within 12 weeks, after which new collagen has formed around the thread to continue to support results, maintaining a smooth and supple texture of the skin.

Treatment is not suitable if:

• You are pregnant or breastfeeding
• You have an autoimmune disease, diabetes or infection

Post treatment care

• Some pain/discomfort after treatment can be expected. Ibuprofen and Tylenol can be taken if required.
• Do not have any other aesthetic procedures (such as toxins, fillers, peels, etc.) for 2 weeks.
• Avoid extreme temperatures, alcohol and anticoagulants for 7 days. Those taking prescribed anticoagulants such as aspirin/warfarin must continue to do so but must be aware that bruising is more likely.
• Gently wash the treated area as required, but do not rub or massage for 2 weeks.
• Avoid dental treatments for 2 weeks pre and post procedure.
• Do not have radio frequency, IPL or laser or other treatments near the treated area for 10 weeks.

Most common side effects

• Pain/tenderness
• Thread protrusion, puckering of the skin
• Bleeding/bruising/hematoma, infection, granuloma
• Swelling/inflammation
• Asymmetry
• Facial nerve trauma
• Stinging/scratching/pulling sensations
• Allergic reaction

INTENSE PULSED LIGHT (IPL) TREATMENT INSTRUCTIONS

Before Treatment

• It is imperative that you avoid sun exposure and tanning beds for at least 4 weeks prior to your treatment. This is a must and no exceptions will be made.
• Avoid applying self-tanner for 2 weeks prior to treatment.
• Avoid aspirin and Ibuprofen for one week prior to your treatment. Inform the laser specialist if you are taking blood thinners or regularly take aspirin or ibuprofen.
• Avoid alcohol for 2 days prior to treatment.
  • Inform the doctor if have taken Accutane (oral acne medication) in the past year.

The Day of your Appointment

• If possible, arrive without creams or make-up on the treatment area.
• Pre-treatment photos will be taken.
• Just prior to treatment, you will be given eye shields to wear to protect our eyes.

After Treatment

• Expect your skin to appear pink (resembling mild sunburn) for a few hours after treatment.
• You will be given a cool compress to apply after treatment.
• Make-up may be applied to cover redness as needed.

What to Expect

• Your skin may be temperature sensitive for several days after treatment.
• Brown spots and freckles will appear darker while healing.
• It will take 4-6 weeks to see the full result and 2-3 treatments may be required to achieve an optimum result.
• The sessions are designed to provide no downtime however, occasionally you may find that your cheeks and under eye areas are slightly puffy after treatment. You may use cold compresses (5 minutes on and 10 minutes off) several times an hour to help ease both redness and swelling.
• Sleeping with your head elevated for the first night will also help decrease any swelling you may experience.
• Blistering and crusting are rare; however, if these do occur a thin layer of over-the-counter antibiotic ointment such as Aquaphor can be applied 2-3 times a day for 3 days. Please call us if you experience either of these uncommon reactions.
• Hyperpigmentation (darkening of the skin color) can occur in some skin types. Please call us if you experience this uncommon reaction.

Vascular Laser TREATMENT INSTRUCTIONS

PRECAUTIONS BEFORE LASER TREATMENT

• Do not drink alcohol, take aspirin, ibuprofen, vitamin E or fish oils for three days prior to, and 3-5 days after your laser treatment. Using these may increase the likelihood of bruising.
• Avoid direct exposure to the sun. A sun screen of 30 or greater should be used when exposed to the sun for several months before and after your treatment, or as long as you plan to continue treatment. Darker melanin or pigment from the sun may produce side effects or make the treatment less effective.

CARE OF THE TREATED AREA
The treated area may show a reddish/bruised discoloration. This will last 5-14 days, depending on what part of the body is treated. The treated area is delicate and should be treated with care. Please read and follow these instructions.

• Discomfort or stinging may be evident, but usually lasts no more than six hours. Tylenol may be taken or cool packs applied during this period.
• If swelling occurs, cool compresses may be applied. For facial swelling, sleep with your head elevated.
• Antibiotic ointment should be applied if there is crusting/scabbing.
• If a crust or scab develops, allow it to fall off on its own. DO NOT PICK OR SCRATCH at the area. Keep the area moist with the ointment until the crust falls off.
• Showering is permitted. Do not soak in a hot tub until the area is healed. Do not rub the treated area with a face cloth or towel. Pat the area dry so the skin is not disturbed.
• Avoid swimming and sports if bruising is present to reduce skin irritation and infection.
• Do not apply make-up for 2-3 days, or as long as the crusting is present.
• Using new make-up will cause less irritation.
• WHEN ANY DISCOLORATION/BRUISING CLEARS, THERE MAY BE VERY LITTLE CHANGE IN THE VASCULAR LESION. IMPROVEMENT WILL TAKE PLACE SLOWLY OVER A PERIOD OF WEEKS.

Laser Hair Reduction Pre/Post Treatment Instructions

PRETREATMENT INSTRUCTIONS

• Avoid the sun 4-6 weeks before and after treatment until your healthcare provider allows it. Epidermal melanocytes compete with melanin in the hair.
• Your provider may ask you to stop any topical medications or skin care products 3-5 days prior to treatment.
• You MUST avoid bleaching, plucking or waxing hair for 4-6 weeks prior to treatment. The melanin containing hair must be present in the follicle as it is the “target” for the laser light.
• If you have had a history of peri-oral or genital herpes simplex virus, your provider may recommend a prophylactic antiviral therapy. Follow the directions for your particular antiviral medication.
• If you have a tan or have a darker skin type, a bleaching regimen may be started 4-6 weeks before treatment.
• RECENTLY TANNED SKIN CANNOT BE TREATED! If treated within 2 weeks of active (natural sunlight or tanning booth) tanning, you may develop hypopigmentation (white spots) after treatment and this may not clear for 2-3 months or more.
• The use of self- tanning skin products must be discontinued one week before treatment. Any residual self-tanner should be removed prior to treatment.

INTRATREATMENT CARE

• The skin is cleaned and shaved prior to treatment.
• When treating the upper lip, the teeth may be protected with moist white gauze. The gauze also serves to support the lip during treatment, allowing a surface to push against.
• The DCD (cryogen cooling device), will be used with the laser to cool the skin during treatment.
• Safety considerations are important during the laser procedure. Protective eye wear will be worn by the patient and all personnel in the treatment room during the procedure to reduce the chance of damage to the eye. In addition, your Provider will take all necessary precautions to ensure your safety.

POSTTREATMENT CARE

• Immediately after treatment, there should be erythema (redness) and edema (swelling) of each hair follicle in the treatment site, which may last up to 2 hours, or longer. The erythema may last up to 2-3 days. The treated area will feel like sunburn for a few hours after treatment.
• Your provider may use an optional cooling method after treatment to ensure your comfort.
• A topical soothing skin care product such as aloe vera gel may be applied following treatment if desired.
• Makeup may be used immediately after the treatment as long as the skin is not irritated.
• Avoid sun exposure to reduce the chance of hyperpigmentation (darker pigmentation).
• Use a sunblock (SPF 30+) at all times throughout the course of treatment.
• Avoid picking or scratching the treated skin. Do not use any other hair removal treatment products or similar treatments (waxing, electrolysis or tweezing) that will disturb the hair follicle in the treatment area for 4-6 weeks after the laser treatment is performed. Shaving may be used.
• Anywhere from 5-14 days after the treatment, shedding of the treated hair may occur and this appears as new hair growth. This is NOT new hair growth. You can clean and remove the hair by washing or wiping the area with a wet cloth or Loofa sponge.
• After the axilla (underarms) is treated, you may wish to use a powder instead of a deodorant for 24 hours after the treatment to reduce skin irritation.
• There are no restrictions on bathing except to treat the skin gently, as if you had sunburn, for the first 24 hours.
• Return to the office or call for an appointment at the first sign of the return of hair growth. This may occur within 4- 6 weeks for the upper body and possibly as long as 2-3 months for the lower body. Hair regrowth occurs at different rates on different areas of the body. New hair growth will not occur for AT LEAST three weeks after treatment.

Post Procedure Skin Care for Ellipse Frax Non-Ablative Skin Resurfacing

Please remember that this treatment is intended to produce very nice results without weeks of healing. Two treatments may be needed for patients who desire maximum results, especially for deep wrinkles around the eyes, mouth and cheeks. You will appreciate the clearer look of your skin as the pigment diminishes in a few days, but remember, wrinkle remodeling requires actual activation of collagen formation in the skin. You may see your wrinkles seem to reappear in a few weeks, but in a few months, you will be delighted with the smoothing out of these same wrinkles as the collagen fills them in. Acne scars require a minimum of two treatments for best scar reduction. DO NOT EXPOSE TREATED SKIN TO THE SUN! BRONZING OR DARKENING MAY OCCUR. USE SUNBLOCK AND HATS FOR AT LEAST 6 WEEKS.

INSTRUCTIONS
Do not use contact lenses until eye swelling is TOTALLY resolved. Immediately after treatment: Cold compresses to be used on the skin for comfort. After a few hours, the sunburned feeling will decrease. A warm sensation may remain. Continue cool compresses until comfortable, then apply healing ointment recommended. Sleep elevated. Please keep cell phone, pets and hair products away from face.

NEXT DAY (Day 1)
Cleanse with water and recommended cleanser. Start white vinegar soaks. (1 TBSP. white vinegar in 1 Qt. warm water, soak for 10 minutes 2-3 times per day). Keep skin moist with ointment.

DAY 2 Post Treatment
Cleanse with mild cleanser, gently wipe off LOOSE crusty debris. DO NOT PICK AT SKIN. This is how scarring may occur. Keep moist with ointment. Continue vinegar soaks until crusting is gone.

DAY 3
Continue to cleanse and gently wipe off debris. Do not pick off skin. Keep moist with ointment.
Hydrocortisone cream 1% purchased over the counter may be used for itching. Discontinue after one week.

DAY 4
Do not pick off skin or attempt home peels. Continue ointment to areas where crust remains.

DAY 5
Continue light moisturizing as skin flakes off. Makeup may be used when crust is gone. Mineral makeup is suggested. PLEASE DO NOT USE ANY HARSH SKIN CARE PRODUCTS OR GLYCOLIC, RETINOL, OR EXFOLIATING PRODUCTS ON YOUR NEW SKIN FOR AT LEAST ONE MONTH. PROBLEMS CAN OCCUR IF PRODUCTS ARE INTRODUCED TOO SOON. You will be instructed on use of daily sunblock at your post procedure office visit.

DAY 6
Continue mild cleansing and moisturizer. Please call with any questions.

Skin Rejuvenation (eTwo) Post-Treatment Care

Post-Treatment Care:

• Use Foaming facial cleanse morning and night.
• Apply Laser Enzyme Gel should be applied regularly throughout the healing process. (This helps to cool, moisturize, ease the itch and irritation that comes with the healing process.)
• Apply UV Clear SPF each morning starting 12 hours after treatment.
• Transient skin redness swelling, as well as heat or tingling sensations, may last up to a few hours after treatment.
• If you feel any post-treatment discomfort, you may cool the treated area with a cool (not frozen) compress.
• Tiny scabs of less than 1 mm diameter will usually form 24-72 hours post-treatment and may remain for a few days. The scabs should not be touched or scratched and should be allowed to shed off naturally. No exfoliation for 7 days.
• Post treatment you can expect skin redness, swelling and dry rough texture. These symptoms may last 5-14 days.
• Some patients may have an exaggerated histamine response which can cause swelling and fluid retention in the treatment area and can last longer than 14 days.
• You should use plenty of moisturizing cream between treatments (starting 12 hours after treatment).
• No make-up for the first 12 hours.
• You should use a high-factor sunscreen (at least 30 SPF) and protect the treated area from Sunlight during the entire course of treatment and for at least one month after.
• No exercising or strenuous activity for the first 24 hours following treatment.
• Avoid hot tubs, saunas, and swimming for 2 days following treatment.

It is important to follow these post treatment instructions to reduce your risk of  complications.

Post Procedure Skin Care for Profound Lift

What can I expect after treatment?

Immediately post treatment the treated area will appear swollen and red. Pin-point from microneedle insertions will be observed and bruising may be noticed from the local anesthesia injection points. Immediately following treatment, ice compress should be used for the first 45 minutes. For next 3 days, continue with cold compress at 20 minutes on – 20 minutes off intervals. It is recommended to sleep with head elevated for the first 2-3 nights post Profound treatment. Redness typically resolves within 1-2 days of treatment. Swelling and Bruising will typically resolve within 5-7 days post treatment.

What post procedure instructions should I follow?

• Ice for 45 minutes directly following treatment. Then every 2 hours, for 20-minutes on/off intervals, on day of treatment. This will help to decrease likelihood of indurations, extended bruising, and increase comfort.
• The day of treatment apply MDPen Copper+HA mist and Pure Hyaluronic Acid.
• A homeopathic Arnica Montana will be given to patient and taken as directed.
• 24 hr. post treatment and while healing, wash treated area 2 times daily with tepid water and gentle cleanser. Avoid wash cloths, harsh irritants, and scrubs. Pat dry and do not rub.
• Ensure hands are clean begore applying product.
• It is recommended to sleep with head elevated post treatment.
• Change your pillowcase daily or lay a clean towel each night. Avoid sleeping with pets.
• Clean glasses frames, cellphone screens, and anything else that comes into direct contact with the treatment area.
• For the first 24 hours post treatment, it is recommended to avoid rigorous exercise, any activities that would stimulate heat, vasodilation, do not take a hot bath or sit in a sauna, etc.
• For 4 to 6 weeks post treatment, please avoid sun exposure. If going outside (even getting into a car, going for a walk) please make sure to apply a physical UV sunblock (SPF 30+) 20 minutes before going outside.
• Avoid picking or exfoliating the area. Allow old/dry/dead skin to flake off naturally. It is imperative to let the area heal on its own. If the area is picked at and further interruption of the epidermal layer occurs, this can increase the risk of infection, PIH, and other post procedure complications.
• Avoid makeup for at least 3 days to avoid irritation- only a mineral makeup may be applied after.
• Tylenol may be taken as directed for discomfort.

Light Peel Instructions

Day 1

• Wash with gentle cleansers if needed
• No strenuous physical activity after your peel for 24-48 hours
• Do not visit or use a steam room or sauna for 24-48 hours
• Limit sun exposure for at least 72 hours
• Apply sunblock with Zinc Oxide and/or Titanium Dioxide

Day 2

• Wash with a gentle cleanser
• Moisturize as needed
• Apply sunblock with Zinc Oxide and/or Titanium Dioxide if you are going to be exposed to the sun

Day 3

• Use a gentle cleanser until irritation/peeling has subsided
• Moisturize as needed
• Apply sunblock with Zinc Oxide and/or Titanium Dioxide if you are going to be exposed to the sun

Additional Important Care Guidelines:

• Do not use facial cleansing device (Clarisonic) until peeling is complete
• Do not start any topical acne medications for 3-4 days
• Do not apply any Retin A/Retinol/Renova for at least 3 days
• Do not use any exfoliating agents or HQRA creams for 3-4 days
• Do not have any facial treatments (facials, microderms or chemical peels for 2 weeks)
• Do not have any facial wax treatments for 2 weeks
• Do not have any Botox or injectable fillers for 2 weeks
• Do not have any laser hair removal or vascular laser treatments for 5 weeks
• Do not smoke/smoke heavily after treatment as it will interfere with the healing process

WHAT TO EXPECT AFTER YOUR PEEL

• Depending on the strength of the peel, you may experience mild redness and/or your skin may feel tight. Your skin may be red as the skin flakes and peels. It is imperative to not peel or pull the skin off, allow the skin to peel at its own pace. Premature peeling of the skin may result in post inflammatory hyperpigmentation.
• 1-3 days post treatment, your skin may develop red-brown or gray coloration. Skin may feel tight or wind burned. Cracks in the skin may occur.
• If you wear glasses, you will need to be careful of the nosepiece. If your glasses fit snug on your nose, the nosepiece could cause the peel to penetrate deeper in those areas.

Heavy Peel Instructions

Day 1

• Do not get treatment area wet
• No strenuous physical activity after your peel for 24-48 hours
• Do not apply make-up for 24 hours
• Do not visit or use a steam room or sauna for 24-48 hours
• Limit sun exposure for at least 72 hours
• Apply sunblock with Zinc Oxide and/or Titanium Dioxide

Day 2

• Rinse treatment with water only
• Moisturize as needed
• Apply sunblock with Zinc Oxide and/or Titanium Dioxide if you are going to be exposed to the sun

Day 3

• Use a gentle cleanser until irritation/peeling has subsided
• Moisturize as needed
• Apply sunblock with Zinc Oxide and/or Titanium Dioxide if you are going to be exposed to the sun

Additional Important Care Guidelines:

• Do not use facial cleansing device (Clarisonic) until peeling is complete
• Do not start any topical acne medications for at least 7 days days
• Do not apply any Retin A/Retinol/Renova for at least 7 days
• Do not sue any exfoliating agents or HQRA creams for at least 7 days
• Do not have any facial treatments (facials, microderms or chemical peels for 2 weeks)
• Do not have any facial wax treatments for 2 weeks
• Do not have any Botox or injectable fillers for 2 weeks
• Do not have any laser hair removal or vascular laser treatments for 5 weeks
• Do not smoke/smoke heavily after treatment as it will interfere with the healing process

WHAT TO EXPECT AFTER YOUR PEEL

• Depending on the strength of the peel, you may experience mild redness and/or your skin may feel tight as well as mild swelling. Your skin may be red as the skin flakes and peels. It is imperative to not peel or pull the skin off, allow the skin to peel at its own pace. Premature peeling of the skin may result in post inflammatory hyperpigmentation.
• 1-3 days post treatment, your skin may develop red-brown or gray coloration. Skin may feel tight or wind burned. Cracks in the skin may occur.
• If you wear glasses, you will need to be careful of the nosepiece. If your glasses fit snug on your nose, the nosepiece could cause the peel to penetrate deeper in those areas.

MICRONEEDLING with PRP PRE/POST TREATMENT INSTRUCTIONS:

Please read each statement below and address any concerns with your esthetician accordingly.

PRE-TREATMENT:

• Sun exposure and/or usage of a tanning bed, including self-tanning products must be avoided for a minimum of 24 hours before and after the treatment, and preferably for up to 1-2 weeks to minimize the risk of post treatment temporary dyspigmentation (darkening or lightening of the skin). Please be advised a treatment will not be administered on sunburned skin.
• Avoid Aspirin, anti-inflammatory medications (i.e. Ibuprofen, Aleve), blood thinners, herbal supplements, Vitamin E, and Fish Oil for at least one week prior to and the day of microneedling to minimize bruising risk-you may restart these the day following your treatment. Accutane should be discontinued for a period of at least 6 months prior to and during the course of any microneedling treatments.
• We recommend pretreating your skin with Vitamin C, sunscreen, and retinols at least 4 weeks before treatment.
• Stop any retinols, topical antibiotics, exfoliants, hydroquinone and benzoyl peroxide products 48 hours before your treatment.
• Eat a healthy meal and drink at least 4-6 glasses of water (8 ounces or more) the morning of your treatment.
• If you have a history of cold sores, we may recommend prophylactic oral antiviral therapy in the form of Valtrex or Famvir to prevent an outbreak. If so, we request you follow the directions of your prescription.

POST TREATMENT:

Immediately after treatment your skin will be red, have pinpoint bleeding, and will feel like a fresh sun burn or wind burn. The skin may feel tight and sensitive to the touch- some of the most common side effects of treatment include mild redness, localized swelling, and dryness. The following day you may have pinpoint scabbing. The treated area/s may darken and flake away within one week. You will likely have 2-3 days of social downtime post treatment.

• Clean glasses frames, cellphone screens, and anything else that comes into direct contact with the treatment area
• Avoid picking or exfoliating the area and allow old/dry/dead skin to flake off naturally
• Avoid makeup for at least 24 hours after treatment to avoid irritation- only a mineral makeup may be applied after
• Avoid sun exposure until healed (i.e. any skin redness and/or flaking away of skin is no longer present)
• Avoid exercise that causes sweating as well as jacuzzis, saunas, and hot showers until the skin is healed
• Advil or Tylenol may be taken as directed for discomfort-cool compresses may also be used every 1-2 hours for 3-5 mins at a time if necessary
• Change your pillow case and treat your face as an open wound until healed-once healed you may return to your regular skin care routine
• For best results and efficacy, we recommend a series of 3 to 6 treatments, administered at 4-6 week intervals
• The morning after your treatment, gently wash your face with a mild cleanser. Apply MDPen Copper+HA mist, Pure hyaluronic acid. Ensure hands are clean before applying any product.

HOME CARE INSTRUCTIONS

• Day 1: Red appearance of the skin will vary depending on your treatment and the depth of the penetration of the needles.
• Day 2: Redness or pinkness of the skin will be similar to moderate sunburn. Swelling may be more noticeable.
• Day 3: Skin may still be pink or have returned to normal color. Swelling will subside.

Precautions

• Wash your face thoroughly a few hours after the treatment. Gently massage your face with tepid water so as to remove all serum and other debris, such as dried blood. Do not use a chemical sunscreen on the same day as your treatment.
• For the first 1-3 days, your skin will be very dry and may feel tight. Frequent use of an HA (hyaluronic acid) serum or other moisturizer will help alleviate this condition.
• After 2-3 days, or as soon as it is comfortable for you to do so, you can return to using your regular skin care products. Products containing Vitamin A are recommend.
• Avoid alcohol-based toners for 10-14 days.
• Avoid direct sun exposure for 3-5 days, if possible. Use sun protection as suggested by your practioner.

Home skin care checklist:

• CLEANSE – Use a soothing cleanser or facial wash with tepid water to cleanse your face for the following 48 hours. Dry gently. Always make sure your hands are clean when touching the treated area.
• SOOTHE – Copper-based skincare is recommended, post-treatment, as the mineral properties are perfect to help heal your skin and will sterilize it as well. Resveratrol-based products can help sooth the skin and lessen irritation.
• HYDRATE – Following your treatment, the skin may feel drier than normal. Hyaluronic acid is an ideal ingredient to hydrate and restore your skin back to a perfect balance.
• MAKE-UP – It is recommended that make-up is not applied for 12 hours after the procedure. Do not apply any make-up with a make-up brush or other applicators that might not be sterile.
• PROTECT – Apply a practitioner-approved sunscreen, if needed. Take precautions against exposure to the sun. Have no direct exposure to the sun for 3-5 days post-treatment. Do not apply chemical sunscreen for 24 hours.

Continue this regimen until after your skin is fully healed/you have stopped peeling (approx. 5–7 days).

PRP for Hair Loss Treatment Pre and Post Care Instructions

Treatment Overview:
PRP therapy for hair loss is a treatment that involves withdrawing a patient’s own blood, processing it so that only the enriched cells (platelet-rich plasma) remain, and injecting it into the scalp. PRP contains essential proteins that stimulate natural hair growth. Due to the natural variation in quality of platelet-rich plasma, results will vary between individuals. Some patients may require multiple sessions to obtain desired outcomes.

Contraindications:
You should not have PRP treatment done if you have any of the following conditions:

• An impaired immune system due to immunosuppressive diseases, HIV, HTV, or immunosuppressive medications
• Skin conditions and diseases including: Facial cancer, existing or uncured. This includes SCC, BCC and melanoma, systemic cancer, and chemotherapy.
• Steroid therapy, dermatological diseases affecting the face (i.e. Porphyria), communicable diseases, blood disorders and platelet abnormalities, anticoagulation
• Do not have PRP treatment if you are pregnant

Pre Treatment Instructions

7 days before treatment:

• Discontinue blood thinning agents such as vitamin E, vitamin A, Ginko, Garlic, Flax, Cod Liver Oil, and Essential Fatty Acids, and multivitamins, a minimum of 7 days (preferably 14 days) prior to treatment. It is fine to continue iron and vitamin D.
• If you are taking any blood thinners, please let your provider know immediately, as they may represent a contraindication to this treatment. These medications include Plavix, Coumadin and Heparin.
• Avoid aspirin, Advil, Motrin, Iburprofen, Naproxen, Voltaren and other anti-inflammatory medications. We want inflammation to occur – as this is one mechanism by which PRP works.
• You may use Tylenol (acetaminophen) as needed prior to 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.
• If you are taking broad beta-blockers such as Inderal (Propranolol), please inform your provider as this medication may need to be changed to a select beta-blocker in advance of the treatment.
• Avoid excessive sun or heat exposure.

3 days before treatment:

• Minimize or avoid alcohol consumption.
• If possible, refrain from or minimize smoking prior to your procedure as it impacts the healing process.
• You may continue other hair loss treatments such as laser treatment, minoxidil, or hormone blocking tablets
  before your procedure. If you are not sure if you should be stopping a medication, please ask.
• It is okay to color your hair up to 7 days before the procedure.

Diet and Fluid Intake:

• Increase your intake of fluid the day before your procedure by simply drinking 2 glasses of water in the morning, 2 glasses at lunch, and 2 glasses at dinner, in addition to your normal intake of water.

Day of Procedure:

• 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.
• Please eat a normal breakfast or lunch the day of your PRP session.
• Drink a bottle of water (500 mL) at least 2 hours before your session.
• It is strongly recommended to take a hot shower to wash your hair that evening, after the treatment, to promote the effects of PRP.

Immediately Following Treatment:

• It is normal to experience bruising, redness, itching, swelling and/or soreness that may last from 2-5 days following your treatment. If you experience any pain or discomfort you may take Tylenol or other Acetaminophen-containing products as directed.
• You may have a bruise at the blood draw site.
• You may notice a tingling sensation while the cells are being activated.
• In rare cases, skin infection or reaction may occur, which is easily treated with an antibiotic or inflammatory. Please contact our office immediately if you notice unusual discomfort.
• Try to refrain from applying ice to the injected area as ice acts as an anti-inflammatory. Ice or cold compresses can be applied to reduce swelling if required.
• Continue to avoid aspirin, Advil, Motrin, Ibuprofen, Naproxen, Voltaren and other anti-inflammatory medications for 3 days after your procedure (if possible try for 7 days).
• Avoid vigorous exercise, sun and heat exposure for at least 2 days after your treatment.
• 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.
• Be sure to take a hot shower and wash your hair that evening, after the treatment, to promote the effects of PRP.
• Avoid saunas, steam rooms and swimming for 2 days after your treatment.
• Avoid alcohol, caffeine, and smoking 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®), hair coloring, and straightening for 3 days.
• Continue increased water intake the first week after your treatment.
• Do not use blood thinning agents such as vitamin E, vitamin A, Ginko, Garlic, Flax, Cod Liver Oil, Essential Fatty Acids and least one week after your treatment

Contact the Office Immediately if any of the Following Signs of Infection Occur:

• Drainage – looks like pus
• Increased warmth at or around the treated area
• Fever of 101.5 or greater
• Severe pain that is unresponsive to over-the-counter pain relievers

CO2 LASER SKIN RESURFACING – PRE-TREATMENT INSTRUCTIONS

It is prudent to follow some simple guidelines before your treatment. These guidelines can reduce possible side effects associated with the procedure and make all the difference between a fair result and a great result.

1. Avoid aspirin, naproxen and Ibuprofen for one week prior to your treatment. Inform your provider if you are taking blood thinners or regularly take aspirin or Ibuprofen. Avoid alcohol and tobacco for 4 weeks prior to treatment and 1 week following procedure. Delayed wound healing, persistent skin redness, and other complications may persist when tobacco and alcohol are not discontinued.
2. Hydrate – We recommend that for seven days pre-treatment you moisturize skin in the morning and evening, drink at least 8 glasses of water per day to completely hydrate your skin and optimize treatment results.
3. Self-Tanner – Stop self-tanner for four weeks prior to treatment.
4. Skin Care – Stop exfoliating skin care products, such as retinols and glycolic acid, for one week before your treatment. This includes Retin-A.
5. Prescription Medications – We will provide you with an antiviral to take before your appointment to decrease the risk of a herpetic outbreak. Take other medications that may be prescribed for pain management as instructed on the bottle. Stop taking prescription medications that may increase the risk of bruising as instructed and in coordination with your physician. Please obtain the prescription before your procedure and bring them with you the day of your procedure.
6. Arnica Montana We will ask you to take Arnica 3 days before and 7 days the procedure; Arnica Montana a natural herb that significantly decreases bruising. We will also ask you to take 1500 mg of vitamin C, which helps promote healing. You may also be asked to take an antibiotic the day of surgery.
7. Supplements – Avoid fish oil, Gingko Biloba, Garlic, Flax Oil, Cod Liver Oil, Vitamin A, Vitamin E, or any other supplements one week before treatment.
8. Accutane – Inform your provider if you have taken Accutane (oral acne medication) in the past year.
9. Ice Packs – Store ice packs in your freezer for use after you get home from procedure.
10. Special Events – Schedule your treatment at least four weeks prior to a special event i.e., wedding, vacation, speaking engagement, to allow time for the healing process.
11. Secure a ride for after treatment – You must secure a ride home if you choose to use the pain medication.
12. Photographs – Take at home photos to monitor your skin improvement.

DAY OF TREATMENT INSTRUCTIONS

Eating/Drinking You may not eat or drink after midnight the evening before the surgery unless instructed otherwise.
Discomfort – The sharp, burning sensation of each laser pulse may produce a moderate to severe amount of discomfort. Topical anesthetics, anesthetic injections, and/or comfort sedation are used to block the pain during the procedure.
Prescription medications – Take prescribed medications as directed.
Social downtime – Expect to stay home/stay “under the radar” for 5 to 10 days (potentially longer for a more aggressive treatment).
Prolonged skin redness – the laser-treated areas will initially appear bright red in color. Once the peeling is complete the redness can be camouflaged with makeup. The redness will fade to pink over the following couple of weeks, and normal skin color over the next couple of months.
Swelling – Plan on swelling after your treatment. Sleep with head elevated with pillows or in a recliner the first 1-2 nights to reduce swelling. Areas most likely to swell are around the eyes and neck. If extreme swelling occurs around the eyes, a corticosteroid prescription can be called into your pharmacy.
Oozing – A clear fluid may be present in the treated areas and may create a crust or scab if the areas are not kept moist. Keep area moist with Aquaphor in the morning and polysporin antibiotic ointment at night for 4 days only. Within about 2 days after the procedure you may appear to have an exaggerated tan with slight crusting that may last as l long as two weeks.
Make-up/Hair – Please arrive for your appointment with clean face and hair.
Clothing – Wear comfortable clothing, a button-down shirt, and slip-on shoes.

POST TREATMENT INSTRUCTION

Immediately after your CO2RE Laser Resurfacing your skin will feel warm and sensitive to the touch. It is important to keep the skin covered with a healing ointment at all times immediately after your treatment. Plan on a recovery period of 5 to 10 days depending on the depth of the treatment. After the initial recovery your skin may continue to be red and sensitive for weeks as it fully heals.

Expect the treated area to be red, swollen, scabby and irritated, similar to a severe sunburn. It is important to keep the treated skin covered with an emollient cream, such as Aquaphor. Similar to a severe sunburn, the treated skin will become darker and will gradually slough off over time.

Redness and swelling – Immediately after your CO2 treatment expect to experience significant redness and scabbing for 1 to 10 days. For more aggressive treatments, this may last longer. Slight to moderate swelling is typically experienced for 2 to 3 days after your CO2 procedure, but can last longer. It is important to keep the treated skin covered with an emollient cream, such as Aquaphor. The dark skin will “flake” off during the vinegar/cleansing process (see below).

Ice Packs for Inflammation – To minimize post-procedural inflammation and to give comfort, apply ice packs (with cloth barrier) to the treatment area for up to 10 minutes per hour, several times a day for 24-72 hours.
Contact Dermatitis – You may experience contact dermatitis due to topical preparations (ointments) used post-procedure.
Skin Itchiness – Your skin may feel itchy in the early healing phase use 1% hydrocortisone cream to help with itching.
Sleep with head elevated – Sleep with head elevated with pillows or in a recliner for the first night to reduce swelling. If swelling persists into day 2, again, sleep with head elevated (above the heart).
Sun Exposure – Start using sunscreen with zinc oxide once peeling has subsided. Avoid direct sun exposure for at least one month after procedure. Lifetime daily sunblock use is a MUST to prolong your results and protect your skin from photo-aging.
Post Treatment Skin Cleaning Process – Use a diluted white vinegar solution and soft gauze pads to gently cleanse the skin 4 times a day beginning the night of, or morning after your CO2 procedure. Clean the skin by gently removing the emollient cream with a gauze pad soaked in the diluted vinegar solution. Do Not scrub or pick off the dead skin, allow it to exfoliate as part of the natural healing process. It will take multiple passes of the gauze over the skin to remove all the emollient cream. After removing the emollient cream reapply fresh emollient cream. This cleaning process should be repeated for 5 to 10 days, until no tightness or discomfort is experienced without emollient cream on the skin. Keep emollient cream on treated areas AT ALL TIMES until peeling has subsided. If in doubt continue use of the emollient cream. Avoid dryness and dry scab formation.

Gentle cleanser may be used starting 6 days after your treatment if it does not cause irritation. Post treatment recovery kit will be provided for you. Details below. There are no restrictions on bathing except to treat the skin gently. Avoid scrubbing or trauma to the treated area. Avoid harsh products, exfoliants, Retinols, and Retin-A for 2 weeks post treatment. Avoid makeup for 7-10 days, and then use only on intact skin.

Supplies to purchase prior to treatment
(start evening after procedure)

• Soft Gauze
• Diluted White Vinegar Solution (1 teaspoon vinegar to 1 cup water)
• Clean Pillowcases (change pillowcases every 12-24 hours)
• Aquaphor
• Polysporin antibiotic cream
• 1% Hydrocortisone Cream

Post Treatment Maintenance Skincare – Beginning fourteen days after your CO2 Laser Resurfacing procedure you can start the skin maintenance program. The skincare products will help maintain the results from your CO2 procedure.

Post Treatment Skincare Kit

• EltaMD Foaming Facial Cleanser
• EltaMD Laser Enzyme Gel
• EltaMD UV Clear Broad-Spectrum SPF46

CO2RE Intima Pre-Procedure Instructions

• The patient should have an up-to-date normal PAP test and a recent normal vaginal exam to ensure that there are no active infections. Please turn in a copy of these test results into our office.
• It is recommended that the patients use Acyclovir or Valcyclovir for prophylaxis prior to treatment.
• Review all indications.
• Review all contraindications.
• Complete the medical history and physical prior to treatment.
• Sign the informed consent prior to the procedure.
• Hair should be shaved in the treatment area the day prior to the procedure. The hair should not be waxed or chemically removed.
• Patient should avoid anticoagulants such as ibuprofen, aspirin throughout the treatment regimen, if medical condition permits and pertinent to physician approval. Anticoagulants increase the possibility of bruising.
• No sexual intercourse the day of procedure.

CO2RE Intima Post-Procedure Instructions

• Post procedure, apply a water-based lubricant or Aquaphor.
• Gently cleanse the area with mild soap and water twice per day.
• There may be a slight itching sensation to the treated area during the healing process. Apply 1% Hydrocortisone (over the counter) twice daily until resolved.
• Avoid sexual intercourse for 7 days after procedure (or anything in the vagina).
• No tampon use for 7 days
• No douching for 7 days.
• No bathtubs, jacuzzies, or swimming until skin is completely healed.
• You may need to use breathable panty liners day of treatment.
• Apply cool compresses to treatment area as needed.
• Day of procedure wear loose, breathable clothing (skirts or loose shorts are recommended).