BOTOX

How to prepare for your visit:

  • Gather photos of you from 5, 10 and fifteen years ago in order to help determine the type of intervention required to restore your natural younger appearance
  • Do not apply makeup, foundation or cream the day of your treatment. Alternatively, bring makeup remover with you to the clinic.
  • Bring a list of your medications with you if you are currently taking medications, or have recently.
  • Avoiding bruising: Taking Advil or other Non-Steroidal Anti-Inflammatory Vitamin E, Coumadin or other anti-coagulants (blood thinners) can increase the occurrence of bruising. You may wish to discontinue the use of Advil or other-Steroidal Anti-Inflammatory and Vitamin E if these products are taken as needed. You may not discontinue the use of Coumadin or other other anti-coagulants (blood thinners) as these are prescribed for serious medical conditions and must be maintained. You may try a natural product named Arnica Montana to decrease the occurrence of bruising.

Some information about your first visit:

  • The first visit will last 30 – 45 minutes as there will be questions about your general health and time for discussion of questions or concerns you may have.
  • Dr. Moyal will map out your facial muscles and take pictures of you with different expressions.
  • In some cases a cold pack will be applied for a few minutes before injection of BOTOX.
  • No anesthesia is required as pain is minimal. Injections are performed with ultra-fine diabetic needles.
  • Dr Moyal will then proceed to treat the areas you have selected.
  • Subsequent visits will lasts 15-30 minutes.

Our minimalist approach:

If this is your first injection, Dr Moyal will determine the smallest quantity of BOTOX that will give the desired results. In subsequent visits, the quantity of BOTOX can be increased if necessary. This approach will avoid over treatment with BOTOX that can lead to a loss of expression. Our goal is to produce a relaxed and refreshed appearance by relaxing overworked muscles while conserving the ability to have natural facial expressions.

It is important to exercise the muscles that have been treated to ensure the absorption of BOTOX into the treated areas and to avoid diffusion into undesired areas.

  • Avoid massaging, rubbing or touching the treated areas, you may apply foundation and make up by applying these lightly.
  • Avoid lying down or bending forward for 4 hours after your treatment.
  • Avoid aerobic exercise till the following day.

Seeing a Difference

You will start to see the effects of BOTOX as early as 4 days but these can take up to 14 days to become noticeable.

Follow up visit: 1-2 weeks after your treatment, Dr Moyal will see you again to make sure you are satisfied with the results. It is at this time that adjustments will be made if necessary. In the meantime, should you have any questions or concerns, Dr Moyal is always available to his patients. You will be given his phone number and email.

Frequency of visits –for the first year, treatments with BOTOX usually occur every 3-4 months . After one year of regular treatments either the quantity of BOTOX is reduced at every treatment or the number of treatments per year is reduced. In some cases both the quantity of BOTOX and the number of treatments are reduced.

Despite using a very small hypodermic needle, there can be Bruising and pain at the site of injection of the BOTOX  – this is rare. Despite proper technique by the trained injector and proper aftercare by the patient there is a 2% possibility of the Botox cosmetic affecting the eyelid or brow and causing a droop. It is treatable with eye drops, it’s mild and lasts approximately 3 weeks after which time the eye drops are no longer necessary.

DERMAL FILLERS

How to prepare for your visit:

  • Gather photos of you from 5, 10 and fifteen years ago in order to help determine the type of intervention required to restore your natural younger appearance
  • Do not apply makeup, foundation or cream the day of your treatment. Alternatively, bring makeup remover with you to the clinic.
  • Bring a list of your medications with you if you are currently taking medications, or have recently.
  • In most cases a cold pack will be applied for a few minutes before injections of Juvederm. No anesthesia is required The Juvederm Ultra XC and Ultra Plus XC come premixed with lidocaine (a local anesthetic) If you have any allergies or sensitivities to lidocaine or any dental anaesthetic please advise Dr. Moyal.

Some information about your first visit:

  • The first visit will last 30 – 45 minutes as there will be questions about your general health and time for discussion of questions or concerns you may have.
  • Dr. Moyal will map out your facial muscles and take pictures of you with different expressions.
  • In some cases a cold pack will be applied for a few minutes before injection of dermal fillers.
  • No anesthesia is required as pain is minimal. Injections are performed with ultra-fine diabetic needles.
  • Dr Moyal will then proceed to treat the areas you have selected.
  • Subsequent visits will lasts 15-30 minutes.

Our minimalist approach:

If this is your first injection, Dr Moyal will determine the smallest quantity of Juvederm that will give the desired results. In subsequent visits, the quantity of Juvederm can be increased if necessary. This approach will avoid overtreatment with Juvederm that can lead to a loss of expression. Our goal is to produce a relaxed and refreshed appearance by relaxing overworked muscles while maintaining the ability to have natural facial expressions.

It is important to exercise the muscles that have been treated to ensure the absorption of dermal fillers into the treated areas and to avoid diffusion into undesired areas.

  • Massaging the area or sleeping on your face for the first 2 weeks.
  • It is recommended to avoid intense physical exercise immediately after as this may increase bruising.
  • For the following 2 weeks avoid extreme temperatures such as sauna , hot tubs and ice baths.
  • Avoid UV rays or sunlight as the areas of injections can become darker than the rest of the skin (hyperpigmentation).
  • No laser treatments, radiofrequency, microdermabrasion, chemical peels or facial treatments should be undertaken in the 2 weeks following the treatment.
  • Lips are mobile and very vascularised – this leads to a faster breakdown of the product.
  • Follow up visit: 1-2 weeks after your treatment, Dr Moyal will see you again to make sure you are satisfied with the results. It is at this time that adjustments will be made if necessary . In the meantime, should you have any questions or concerns, DR Moyal is always available to his patients. You will be given his phone number and email.
  • Frequency of visits and product longevity – In general, the thicker products such as Juvederm Ultra plus and Voluma will last longer. Treatments to the cheek area lasts approximately 12 months, the nasolabial lines 6-12 months and other areas less. The duration of the product varies from one individual to another. It is clear that areas with greater movement cause the product to be broken down faster.
  • Massaging or pressing on the area treated will also dissipate the product faster.

As with any treatment, there are a few minor risks. As with any lip filler, inflammatory reactions (redness, swelling, etc.), along with irritation or pain upon application of pressure, may occur after the initial injection. These reactions are typically temporary in nature. Lumps or nodules may appear at the injection site. Very rare cases of reversible colouring at the injection area have been reported.

Rare cases of necrosis in the glabellar area, abscesses, granuloma, and hypersensitivity have been reported after injections of hyaluronic acid. You should be sure to report any concerns or discomfort you experience to your practitioner immediately.

PRP

What can you do to prepare for the procedure itself?

  • Come early. Coming in 30 minutes prior to your appointment start time allows us to perform all the steps (draw, centrifuge, and platelet extraction) before the actual injection without making your appointment run late. It also gives us a time buffer in case we run into any issues during the blood collection. Additionally, this time is beneficial to patients as it gives them a time to relax between the blood draw and the injection. If you do not arrive 30 minutes early, there is a chance your procedure will need to be rescheduled.
  • Hydrate! Water is an important component of blood, and makes it much easier for any healthcare professional to draw blood from your arm. Your veins are fuller (making it easier to perform the actual blood draw) and your blood moves quicker (less time with a needle in your arm!).

Immediately after the treatment one can expect some swelling that will subside in 4-7 days after which time there is usually no evidence of the procedure. there may be bruising with the injection and this may take longer to subside.

  • Rest and get more sleep. Sleep is a wonderful thing, so I feel strange having to recommend it. But many patients do not get enough sleep, and lack of sleep can have a very detrimental effect on your healing rate. Use this procedure as an excuse to get more restful sleep. I recommend using your recovery phase from this procedure as a jumping off point to establish a good sleep routine you can use when you’re back to your fully functional self.
  • Limit forceful weight bearing and movements with excessive range-of-motion. Imagine a glob of peanut butter sandwiched between two saltine crackers. Now imagine squeezing the crackers together and spilling the peanut butter onto the floor. You don’t want peanut butter on the floor, just like how you don’t want the Platelet-Rich Plasma anywhere other than where your injury is located. The general idea behind PRP therapy is to concentrate healing factors into a specific, targeted area. An excessive contraction of a muscle, or movement of a joint past normal range-of-motion, can “squeeze” the platelets away from the targeted area. For some cases when the PRP is meant for a lower body part, we may recommend being on crutches for two weeks to really ensure the PRP stays where it should.
  • NO NSAIDs. Your body’s natural response to injury is to cause inflammation. We typically only associate inflammation with pain, which is why people often take an NSAID (non-steroidal anti-inflammatory drug) like ibuprofen or naproxen (e.g. Advil, Aleve). However, inflammation also triggers a healing response by the body. PRP therapy will cause some inflammation and therefore may increase a patient’s pain level for the first two weeks. This is a completely normal part of the healing cascade, and is temporary. Taking NSAIDs to alleviate the temporary pain will reduce the likelihood of having a more permanent recovery. Do not sabotage your ultimate goal of getting back to fully functional activity for some temporary relief. Keep your end goal in mind!
  • Ice if necessary, Tylenol if necessary. We recommend ice as our first-line pain reliever, as ice has been shown to reduce pain and inflammation without having to take medication. However, PRP might be the only instance we recommend discretion when icing. Icing is counter to what the therapy is trying to accomplish. Therefore, we recommend icing only when completely necessary and the pain in unbearable. You can also try acetaminophen (e.g. Tylenol), as that is a non-NSAID pain reliever.

Since PRP uses your own blood, you should not have a reaction to it. Studies have noted that PRP has been found to have a positive effect on male and female pattern hair loss without major adverse side effects. You may experience minimal pain, pinpoint bleeding, and redness when the injections are being delivered.

LASER HAIR REMOVAL

In preparation for your treatment :

  • Gently shave the area to be treated.
  • Avoid dark or colored undergarments that may stain or leave a film on your skin.
  • Remove all creams, lotions, ointments, oils or deodorant & anti-perspirant from areas that will be treated.
  • 1 Month prior to treatment do not use tanning products, retinoic acid or hydroquinone containing products.
  • 1 month prior to treatment do not expose yourself to the sun or UV rays
  • 1 Month prior to treatment do not wax, use tweezers to remove hair or perform electrolysis on the area to be treated.
  • 6 months prior to treatment stop using Accutane or any other retinoic acid product.
  • If you are using medications or products known to cause photosensitization for example: tetracycline please advise your physician before coming to the clinic.
  • The most frequent drugs involved in photosensitization are: Tetracycline, Ibuprofen, Naproxen, Isotretinoin (Accutane), Retin-A, Oral Contraceptives (birth control pills), Hydrochlorothiazide.

RECOMMENDATIONS:

  • Laser treatments can dry the skin. Use moisturizing lotion in the days following your treatment.
  • Treated hairs will fall out by themselves 1-2 weeks following your treatment. You may think that regrowth is occurring but this is not the case. The use of an exfoliant or a glove can help accelerate this process. You may shave but this is not necessary.
  • Note any changes and advise us if you think you are having an abnormal reaction.

DONTS

  • In the hours following your treatment avoid taking a hot shower or bath.
  • Do not pull hairs out with tweezers or by other means.
  • Do not irritate the recently treated area as this may cause discoloration. Avoid irritating clothes, creams perfumes etc… Please discuss the use of creams, oils, ointments etc…with our knowledgeable staff.
  • Do not remove scabs or blisters that may have formed in the treated area.
  • Do not expose yourself to the sun or UV rays for 2 weeks after your treatment or if your skin has not completely healed.

An inflammatory reaction around the hair follicles that have been treated with laser is normal. It is referred to as a ‘‘folliculitis’’ or an inflammation of the follicle. The type of reaction varies from one person to the next and can go from slight swelling and redness to blisters. People can feel tingling, burning and other sensations. These are transient and never severe or persistent. If this is not the case or you are unsure please call our knowledgeable staff.

Applying cold compresses, moisturizing cream that is hypoallergenic and scent free or an ointment such as Zincofac can help with temporary discomfort. In some cases, a cream such as Polysporin can help with the healing process.

The most common side effects of laser hair removal include:

  • Skin irritation. Temporary discomfort, redness and swelling are possible after laser hair removal.
  • Pigment changes. Laser hair removal might darken or lighten the affected skin, usually temporarily.

BOOK A CONSULTATION

with Dr. Yoel Moyal, MD CCFP FCFP DipPDerm
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