Can Botox, Filler, Carbon Laser Peel, Fraxel and Thermage Be Performed in One Visit?

Question

Hi, doctors! I need your expertises on this. I found a very interesting price for a package offer of botox, filler, carbon laser peel, fraxel and thermage in one visit. Is it possible to have them all done in one visit??? I was told that the carbon peel, fraxel and thermage would be performed before botox and filler. Won't the botox and filler migrate to other part of the face?

Jamil Asaria, MD · Answer

It is certainly possible to combine Botox, Fillers (such as Juvederm or Restylane), and skin resurfacing with RF, Laser, or Chemical Peels at one visit. The advantage is the combination of treatments with one period of short downtime. In a week's time, the entire face can be dramatically refreshed.

	I usually do the fillers and botox after the skin treatments in order to prevent the products from migrating. Both of these products are injected deep to the epidermis (in the deep dermis, subcutaneous, and muscular layers) so the superficial skin treatments will not negatively impact their results.

Sam Naficy, MD, FACS · Answer

It is best to have skin treatments prior to Botox and/or filler. Consulting with a well-trained and reputable provider will help you determine what will be your best treatment!

Stewart Wang, MD, FACS · Answer

It's possible to have it all done at once but I wouldn't recommend it. Carbon laser peel and fraxel are minimally invasive treatment to the skin and should not be combined with Thermage at the same setting. I also like to separate injectables (Botox and fillers) from resurfacing treatment. I think it's important not to sign up treatment just because it's a "package" deal. Make sure that all of the above treatments are truly needed and recommended by your physician. You may end it up with unnecessary treatment and added risks.

David Shafer, MD, FACS · Answer

While you could have all of the procedures at the same visit, I tend to recommend separating the treatments.  However, it really depends where you are having the Botox, where you having the filler and which areas you are having treated with the laser.  My suggestion is to go in for the consultation and discuss this with the doctor you are seeing.

	 

	Good Luck.

Kenneth Hughes, MD · Answer

I usually separate Botox and fillers from the laser or peel, but there is no evidence to support this approach or the approach to perform all at once.

Martie Gidon, MD, FRCPC, FAAD · Answer

You should not have all of these treatments done in the same areas in one day. Heat and swelling from the Thermage, Fraxel and peel can affect your Botox and filler results. Ideally, have your Botox and filler on one day and then wait 2 weeks for the Thermage and Fraxel which can be done the same day.

Omar Ibrahimi, MD, PhD · Answer

You're very smart for wondering about this and I agree with you completely. In my practice, I would never do this combination of treatments together because the risk of migrating the botox to unwanted areas is higher than what I am comfortable with.

Francis R. Palmer, III, MD (retired) · Answer

Most would consider separating the Botox and fillers from the resurfacing procedures.

F. Victor Rueckl, MD (in memoriam) · Answer

The initial idea here is to lower your downtime, but I think you might also lower the results. I don't recommend you do all of these on the same day. But if you elect to, the Botox and fillers should be done after any laser, lights, or chemical peels, like they told you. Otherwise, the heat can alter the effects of Botox and fillers.

Can Botox, Filler, Carbon Laser Peel, Fraxel and Thermage Be Performed in One Visit?

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