Had Mitral & Aortic Mechanically Valve Replaced Due to Bacterial Endocarditis. Botox & Juvederm Ok?

You should check with your cardiologist, who may need to speak with your doctor who will inject you, to make sure they all understand the treatment plan.  If your INR is of a reasonable level for the cardiologist's satisfaction to make sure the coumadin dose is OK, injections are often done cosmetically, provided these are fine needles with fine fillers, not the thicker needles needed for deeper fillers which potentially traverse larger diameter blood vessels in those planes.  The cardiologist may be concerned if you have Juvederm or Restylane injected in the lip area as this is considered similar to having dental work, possibly, and they may wish you to be taking an antibiotic prior to the injections to prevent bacterial endocarditis.

Being on coumadin enormously complicates treatment because of the risk of bruising.  While it may be possible to get away with botox, fillers are more challenging.  I personally would advise you to proceed with extreme caution.  This does not mean that you can't be treated but if you are severely bruised after a service I can assure you your enthusiasm for the treatment will be affected.

If you weren't on Coumadin (blood thinner), these injections would pose no risk for bacterial contamination, assuming good injector technique and alcohol prep of the injected skin. I bet you have had plenty of injections and blood draws since your valve replacements. If these pose no risk, then Botox and fillers represent no problem either. BTW, Botox has no bacterial component in it at all--it is the purified protein neurotoxin produced from the Clostridium Botulimun bacteria, not the bacteria themselves.

Your Coumadin adds another wrinkle (no pun intended) in that (even though there is no bacterial contamination concern) you could have a serious bruise or bruises from these injections that are much more visible. Even if you had these injections in the past with no problems, your Coumadin makes a significant difference: you could potentially look like you were the loser in a bar fight from just a few injections in your face (with blood thinner in your system). This certainly mandates careful consideration and a call to your cardiac surgeon, cardiologist, and plastic surgeon, in that order. Any NOs and I'd say "Skip it!"  Best wishes!