Should you allow Botox/Dysport dissipate before having laser?

Question

I'm wondering if facial procedures (laser, blepharoplasty, chemical peel, face lift, etc) will have a better chance of successful outcome if Botox/Dysport/Xeomin is fully out of your face before undergoing these procedures?

Anil R. Shah, MD · Answer

Hello Reader321

My name is Melanie a Medical Aesthetician at Aesthetic Skin located in Chicago IL. No, botox or dysport will not effect the effectiveness of the following treatments. It is always recommended to wait 2 weeks post neurotoxin injectables before receiving any facial treatments or have the injectables completed after your treatment to allow the neurotoxin to settle completely. Actually combining Neurotoxin with the treatments listed will give your skin even better results! I hope this helped.

Shanthala Shivananjappa, MD · Answer

This is an excellent and thoughtful question! The answer depends on whether you’re planning a non-surgical procedure, such as laser resurfacing, or a surgical procedure, such as blepharoplasty. Let me explain both scenarios.

For non-surgical procedures like Laser-Coring & UltraClear or CO2 Laser resurfacing, having fully effective Botox or Dysport before your treatment can significantly enhance results. Relaxed facial muscles provide a smoother, more static canvas for the laser to work on, optimizing the treatment’s impact. This is particularly true for aggressive resurfacing technologies such as the Ultraclear Laser, CO2 laser, or other modalities like high-intensity focused ultrasound (HIFU) or radiofrequency microneedling.

Additionally, lower facial Botox can play an important role. Injecting Botox into areas like the DAO, mentalis muscle (chin depressor) and along the jawline can reduce the pulling effect of the lower face, allowing for a subtle lifting effect. This can enhance the outcome of laser procedures, especially when combined with other advanced treatments. Similarly, carefully placed Botox in the neck area can help relax vertical bands, creating a smoother and more youthful appearance when complemented with laser resurfacing. Injecting neurotoxins meticulously in the upper face, lower face, and neck can therefore have a synergistic effect, amplifying the benefits of laser treatments.

When it comes to surgical procedures like blepharoplasty, timing and placement of Botox require extra care. For example, injecting Botox into the forehead before eyelid surgery can paralyze the frontalis muscle, which is responsible for lifting the eyebrows. This could interfere with the surgical outcome and recovery process. Similarly, avoiding Botox in specific muscles before surgery is essential to maintain proper muscle function and ensure the surgeon can work with your natural anatomy. It’s crucial to discuss this with your plastic surgeon or an expert in eyelid surgery to develop the best plan for your specific needs.

In summary, for non-surgical procedures like laser resurfacing, Botox and Dysport can complement the treatment by relaxing facial muscles and enhancing lifting effects in both the upper and lower face. For surgical procedures, muscle function and timing are critical and must be carefully managed in collaboration with your surgeon.

Thank you for asking this insightful question! I wish you the best in achieving beautiful and long-lasting results.

Warm regards,

Mahira Tanovic, MD · Answer

Hello,
In my practice of 30+ years, I have found that non-invasive treatments work in combination with each other to provide the best results possible! I would always recommend combining different treatments with each other, since they all work differently. For example, fillers FILL volume loss, botox helps with wrinkles, and lasers/microneedling work on the skin itself. I would, however, recommend that you do wait 2 weeks in between sessions of botox and filler to do any skin rejuvenation to fully allow the botox/filler to settle. 
As for surgical procedures (blepharoplasty, face lift), it is up to the preference of the surgeon. I would personally recommend waiting until botox is out and fillers are fully dissolved and may even recommend to dissolve. 
Therefore, if you are doing a non invasive procedure (botox, fillers, lasers, chemical peels, microneedling, ultherapy, coolsculpting), you do not need to wait until everything has dissipated.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question. It’s best to place Botox into the face one week prior to laser resurfacing. This decrease facial movement and allows greatest potential for new collagen to form without recreating the original lines in the face. Consider seeing an oculoplastic surgeon with expertise in erbium lasers. 
Good luck.

Vickram Tandon, MD · Answer

Allowing the neurotoxin to dissipate prior to a skin resurfacing procedure is not necessary. The neurotoxin works by paralyzing the deeper, underlying muscles whereas a peel or laser act within millimeters of the skin surface by applying energy in a controlled fashion to stimulate collagen production.

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