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Botox and Dermal Filler “3-to-5 Rule”


Botox and Dermal Filler “3-to-5 Rule”

We should start by saying that this rule-of-thumb is by no means scientific. It is just a way of summarizing the post-treatment counseling for patients after Botox and dermal filler in a way that is easy to remember. You will often hear different timelines, and some activities are important to avoid for longer periods of time. But no instructions are effective if you cannot remember them, so the “3-to-5 Rule” is what we find to help patients remember the timelines to expect after Botox injection. It goes like this:

  1. Hours: For 3-5 hours after your Botox or dermal filler injection, think “upright and lazy.” What does this mean? In more detail, this outlines several activities that could cause increased blood flow to the face and/or compression of the facial tissue that could either displace your product or increase the risk of bruising. These specific things to avoid include avoiding: Rubbing your face, lying on your face or lying down, strenuous exercise, alcohol intake, deep facial cleansing, heat and sun.
  2. Days: Often the results of neurotoxins are immediate. However, it may take up to 3-5 days to see complete paralysis of the muscles and relaxation of your expression. So it is important to remember to wait up to 3-5 days to see the effect of Botox or neurotoxin on your muscle movement. The corollary to this for dermal fillers is that, while we generally want to avoid bruising, it is possible to have bruising and initial swelling for up to 3-5 days. Lastly, if you take any blood thinners, it is best to avoid these (if considered safe by your prescriber) for at least one day before and after your injection.
  3. Weeks: If you receive treatment consistently with neuromodulators without a lapse in therapeutic effect, then there is likely no delay to the results you will notice on your wrinkles. However, if you haven’t been treated for some time, then it is possible that you will not see the results on the skin for 3-5 weeks after injection. Likewise, there are many dermal fillers, such as hyaluronic acids (HA; such as Juvederm and Restylane), PLLA/Sculptra, and others that volumize over time. Hyaluronic acid products recruit water to the site of injection over about 3-5 weeks, whereas Sculptra stimulates collagen production over greater than 3-5 weeks (more likely 6 weeks). So 3-5 weeks is a period of time that it is important to wait for the full effect of a neurotoxin on wrinkles or experiencing the full volume from a filler product.
  4. Months: Botox lasts approximately 3-5 months. Patients report variation in the duration of their neurotoxin results. Some with higher metabolism or higher activity lifestyles tend to claim their results resolve in 3 months, whereas others say they notice effects as long as 6 months. Allergan, the makers of Botox, recommends repeat treatment every 4 months. Other neurotoxins are different, such as Dysport, Xeomin, and Jeuveau, have different durations of action, and dermal fillers like HA’s generally last between 12-18 months, whereas Sculptra lasts approximately 24 months. So this part of the rule of thumb doesn’t typically apply to fillers or other paralytics. But, in general, the effects of Botox will last approximately 3-5 months.

Again, you will hear many different timelines for the above, and most of these are guidelines and not precise evidence-based principles. So take the above with a grain of salt. However, keeping the above Botox and dermal filler “3-to-5 Rule” in mind are all helpful guidelines to optimize results and inform expectations: 3-5 hours of restricted activities, 3-5 days to onset of effects, 3-5 weeks until full results, and 3-5 months for duration of treatment (Botox).

Call Pacific Sound Plastic Surgery today if you would like to explore Botox, Sculptra, Juvederm, or other neurotoxin or dermal filler treatment!

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