Pre & Post Care

North Medical Spa offers a wide range of targeted, expert treatments. Please review the pre and post care instructions before your appointment to properly prepare for your treatments.

If you have any questions, give us a call.

PLEASE NOTE: Do not take NSAID’s (nonsteroidal anti-inflammatory drugs), anti-inflammatories or drink alcohol the day before any injectable treatment. This is to ensure that you don’t experience any excessive bleeding or bruising during or after your treatment.

Treatments

BOTOX™

Pre-Treatment Instructions

1 week before treatment: AVOID blood thinning over-the-counter medications such as Aspirin, Motrin, Ibuprofen, and Aleve. Also avoid herbal supplements, such as Garlic, Vitamin E, Ginkgo Biloba, St. John’s Wort, and Omega-3 capsules. 3 days before treatment: AVOID topical products such as Tretinoin (Retin-A), Retinols, Retinoids, Glycolic Acid, Alpha Hydroxy Acid, or other “anti-aging” products. Also AVOID waxing, bleaching, tweezing, or the use of hair removal cream on the area to be treated. Do not drink alcoholic beverages 24 hours before (or after) your treatment to avoid extra bruising. Inform your provider if you have a history of Perioral Herpes to receive advice on antiviral therapy before treatment. Do not use BOTOX/ Xeomin™ if you are pregnant or breastfeeding, are allergic to any of its ingredients, or suffer from any neurological disorders. Please inform your provider if you have any questions about this before the treatment.

Day of Treatment

We will be removing all your makeup from your face. Please ensure you bring extra make-up for touch-ups following your treatment. You may experience a mild amount of tenderness or a stinging sensation following injection. Redness and swelling are normal. Some bruising may also be visible in the treated areas. You may experience some tenderness at the treatment site(s) that can last for a few hours or a few days.

Immediately The Following Treatment

It is best to try to exercise your treated muscles for 1-2 hours after treatment (e.g. practice frowning, raising your eyebrows, and squinting). This helps to work BOTOX® into your muscles. Stay in a vertical position for four hours following injection. Don’t rest your head or lie down; sit upright. You may apply an ice or cold gel pack to the area(s) treated (avoiding pressure) as this helps reduce swelling and the potential for bruising. Once you have adequately cooled/iced the area(s) as instructed and any pinpoint bleeding from the injection site(s) has subsided, you may begin wearing makeup. Avoid placing excessive pressure on the treated area(s) for the first few days; when cleansing your face or applying makeup, be very gentle. Avoid exercise or strenuous activities for the remainder of the treatment day; you may resume other normal activities/routines immediately. You may take Acetaminophen/Tylenol if you experience any mild tenderness or discomfort. Avoid extended UV exposure until any redness/swelling has subsided. Be sure to apply an SPF 30 or higher sunscreen. Wait for a minimum of 24 hours (or as directed by your provider) before receiving any skin care or laser treatments. Please contact us if you have any questions or concerns.

DERMAL FILLERS

Pre-Treatment Instructions

Inform your provider if you have a history of Perioral Herpes to receive advice on antiviral therapy before treatment.

Avoid dental work (including standard teeth cleaning) at least two weeks before treatment and one month following treatment. Avoid oral surgery at least four weeks before treatment and one month following treatment.

7 Days Before Treatment:

To prevent bruising: Avoid blood thinning over-the-counter medications such as Aspirin, Motrin, Ibuprofen, and Aleve. Also avoid herbal supplements, such as Garlic, Vitamin E, Ginkgo Biloba, St. John’s Wort, and Omega-3 capsules. Please note: If you have a cardiovascular history, please check with your doctor before stopping the use of Aspirin.

3 Days Before Treatment:

Avoid topical products such as Tretinoin (Retin-A), Retinol, Retinoids, Glycolic Acid, Alpha Hydroxy Acid, or any “anti-aging” products. Also avoid waxing, bleaching, tweezing, or the use of hair removal cream on the area to be treated.

Do not drink alcoholic beverages 24 hours before (or after) your treatment to avoid extra bruising.

Do not use Dermal Fillers if you are pregnant or breastfeeding, are allergic to any of its ingredients, or suffer from any neurological disorders. Please inform your provider if you have any questions about this before the treatment.

Day of Treatment

We will be removing all makeup from your face. Please ensure you bring your make-up for touch-ups post-treatment.

To maximize your comfort during the procedure, a topical anesthetic may be applied. In some cases, a local numbing medication will be injected into or around the area(s) to be treated.

You may experience a mild amount of tenderness or a stinging sensation following injection.

To ensure a smooth and even correction, your provider may massage the area(s) treated, which may cause a temporary, minimal amount of redness to your skin.

Immediately After Treatment

Redness and swelling are normal. Bruising may also be visible. You may experience some tenderness at the treatment site(s) that can last for a few hours or a few days.

Depending upon the area(s) treated and product(s) used, you may feel “firmness” in the treated area(s) for 1 to 2 weeks after treatment. Over time, the area(s) will soften and “settle.”

Post-Treatment Instructions

Apply an ice or cold gel pack to the area(s) treated (avoiding pressure) as this helps reduce swelling and the potential for bruising.

Once you have adequately cooled/iced the area(s) as instructed and any pinpoint bleeding from the injection site(s) has subsided, you may begin wearing makeup.

Avoid placing excessive pressure on the treated area(s) for the first few hours and up to 2 to 3 days; when cleansing your face or applying makeup, be very gentle.

Avoid exercise or strenuous activities for the remainder of the treatment day; you may resume other normal activities/routines immediately.

You may take Acetaminophen/Tylenol if you experience any mild tenderness or discomfort.

Avoid extended UV exposure until any redness/swelling has subsided. Be sure to apply an SPF 30 or higher sunscreen.

Wait for a minimum of four weeks (or as directed by your provider) before receiving any skin care or laser treatments.

Any bruising will fade in 5 to 14 days.

Please contact us if you have any questions or concerns.

BELKYRA™

Pre-Treatment Instructions:

Belkyra™ should not be administered if you are pregnant, nursing, trying to get pregnant, have experienced hypersensitivity in the past, if you have severe allergies, and should not be used in areas of active inflammation or infection (cysts, pimples, rash). You should not get this procedure if you currently have or have a history of nerve damage, facial paralysis, facial movement issues, difficulty swallowing, bleeding problems, and prior or planned surgery, cosmetic treatments or medical conditions on or near my face, neck or chin. These conditions may be contraindications to receiving the treatment.

Notify your North Medical Practitioner if you have had major dental work (excluding routine cleanings) 2 weeks before/after proposed injection procedure or if you have had any recent procedure (cosmetic, surgery, laser, or other) or any recent illness. If you are a male, you should come clean shaven (neck) to the treatment.

Post-Care Instructions:

Redness/swelling is normal for a few days to a week. Real results can be expected at four weeks (after all swelling has resolved).

Swelling is usually significant in the first couple of days to a week. Patients report looking like a “bullfrog” with a lot of fluid in the skin under the chin. This is normal.

Numbness is common for the first few weeks to a month. Discomfort and tenderness to the touch are also common in that time frame.

Do not rub the area treated. Do not massage the area.

Gently clean the area twice daily with mild soap.

Avoid irritants (glycolic, acid, retinoids, etc.) until all redness/swelling resolves.

You may apply cool compresses/ice for 15 minutes/hour for comfort and to reduce swelling.

Make-up may be used as long as the skin is not broken or irritated.

Avoid use of aspirin, St. John’s Wort, and high doses of vitamin E for one week. Non-steroidal anti-inflammatories (ibuprofen) can be safely taken for discomfort.

Avoid strenuous exercise and alcohol for 24 hours after treatment.

Try to sleep upright, not on your side for the first 48 hours to take the pressure off your neck.

Do not have major dental work (excluding routine cleanings) for two weeks after the proposed injection procedure.

You should immediately notify us if you have any questions or concerns, or see any signs of problems (severe or extended: pain, redness, swelling, bruising, lumpiness, a sign of infection, blood supply compromise, trouble swallowing, uneven smile or trouble with moving the mouth/chin, or other). Signs of blood supply compromise include blanching or whitening/darkening/blackening of the skin, any discoloration, pain, or skin break/sloughing.

COOLSCULPTING™

Pre-Treatment Instructions:

Stop any medications that thin your blood as bruising in the areas of treatment is possible. If you are unsure about whether your medications are blood thinners, please review this with our North Medical Practitioner. Over the counter medications such as aspirin, anti-inflammatories and fish oil supplements may also exacerbate bruising and should be discontinued.

Your Coolsculpting Treatment Day

Wear comfortable, loose clothing to your appointment.

Wear inexpensive undergarments and bring an extra pair to wear home as gel pads will be applied with the applicator and may make any clothing you are wearing during the treatment wet.

You may eat before arrival, but we recommend a light meal as rarely some patients may feel nauseated at the start of the session. We will provide snacks and beverages during the session if you begin to feel hungry.

Before your treatment photography, measurements and weight will be taken for comparison on your follow up.

The treatment rooms have an iPad with a selection of movies and programs, but you may also want to bring your iPad, phone, reading materials, knitting or laptop to entertain yourself. Total treatment times will vary from one to five hours.

What to Expect During The Treatment

There are two types of applicators (vacuum assisted and flat applicators) which may be used during your session.

Vacuum-assisted applicators: The most commonly used applicators use suction to draw the fat into the device. The vacuum pressure may cause sensations of deep pulling, tugging and pinching in the area being treated. This sensation will subside over the first five to seven minutes of each application and for the remainder of the session should be comfortable.

Flat applicator “Coolsmooth”: The flat applicators do not involve suction, but you will feel tingling and stinging for approximately ten minutes as the applicator cools the fat.

Most patients experience very mild sensations; some patients experience more intense sensations at the beginning of each session, but the symptoms will subside after the first 10 minutes.

After one hour (two hours with the flat applicator) the treatment for that area is completed, and the device is removed. Immediately upon removal of the device, the tissue will be firm, and massage is important to maximize the treatment result. During this 2-5 minute process, it will feel like a deep tissue massage – uncomfortable but bearable.

Immediately after the procedure the treated area may look or feel stiff, white (or red), bruised or swollen/bloated.

You may feel a sense of nausea or dizziness as your body naturally warms and sensation returns to your treatment area. If you are experiencing these symptoms let your North Medical Practitioner know and we will help you as necessary.

In some patients, the skin may ache or sting for a brief period as sensation returns to the area.

The skin will initially be pink, and some evidence of bruising may be immediately visible. The pinkness will subside over the first several hours after treatment. If you have developed bruising it may remain for up to a week following the session.

Post-Treatment

You can expect none or some of the following symptoms immediately after the procedure. These symptoms may persist for up to several weeks. Most patients have very mild symptoms but, as with any medical procedure, each patient experiences it uniquely.

Symptoms always subside over time and have NO long-lasting complications.

The treated area may be red for up to a few hours after the applicator is removed. This is an expected but temporary effect.

Bruising, swelling and tenderness can occur in the treated area. This typically resolves within a week or two.

Nausea, tingling, stinging and cramping in the treatment area are possible on treatment day.

You may feel a temporary dulling of sensation or itching sensitivity in the treated area.

Numbness at the site is common, resolving over 1-3 weeks.

There typically is minimal recovery time after CoolSculpting. You will be able to return to your normal daily routine immediately after the procedure.

It is common for the treated area to feel bloated and to look swollen for the first three weeks after CoolSculpting. Compression tights such as yoga pants or Spanx may feel good to wear during this period.

You may experience a temporary dulling of sensation or itching/tingling/off the sensation that can last for several weeks.

4 – 10 Days Post Coolsculpting

You may notice more intense sensations than during the first few days. This is due to the inflammatory response your body naturally mounts to remove the dead fat cells. For most patients, the symptoms are mild to moderate and often are more apparent when trying to sleep. If you have difficulty sleeping, please notify us and we may be able to prescribe medications that can help.

You May Experience:

  • Deep itching
  • Tingling
  • Numbness, soreness, or tenderness to the touch
  • Pain or aching in the treated area
  • Cramping or muscle spasms
  • Diarrhea

Please notify us if these conditions persist beyond two weeks.

Please notify us if your symptoms are severe or are interfering with your ability to perform activities or sleep.

Following the procedure, a gradual reduction in the thickness of the fat layer will take place. You may start to see changes as early as three weeks after CoolSculpting, and you will experience the most dramatic results after two to three months. Your body will continue to process the injured fat cells from your body for approximately four months after your procedure.

How Do I Maximize My Treatment Results?

Weight gain will prevent you from appreciating your full results. Maintaining a healthy diet and exercise routine after your procedure can help prevent this. Just like liposuction, Coolsculpting kills and eliminates fat cells from the treated area. If you are eating more calories than you are burning off through normal activity and exercise, the extra calories will be stored as fat in other locations in your body.

This is the perfect time to evaluate your eating and exercise habits and to make changes if merited to optimize your result. Our providers are happy to provide advice and counselling to help you make changes or assess proper caloric goals.

Six Weeks Post-Treatment

Avoid the use of anti-inflammatory medications such as ibuprofen, naproxen and Celebrex for six weeks after the treatment. The inflammatory response in your body is the mechanism which removes the fat cells and inhibiting the body’s ability to mount a response may slow the progress of your result following Coolsculpting.

Schedule a follow-up medical assessment to review your clinical results and discuss the option of additional treatments to achieve the desired outcome for this treatment site and other treatment sites.

HYDRAFACIAL™

Pre-Treatment Instructions:

Discontinue use of Isotretinoin for 6months (Sotret, Claravis, Amnesteem, and Accutane).

Discontinue use of topical prescriptive medications for 48hrs (Retin-A, Tazorac, Dierin, EpiDuo, Ziana).

Refrain from any exfoliating treatment(s) (glycolic, enzymes) to the area of treatment for 48 hrs.

Refrain from any Medium/Deep chemical resurfacing and laser treatments for 1 month.

Refrain from waxing and use of depilatories for 48hrs.

Discontinue use of OTC acne medications (Benzoyl Peroxide, Salicylic) for 48hrs.

If you are prone to cold sores, Hydrafacial may cause a breakout; ask your doctor for a prophylactic treatment such as Valtrex. Please use medication two days before, during and two days after.

Avoid sun tanning or tanning creams/sprays for at least 72hrs.

Post injections (Dysport, Juvederm) wait at least two weeks. Botox at least five days.

For Gentlemen’s Hydrafacial treatment shaving is not recommended on the day of treatment. If you choose to shave, please shave at least 3-4 hours before your treatment.

The day of your appointment a full consultation will be provided. If you have any special health considerations, allergies, pregnant, etc., be sure to notify us when you make your appointment.

After Your Treatment:

Avoid sunbathing for at least 48hrs, (although, we recommend this indefinitely) to prevent UV rays from damaging your skin which slows down the benefits of Hydrafacial. Patients who absolutely cannot avoid sun exposure should use a broad-spectrum sunscreen with an SPF of 30 or higher to maintain your improved skin.

Injections can be resumed in 24hrs.

Waxing and depilatories can be resumed in 48hrs.

Avoid heat (hot showers, sauna, and intense cardio) for 24hrs.

Makeup can be applied post-treatment. For best results leave the face clear until the following morning.

Topical prescriptive medications can be resumed in 48hrs.

OTC acne medications may be resumed in 48hrs.

FACIALS/ CHEMICAL PEELS

Pre-Treatment Instructions:

Avoid sun exposure before treatment. Sunburned skin cannot be treated.

If you have a history of perioral herpes, advise office so you may begin prophylactic antiviral therapy the day before treatment.

Schedule this treatment at a time when minor swelling or peeling will not disrupt your social obligations.

3 Days Before Treatment:

Do not bleach, wax, tweeze or use depilatory creams in the treatment area.

Discontinue use of retinoid (Retin A, Tazorac, Differin, etc.) and Hydroquinone products.

Discontinue use of 10% or higher Alpha Hydroxyl Acids, Glycolic Acids, and exfoliants.

Day of Treatment Instructions:

Do not apply lotions, creams, makeup or deodorant in the area to be treated.

Arrive with clean washed skin.

Inform provider of any changes in medical history and of all medications you are taking.

Post- Treatment Instructions:

Redness might be present (and last up to several hours) after the peel.

Use Tylenol only as needed for any soreness.

Swelling might occur after treatment for 3-5 days.

Peeling will start 3-5 days after the peel. Do not pick or scratch treated skin but instead keep moisturized.

Eat fresh pineapple to optimize healing.

Avoid strenuous exercise or sweating for 24 hours.

Treat skin gently washing with a gentle cleanser, cool water, using hands only and pat dry no earlier than.

4 hours After Chemical Peel

May use cool compress after 4 hours if excessive discomfort, burning, redness, or swelling.

Follow post peel instruction sheet with products if included in the peel.

Avoid sun exposure if possible and use a minimum of SPF 30 daily and every 2 hours if outdoors.

Please note: Everyone is different and your results and recovery time may vary from person to person. If you have any questions or concerns following your treatment, please let us know.

MICRONEEDLING

Pre-Treatment Instructions:

Avoidance of Accutane for six months before treatment.

Avoid retinoids, topical antibiotics, exfoliants, hydroquinone, sunburn, and benzoyl peroxide three days before the procedure.

Use of recommended skin care system for preconditioning for 4-6 weeks for optimal results.

Avoidance of IPL/Laser procedures for seven days prior to treatment.

No waxing, depilatory creams or electrolysis 5-7 days before the treatment.

If the use of a peel was recommended in conjunction with the microneedling, no topical agents that may increase skin sensitivity, reaction to the peel, or dryness 3-4 days before the peel (topical retinoid or hydroquinone products). No acids or defoliants that may be drying or irritating to the skin (such as alpha hydroxy acid (AHA) beta hydroxy acids (BHA), exfoliating masks, hydroquinone, or benzoyl peroxide acne products). If no peel has been recommended, avoid mentioned ingredients for 24 hours.

No shaving the day of the procedure.

There can not be any significant changes in the skin recently reported including the breakdown of the skin or excessive dryness or sunburn.

Skin is clean without lotion, oil, makeup, deodorant, powder, perfume or sunscreen.

If there is a history of cold sores, an antiviral agent should be taken for two days prior to and day of treatment.

The patient cannot be treated if the following is presented: active cold sores, herpes simplex, or warts in the area to be treated, open sores, sunburned, or excessively sensitive skin within the application area, pregnancy, dermatitis or inflammatory rosacea within the application area.

Day of Treatment Instructions:

Omit lotions, creams, make-up or deodorant in the area to be treated
Arrive with clean washed skin.

Inform provider of any changes in medical history and of all medications you are taking.

Post- Treatment Instructions

Immediately after your Medical Micro-Needling procedure, your health care provider may apply moisturizer and sunscreen topically.

Do not take any anti-inflammatory medications such as ibuprofen, Motrin or Advil. These agents will interfere with the natural inflammatory process that is critical and responsible for your skin rejuvenation.

Avoid sun tanning and prolonged exposure to direct sunlight. When exposed to the sun, always use sunscreen SPF30 or above. You may clean your face with a gentle cleanser before bed.

Redness or sensitivity might be present (and last up to a few days) after microneedling.

Use Tylenol only as needed for any soreness.

Avoid strenuous exercise or sweating for 24 hours due to open pores.

Treat skin gently washing with a gentle cleanser, cool water, using hands only and pat dry no earlier than 4 hours after microneedling.

Avoid sun exposure for three days and if possible ten days. Apply a minimum of SPF 30 every 2 hours.

May use mineral makeup after 24 hours.

Restart regular skin care regimen in 48 hours and retinol/retinoid in 72 hours.

Recommend follow up and repeat treatments in 4 weeks and for best results a series of 3 – 5 treatments.

Day 1:

On the next day, you may clean your face as usual and apply makeup, lotions and other topical products as usual. Stay away from exfoliants or glycolic acids that are present is cleaners as these can make your skin very dry after the procedure. Be sure to use an approved SPF30 or greater sunscreen!

Days 2-7:

Within two (2) days following your Medical Microneedling procedure, you may notice skin dryness and flaking. This is due to an increased turnover of skin cells. During this period, you may apply your regular skin moisturizer. Follow the instructions given to you by your medical professional. If your medical professional used the roller around the eyes, you may have a little micro bruising that may exist for three or four days. This can easily be covered with makeup. Days later, your skin will start shedding. These are skin layers that would regularly shed a week later, but the Microneedling brings this skin to the surface sooner. During this temporary process, your skin will shed and be dry. You may use your regular skin care products once your skin is not irritated.

Days 7+:

A week after the Medical Microneedling procedure, most patients notice that their skin is smoother and more radiant. Continue with sun protection every day and reapply every 2 hours if outdoors.

BBL™

Before your Treatment:

Use sunscreen and physical sun protection.

Avoid extended sun exposure, i.e. beach, travel to sunny locations, sunbathing, sports outdoors.

Inform your BBL clinician if any physician has ordered Accutane for you in the last 6 months.

Inform your doctor of any medical conditions or medications you are taking that might sensitize you to light, affect wound healing or affect coagulation.

Skincare Recommendations:

Sunscreen:

Sunscreen is a MUST and should be used daily beginning the day of treatment and used consistently. Use sunscreen with Broadband UVA and UVB protection and an SPF of at least 30. Ensure to reapply during sun exposure. DO NOT expose your skin to direct sun exposure for 14 days. The treated area is more prone to sunburn and pigmentation change.

Cleansing:

Cleanse the skin two times a day with plain, lukewarm water and a gentle cleanser. Use your hands and fingertips to cleanse using gentle patting motions. DO NOT rub, scrub, use an exfoliant soap or skin care brush, e.g. Clarisonic in the treated area.

Moisturizer:

Moisturizer should be applied generously with clean hands over the treated area and reapplied whenever your skin feels dry.

Tips & Tricks:

  • Use soft washcloth and towels to avoid any scrubbing.
  • Wear a wide-brimmed hat or sun protecting clothing
  • post-treatment to avoid blistering, scarring, hyperpigmentation and hypopigmentation.
  • Avoid strenuous exercise and sweating until after skin has healed.

Watch Outs:

  • If the treated area is especially warm within the first 12 hours after the treatment, a cold compress or ice pack can be used to provide comfort.
  • If the skin appears red or swollen (sunburn sensation), an ice pack can provide comfort, same as Vitamin E or Aloe Vera applied to the treatment area. In rare cases, oral pain relievers, i.e. Extra Strength Tylenol or Advil, may be used.
  • While the skin is healing, avoid anything that will irritate the skin, such as exfoliants, shaving, too hot or too cold water and swimming pools and spas with multiple chemicals/chlorine.

Warning:

  • In the unusual case of broken skin or blistering, contact the office immediately. Keep the affected area moist and avoid direct sunlight.

After your Treatment:

You may experience some redness in the treatment area that should resolve within a few hours.

You may notice darkening of your pigmented spots, followed by fading and flaking off at a later stage.

Follow your clinician’s aftercare plan until skin is completely healed – typically one week after the treatment. The skin on your body might take longer to heal, compared to your face.

LASER HAIR REMOVAL

What You Should Know Before Your Treatment:

Avoid active sunshine at least 2 weeks before the procedures, or use sun-screen creams with SPF values higher than 25–30; do not use any self-tanning creams.

Do not use plucking or waxing 1 month before the procedure. All other hair removal methods when the hair root is preserved, e.g. shaving and cutting, are permissible.

Do not apply to the skin any irritating compounds such as glycolic acid or retinoids 1 week before the procedures.

The procedures have the highest effect in case of light skin and darker hair. In case of darker skin, skin-bleaching products can be prescribed 4-6 weeks before the procedure.

In case of perioral viral herpes, antiviral therapy will be prescribed if the procedure is to be performed in the facial area.

The procedure will not be performed if you are pregnant. Nursing mothers are allowed to undergo the procedure.

After Your Treatment:

After treatment, the skin may immediately be red, and the hair follicles where the surface has been treated may be raised or bumpy. Very few patients experience any itching, redness, or bumps. This is normal and the swelling and bumps should disappear within hours of treatment.

Sun exposure after treatment can increase the risk of hyperpigmentation, so we recommend sun avoidance and the use of broad-spectrum UVA/UVB sunscreen SPF 30 or higher. In the first few days after treatment, don’t scrub or rinse the treated areas with abrasive skin cleansers. Written post-treatment guidelines will be provided after your treatment.