Preparing for a Medical Aesthetic Procedure: What to Tell Your Physician, Timing and the Day Itself

Why does preparation matter?

Expert consensus reports prepared for injections such as botulinum toxin and hyaluronic acid filler list correct patient selection, information and consent, good preparation and careful technique together as the ways of reducing side effects. Technique is the physician’s responsibility; a large part of preparation, however, depends on the information you give and on what you do in the days before the procedure.

This article focuses on the period before the procedure. For care after the procedure, see our article “Aftercare Following Medical Aesthetic Procedures: General Principles and Warning Signs”, and for all the steps aimed at reducing risk, our article “Reducing the Risk of Complications: 15 Precautions Before, During and After an Aesthetic Treatment”. If you are considering a procedure for the first time, “A Guide for First-Time Medical Aesthetic Patients” is a good place to start.

What should I tell the physician at the consultation?

Going to the consultation with a written list reduces the chance of forgetting an important piece of information. A detail that seems unimportant to you may change the choice or timing of the procedure.

If you do not remember your previous procedures or do not know which product was used, say so plainly as well; saying 'I don’t know' is safer than guessing. For people with a chronic condition or on regular medication, we give the details in our article “Medical Aesthetics for People on Medication or with Chronic Conditions: What to Watch Out For and What to Ask Your Physician”, and we cover pregnancy and breastfeeding in our article “Medical Aesthetics in Pregnancy and Breastfeeding: Which Treatments Should Be Postponed, and What Should You Discuss with Your Physician?”.

Should I stop my medicines and supplements?

Do not stop any medicine you take on prescription, or change its dose, on your own for the sake of an aesthetic procedure. This is especially important for blood thinners given for heart, vascular and clotting conditions: stopping the medicine can have far more serious consequences than bruising. Consensus reports on injections also do not, in general, recommend stopping prescription blood thinners for this purpose.

The situation may be different for non-essential products that you take without a prescription. Your physician may ask you to pause some painkillers and supplements that can affect clotting for a time before the procedure. Your physician decides which product to pause and for how long; if you take a painkiller regularly on a doctor’s advice, mention this separately.

• Take to the consultation a list with the name and dose of all your medicines and supplements.
• If pausing a medicine is raised, ask for this to be discussed with the physician who prescribed it.
• Ask in advance which painkiller you can use if you need one for a headache or any other reason in the days before the procedure.
• Also mention the retinoid and acid-containing products you use in your skin care; you may be asked to pause them for a time before procedures such as laser and peels.

When should I schedule the procedure?

The right timing varies with the type of procedure. The headings below summarise the subjects you need to discuss with your physician; the exact periods are set by your physician.

• Sun and tanning: in procedures such as laser, intense light and peels, tanned or sunburnt skin increases the risk of burns and pigmentation. Dermatology sources recommend arriving for a laser procedure with skin that is not tanned or sunburnt, and avoiding the sun and sunbeds beforehand. For this reason these procedures are usually scheduled outside periods of strong sun and holidays in the sun.
• Skin preparation: before some peels your physician may recommend a pre-treatment plan that can last several weeks. Follow this plan as your physician describes, not on your own initiative.
• Important events: swelling and bruising can occur after injections, and the effect of some procedures appears over days or weeks. If you have a date such as a wedding, a presentation or a photo shoot, say so, and do not squeeze the procedure in just before the event. For the course of bruising, see our article “Bruising and Swelling: How Long Do They Last after an Aesthetic Treatment, How Can They Be Reduced and When Should You Worry?”.
• Illness and infection: if you have an illness such as a fever, a cold or flu, or an active spot, cold sore or other infection in the treatment area, the procedure is usually postponed. Let your physician know without waiting for the day of the appointment.
• Dental treatment and vaccination: recent dental treatment is listed among the possible risk factors for the reactions that can occur late after filler; however, the evidence on this is limited and no period that applies to everyone has been defined. If you have dental treatment or a vaccination in the near future, tell your physician, who will decide whether to leave an interval.
• More than one procedure: the order of, and interval between, procedures aimed at the skin surface such as laser or peels and injections are planned by the physician. If you are having procedures at short intervals at different facilities, tell each of them about the other.
• Travel: if you will be going out of town or abroad straight after the procedure, say so in advance. It is safer to choose a time when you will be able to reach your physician if there is a problem. We deal with this subject in our article “Travelling to Another Country for an Aesthetic Treatment: Follow-Up, Flight Timing and Safety Questions”.

Alcohol and smoking

Alcohol can increase bruising and swelling in some people. For this reason physicians mostly recommend not drinking alcohol on the day before the procedure and on the day itself. This recommendation is based mainly on clinical experience rather than on strong research; ask your physician what period is appropriate for you.

The adverse effect of smoking on wound healing, by contrast, is well documented. In a large systematic review covering surgical patients, healing problems and wound infections were reported to be markedly more common in smokers than in non-smokers. These data relate to operations; even so, you may be asked to stop smoking, or at least to take a break from it, before procedures that injure the skin such as laser, peels and thread lifts. Tell your physician that you use cigarettes or other tobacco products.

The day before and the day of the procedure

• Read the preparation instructions you were given once more; if there is a point you do not understand, call and ask before the procedure.
• Arrive for the procedure with clean skin and, if possible, without make-up. Cleansing and disinfecting the skin is part of the treatment.
• Consult your physician before waxing, shaving, or applying a product with a peeling effect or a tanning product to the treatment area shortly beforehand.
• Do not arrive hungry, and drink enough water; if your physician has given different instructions, follow those.
• Have with you your list of medicines and supplements, your allergies and, if you have them, the product records from your previous procedures.
• If anything has changed since your last consultation, say so: a newly started medicine, a fever, a cold sore, a possible pregnancy, a skin rash.
• Review your plans for after the procedure: do not plan intense exercise, a sauna or a long journey for the same day.
• If you tend to faint at the sight of needles or blood, tell the clinic in advance.

Informed consent: before you sign

The consent form is not a piece of paper signed just before you lie down on the treatment couch; it is the record of your decision-making process. You can ask for time to read the form, ask questions and think. The United Kingdom’s health service also reminds patients to give themselves time to decide and that they can change their mind if they do not feel comfortable.

• The purpose of the procedure, the expected result and how long its effect may last
• The common side effects and the rare but serious risks
• The alternatives to the procedure; having nothing done is also an option
• The active substance of the product to be used and whether you will be given a record of it
• What will be done if a problem arises and whom you can reach out of hours
• Whether a follow-up appointment is needed

For questions about choosing a physician and facility, you can refer to our article “A 10-Point Safety Checklist for Choosing a Clinic and Physician for Medical Aesthetics”.