Botox® cosmetic (onabotulinumtoxinA) is indicated in adult patients for the temporary improvement in the appearance of:

• moderate to severe glabellar lines (in between the eyebrows)

• moderate to severe lateral canthal lines (crows feet)

• moderate to severe forehead lines

Duration of treatment is on average 3-4 months. Many factors contribute to individual experience with longevity such as metabolism, daily activity, current medications, and more. Please talk to your provider during your consultation about how this may pertain to you.

Dysport® (abobotulinumtoxinA) for injection is an acetylcholine release inhibitor and neuromuscular blocking agent indicated for the temporary improvement in the appearance of moderate to severe glabellar (between the eyebrows) lines assocaited with procerus and corrugator muscle activity in adults <65 years of age.

Duration of treatment is on average 3-4 months. Many factors contribute to individual experience with longevity such as metabolism, daily activity, current medications, and more. Please talk to your provider during your consultation about how this may pertain to you.

Adverse Reactions:

• The most common adverse reactions following cosmetic injections are headaches, brow ptosis, eyelid ptosis, eyelid edema, facial pain, facial paresis, and muscle weakness. If you are considering being injected, please note these are always possible no matter the product or place of injections. Proper precautions are taken to avoid these at all costs.

• other adverse reactions / common side effects include: stuffy or runny nose, upper respiratory infection, blood in urine, swelling of the eyelids, drooping eyelids, sinus infection, nausea

Patients should be advised to seek immediate medical care if swallowing, speech, or respiratory disorders occur.

• Dysphagia and Breathing Difficulties: These products can result in swallowing or breathing difficulties. Patients with pre-exisiting swallowing or breathing difficulties are more susceptible.

Serious and/or immediate hypersensitivity reactions have been reported. These include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injectors should be discontinued and appropriate medical therapy immediately instituted.

There have been reports of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Please proceed with caution if this attains to you.

Patients with neuromuscular disorders may be at increased risk of clinically significant effects including generalized weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia, and respiratory compromise.

Dry Eye has been reported with use of cosmetic injections. If symptoms occur (eye irritation, photophobia, visual changes) persist, additional medical help may be necessary.

Drug Interactions with other medications you are taking may cause the toxin injected to be potentiated. Please share all current medications on your medical history form to avoid being injected while taking medications known to cause this reaction.

Infection is always a risk when the skin barrier is penetrated.

• Allergic to any listed ingredients within the products (ingredients lists are always available at Purra or online)

• Allergic to cow’s milk protein

• Have ever had an allergic reaction to any type of neurotoxin injection before

• have a skin infection at site you plan to get injected

• pregnant or breastfeeding

• patients with allergies to human albumin (small risk of transmission from human albumin used in Type A to provide a larger particle)

• infection, inflammation (including acne), or dermatitis of areas to be injected

• fever, flu, or cold symptoms

• facial asymmetry such as Bell’s Palsy

• Patients with neurological disorders including:

  • Amyotophic Lateral Sclerosis (Lou Gherig’s disease)

  • Lambert Eaton Disorder

  • Multiple Sclerosis

  • Parkinson’s Disease

• Antibiotics may potentiate the effects of Dysport/Botox

• Taking medication such as aminoglycosides or medications that interfere with neuromuscular transmission may have a potentiated effect

• thick sebaceous skin may have very deep wrinkles making them poor candidates

• a natural eyelid ptosis may be more susceptible to drooping of the eyelid

• Neurotoxin does not diffuse over scar tissue

• Due to bruising potential, you should schedule injections at least 2-3 weeks prior to an important event

• alcoholic beverages 24 hours prior to injections may increase bruising

• blood-thinning medications and herbal supplements 2 weeks prior and 2 weeks after typically increase bruising

Before your treatment we ask that you:

• read up on & educate yourself on Botox® or Dysport®. Our website offers a lot of great information as well as Allergan® (the creator of Botox) and Gallderma® (the creator of Dysport respected websites.

• Understand the treatment itself, the benefits and risks entailed. It is important to understand that all procedures carry a risk and could end in an unintended outcome, especially if not treated with full recommended dosing. A dosing chart is available below.

• Do not drink coffee or caffeinated beverages before appointment (to avoid thinning the blood)

• Do not get waxed/ dermaplaned or any intense treatment to the skin before appointment.

• Do not drink alcohol the day before or the day of treatment if possible to prevent increase bleeding & bruising

• Common side effects to prepare for are: redness, pain, swelling, bruising, drooping eyelids, and headaches. A full list of side effects and adverse reactions are available under safety information.

• Stop taking specific medications & ask your doctor for approval discontinuing prescribed medications for a minimum of 3 - 5 days prior to and 3 - 5 days post appointment

  • These medications include: aspirin, ibuprofen, blood thinners, muscle relaxers, allergy medications, and anitbiotics

  • most common are: aspirin, ibuprofen, ginseng, fish oil, St. John’s Wort, Vitamin E, Ginkgo Biloba

• Other measures to take to limit bruising are:

  • try to not smoke cigarettes before or after appointment

  • Application of ice before and after the appointment - especially if you are easy to bruise - can help. Ice packs are available from us to take home.

Schedule your appointment at an appropriate time! No need to increase the anxiety around the appointment. Schedule at a time that you can be relaxed! Also, prepare for some swelling and redness at least on the day of.

The treatment is quick & easy. Most patients report little to no pain. We will do our best to make you as comfortable as possible.

Continue to prevent bruising as much as possible.

• Do not drink alcohol for 24 hours post injections

• avoid exercise for an minimum 6 hours post injection. We do suggest waiting 24 hours minimum to avoid metabolism or product - especially heat induced / heavy cardio.

• continue to refrain from certain medications listed in pre-care information if you are able.

• use ice on areas injected

• refrain from rubbing the eyes/ skin in areas injected

Avoid hot environments such as hot- tubs, saunas, or intense work outs for at least 72 hours post injection to prevent product metabolism.

Be aware of all possible adverse reactions and side effects. Know when to contact your injector or provider for further help if necessary.

Please remember, touch-ups cannot take place until 14 days post injection. This is to allow all previously placed product to fully settle without the possibility of creating complications. Please let your injector know if you have a complication you would like to try to get corrected ASAP so we can get you scheduled as close to two weeks post first injections as possible.