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Pre and Post Op Care

Botox & Dysport:

BOTOX® Cosmetic by Allergan is an FDA approved drug commonly used to relax facial muscles that cause dynamic expression lines. Made from a purified protein, BOTOX® injections are used to block nerve impulses by weakening muscles to relax wrinkles. The result is a relaxed, smooth, and rejuvenated look. BOTOX treatments are typically noticeable one-two weeks post treatment.

Dysport by Medicis, an FDA approved cosmetic injection, is also used to reduce the appearance of dynamic expression lines by relaxing facial muscles. Dysport is made from a protein that is extracted from the bacterium Clostridium botulinum, the same protein used in BOTOX injections.

Similar to BOTOX® Cosmetic, Dysport is injected the same way as BOTOX. The difference between BOTOX and Dysport is that Dysport can diffuse muscles one to three centimeters from the injection site, while BOTOX can only reach as far as one centimeter, which allows results to reach further areas with just a single injection.

The results of Dysport are typically noticeable within one to seven days post treatment. Dysport has less protein than BOTOX, therefore, is metabolized more slowly by the body.

Pre-treatment Instructions:

2 weeks prior to treatment
Stop all blood thinning supplements and medications. Some of these may include St. Johns Wort, Fish Oil/Omega 3, Flax Seed Oil, and Vitamin E

1 week prior to treatment
Stop taking aspirin or anti-inflammatory medications like ibuprofen. Some of these may include, Aleve, Advil, or Motrin. Tylenol is fine.

  • Patient cannot be under the influence of alcohol at the time of treatment
  • Patient cannot be pregnant or nursing at the time of treatment
  • Please tell your provider if you are currently taking any other medications at the time of your treatment

Post Treatment Instructions:
Small bumps appearing like mosquito bites can appear at the injection site. These bumps usually subside within a few hours. On occasion the injection site can bruise and last 3-7 days if aspirin or blood thinning medications were taken close to the day of treatment

  • Avoid rubbing the treated area post treatment. You may lightly apply cosmetics and sun-block.
  • Avoid lying down 4 hours post treatment
  • Avoid strenuous activity for the remainder of the day post treatment
  • Exercise the muscles that were treated as much as you can for a few hours post treatment-by making faces such as frowning or smiling.
  • Normal activity can be resumed the next day
  • Please allow a full two weeks to appreciate the results and to determine if another treatment is needed

Facial Cosmetic Fillers

Facial Fillers are commonly used to restore volume, facial symmetry, and soften wrinkles. As our faces age, certain features are disrupted and metamorphic changes take place. Our facial features change due to facial bone loss, dermal collagen degeneration and loss of subcutaneous fat. These changes result in hollowed eyelids and temples, sunken cheeks, thinning lips, chins becoming less prominent, wider lower facial depressions and deeper grooves and folds. The goal of facial fillers is to harmonize the upper, middle, and lower face. By replacing lost bone and fat with facial fillers, you can create a more youthful contour to the face. During your consultation, we will determine what facial filler is best for you.

Common areas treated:

  • Hollow Temples
  • Lower Eyelids
  • Nasolabial Folds
  • Marionette Area
  • Cheek Enhancement
  • Lip Enhancement

Pre-treatment info:
Patients who are NOT candidates for this treatment

  • A patient who is pregnant or nursing.
  • A patient who is on Accutane. Treatment can be done 6 months post the patient’s last treatment of Accutane.
  • A patient who has an active cold sore/ fever blister or skin infection.
  • A patient can not be under the influence of alcohol at the time of treatment.

2 Weeks before treatment:
Stop all blood thinning supplements and medications. Some of these may include St. Johns Wort, Fish Oil/Omega 3, Flax Seed Oil, and Vitamin E. These supplements will increase bruising and bleeding at the injection site. As always, consult with your doctor if you are on a prescription prior to stopping.

1 Week before treatment:
Stop taking aspirin, this will increase bruising and swelling. Tylenol is fine to take.

Day before treatment:
Please let the staff know if you have a history of cold sores/fever blisters PRIOR to treatment, so an anti-viral medication can be prescribed. Treatment can not be done if you have an active cold sore or skin infection and will be rescheduled.

Day of Treatment:
If this is your first treatment, you must arrive 30 minutes prior to take photos and make sure consents are signed. If you choose to use a topical numbing agent, you must also arrive 30 min prior to your treatment. Most of our dermal fillers have Lidocaine in them which helps with the discomfort associated with this treatment. Please advise the staff if you are allergic to Lidocaine or Novacaine.

Bruising is common and can last 7-14 days. Please plan your events accordingly. Arnica, a homeopathic supplement, has been shown to reduce swelling and bruising. It can be taken one week prior to treatment and 2 times daily for 4 days post treatment.

The provider will massage the treated area to ensure a smooth, even correction. Massaging the area can leave a mild to moderate amount of redness.

Post-treatment info:
It is normal for the area treated to feel tender for a couple days post treatment. Tylenol is fine to take.

Apply an ice pack immediately after to help reduce swelling. Swelling usually dissipates within 48 hours. If your lips were treated, swelling can last up to a week.

You can continue using the ice pack at home 2-3 more times in 15 minute increments.

  • Makeup can be applied post treatment if no complications are present. Please apply gently to the treated area.
  • Gentle washing is allowed a few hours post treatment.
  • For 6 hours post treatment, avoid touching the area, strenuous exercise, and alcohol.
  • A post procedure skin care regimen will be suggested by our staff to maximize and prolong your treatment.
  • Please contact our office if you experience any signs of infection, fevers, cold sores, increased pain, or redness.
  • A follow up appointment is needed 1-2 weeks post your treatment.

Nouveau Lift (Mini Face Lift):

Why choose the Nouveau Lift?

  • Avoid General Anesthesia
  • Reduced Recovery
  • More Affordable

Pre-Treatment Instructions:

  • Do not take any aspirin, Advil or any medication containing aspirin for two weeks before and two weeks after your surgery. Drugs containing aspirin include: Anacin, Bufferin, Excedrin, Midol, Fiorinal, Percodan, Alka Seltzer and numerous others. Check with your pharmacist if you have questions about blood thinning medication.
  • Prescriptions from our office will be distributed to you at the time of you pre-op appointment. This includes something to calm the nerves, pain medication, and a stool softener.
  • Bring a scarf and dark glasses with you to wear after your surgery for your ride home.
  • Wear comfortable clothes
  • You must wash your face and do not apply any products (moisturizers, toner, etc.) to your face the day of your surgery.
  • No smoking, alcohol, or Nicorette Gum for three weeks before and after surgery.
  • Females: Stop birth control pills or estrogen replacement three weeks before surgery due to the increased risk of developing a blood clot post-surgery.

Post-Treatment Instructions:

  • There will be a significant amount of swelling and bruising of the face and neck. The bruising usually lasts approximately 7 – 10 days and the swelling will gradually dissipate over the next couple of weeks.
  • Oozing will occur from the incision sites which will gradually stop.
  • Immediately after surgery, you will have an ace bandage and dressing wrapped around your head with your eyes and mouth showing. This dressing will be removed at your first post-operative visit in the office.
  • Stick to eating softer foods such as bread, soups, protein shakes, etc. Your jaw area may be sore for the first few days post-surgery so crackers, large sandwiches, or cereals may be hard to consume.
  • Camouflage makeup can be done if desired. Please ask our cosmetic coordinator for more details.
  • Sleep on your back with head elevated on one or two pillows for ten days.
  • Cold compresses for 20 minutes on and off to reduce swelling for the first 48 hours. DO NOT apply ice if you had a fat transfer!
  • You may shower and shampoo your hair after your first post-operative visit in the office.
  • There will be numbness of the face, scalp, ears and/or neck for possibly several months or longer following the surgery.
  • Makeup can be used 2 – 3 weeks after surgery if there are no open healing areas.
  • You will wear a stretch support garment for a couple of weeks after surgery. The garment should be worn continually for the first two weeks. The garment should be worn as must as possible after that, even to bed at night.
  • Medication will be prescribed for discomfort.
  • The doctor will inform you after surgery when he would like to see you again for your first post-operative visit.

Nouveau Neck Lift

Post-Operative Care


  • Have someone drive you home after surgery and help you at home for 1-2 days.
  • Get plenty of rest.
  • Follow a balanced diet.
  • Take pain medication as prescribed. Do not take aspirin or any products containing aspirin unless approved by your surgeon.
  • If you are takin vitamins with iron, resume these as tolerated.
  • Do not smoke, as smoking delays healing and increases the risk of complications.


  • Start walking as soon as possible, as this helps to reduce swelling and lowers the chance of blood clots.
  • Do not drive until you are no longer taking any pain medications (narcotics).
  • Return to work in approximately one week.
  • Avoid strenuous exercise and activities 3-4 weeks.

Incision Care:

  • If a drainage tube(s) has been placed, you may shower 48 hours after removal.
  • Avoid exposing scars to sun for at least 12 months.
  • Always use a strong sunblock, if sun exposure is unavoidable (SPF 30 or greater).
  • Keep steri-strips on.
  • Keep incisions clean and inspect daily for signs of infection.
  • Hair can generally be shampooed in 2-3 days.
  • Hair bleach and/or permanent dye can be applied after complete healing, usually 3-4 weeks.
  • When using a hair dryer, never use a “hot” temperature setting, as you may not have feeling in the operated area.

What to Expect:

  • Minimal postoperative pain.
  • Temporary numbness.
  • Swelling, discoloration, and tightness of skin for 10-14 days.
  • Follow-Up Care:
  • Sutures are usually removed within 7 days.


What causes spider and reticular veins?
Spider and reticular veins can be caused by many factors.

  • Heredity. Having a family member with prominent veins may increase the risk of you developing them. Approximately half of the people who get varicose veins have a family history of them.
  • Age. The normal wear and tear of aging may cause valves in the veins to weaken and not work as well.
  • Gender. Women are two to three times more likely to develop varicose veins than men. Up to half of American women have varicose veins. Changes in hormones due to puberty, pregnancy, menopause, or taking birth control pills may increase a woman’s risk of developing varicose veins.
  • Pregnancy. During pregnancy, the growth of the fetus increases the pressure on the veins in the legs. Varicose veins that occur during pregnancy usually improve within 3 to 12 months following delivery.
  • Overweight and obesity. Having extra weight on the body can put additional pressure on the veins.
  • Prolonged standing or sitting. This is particularly true with legs bent or crossed. When standing or sitting with legs bent or crossed, the veins have to work harder to pump the blood up to the heart.

What is sclerotherapy?
Sclerotherapy is a minimally invasive procedure done by your healthcare provider to treat uncomplicated spider veins and uncomplicated reticular veins. The treatment involves the injection of a solution into the affected veins.

Pre-Treatment Instructions:

  • Bring your support hose/stockings with you at the time of your treatment. For a list of stores close to you that sell these stockings please call our office.
  • Wear comfortable clothes that can reveal the areas to be treated. Skirts, shorts etc. are perfect for the day of treatment. Bring sweat pants or a long skirt to wear home so your treatment sites/stockings are not visible.
  • Stop all Vitamin E, Aspirin, Ibuprofen (Motrin, Advil, Naprosyn), and alcohol one week PRIOR to your appointment.
  • You may drive to and from your sclerotherapy appointments.

Post-Treatment Instructions:

Immediately after procedure:
Expect to have minimal to mild pain, bruising, cramping and swelling for the first 24 hours after therapy.

Day 1 to 3:

  • Wear prescribed compression stockings for a continuous 3 days after procedure.
  • Leave all taped gauze in place until 1 day after procedure.
  • Take over-the-counter Tylenol per directions as needed for pain.
  • Avoid Motrin and Aspirin.
  • Take over-the-counter Benadryl per directions as needed for itching.
  • Use ice packs for especially sore areas.
  • Elevate legs for added pain relief.
  • Resume normal diet and medications.
  • Resume normal daily activities, except you should avoid strenuous activities such as high impact
  • aerobics, running, or weight lifting for 3 days.
  • Walk at least 1 hour per day.
  • No hot baths or hot tubs. Shower with your stockings or take a sponge bath.
  • Notify us for increasing pain, persistent itching or rash, progressive areas of redness, warmth or drainage, fever, swelling, persistent bleeding, lump formations, shortness of breath, chest pains, or leg numbness.
  • Day 3 to 2 weeks:
  • Treated areas will be red-purple in color, with some bruising.
  • Remove prescribed compression stockings and all bandages on day 3
  • Wear compression stockings during day hours for next 14 days (put on in the morning and take off
  • before going to bed).
  • Use a triple antibiotic ointment per package instructions on any ulcers or tape blisters.
  • You may shower with stockings off, but continue to avoid hot baths and hot tubs.
  • Resume normal athletic activities as tolerated

Nouveau Medispa – Hockessin

Hockessin Athletic Club*

100 Fitness Way, Hockessin, DE 19707

*Non-members are welcome

(302) 355-1123


Advanced Plastic Surgery Center - Newark

774 Christiana Road, Suite 101, Newark, DE 19713

(302) 355-0005

Philadelphia is 50 min. away from main office: Newark, Delaware

Cherry Hill is 50 min. away from main office: Newark, Delaware

Atlantic City is 1 h 30 min. away from main office: Newark, Delaware

Baltimore is 1 h away from main office: Newark, Delaware

Open 6 days a week
including evening appointments


Advanced Plastic Surgery Center - Elkton

111 West High Street, Suite 207, Elkton, MD 21921

(410) 996-0039


Advanced Plastic Surgery Center - Dover

95 Wolf Creek Blvd. Unit 1, Dover, DE 19901

(302) 355-0005


Rehoboth Plastic & Dermatologic Surgery

18947 John J. Williams Hwy, Suite 305, Rehoboth Beach, DE 19971

(302) 645-7435