Aftercare in the first six weeks

Aftercare instructions in aesthetics vary from clinic to clinic in ways that can be difficult to reconcile, partly because some of them are precautionary conventions rather than evidence-led rules. That does not make them worthless. It does mean it is worth understanding which instructions have a mechanism behind them and which are habit, so that you follow the ones that matter properly.

The first 48 hours

This period is about limiting swelling, bruising and the risk of infection, and about not moving product that has just been placed.

• Keep upright for several hours after facial injectables. Lying flat too soon increases swelling and, after botulinum toxin, is conventionally avoided to reduce any chance of spread.
• Sleep slightly elevated for the first two nights. This makes a noticeable difference to morning swelling, particularly after lip treatment.
• Avoid heat. Saunas, steam rooms, hot yoga, very hot showers and sunbeds all increase blood flow and swelling.
• Avoid strenuous exercise for 24 to 48 hours. Same mechanism.
• Avoid alcohol for 24 hours before and after. It dilates blood vessels and worsens bruising.
• Leave the area alone. No massaging, no pressing, no facials, and no sleeping face down. Where a practitioner has specifically instructed massage, do exactly what they said and nothing more.
• Keep it clean. Avoid makeup over injection points for the first 12 to 24 hours, because those points are small breaches in the skin barrier.

Week one

Bruising will do what bruising does, changing colour before it fades. Cool compresses in the first day or two can help swelling, applied gently and not directly to the skin. Arnica is widely recommended in the sector and widely used, and the evidence for it is not strong. It is unlikely to do harm and it is not a substitute for the measures above.

Avoid facials, dermaplaning, waxing, laser and other facial treatments for about two weeks after injectables. Dental treatment is best deferred for a couple of weeks after facial filler where the timing is flexible, because both carry a small risk of introducing bacteria to the area.

If you get cold sores and have had lip treatment, watch for the early tingling stage and act on the plan your practitioner gave you.

Weeks two to six

Two things matter in this window. The first is the review appointment. Two weeks is the point at which botulinum toxin has reached full effect and adjustments make sense. Four weeks is the point at which filler has settled. Attend it even if you are pleased, because a practitioner who sees results routinely learns more from your face than you do, and it informs the next treatment.

The second is sun protection. Skin recovering from any procedure is more prone to post-inflammatory pigmentation, and that risk is higher in deeper skin tones. Daily broad spectrum sun protection through this period is the single aftercare instruction with the clearest rationale, and it matters most after resurfacing treatments. The British Association of Dermatologists publishes patient information on sun protection worth following.

Aftercare specific to resurfacing

Peels, laser and microneedling have their own regime, because the skin barrier has been deliberately disrupted. Expect instructions to use a bland emollient, avoid active ingredients such as retinoids, acids and vitamin C until the skin has re-epithelialised, avoid picking or pulling flaking skin, and avoid exercise that produces heavy sweating during the healing phase.

Picking is the one that causes lasting damage. Flaking skin lifting after a peel is protecting what is underneath, and removing it early raises the risk of scarring and pigment change. Recovery timelines for each treatment are set out in downtime by treatment.

What makes no measurable difference

A quantity of aftercare product is sold on the way out of clinics. Very little of it changes an outcome. Specifically, no topical product makes botulinum toxin work better, last longer or settle faster. No supplement has been shown to make dermal filler last longer. Ice applied aggressively for long periods does not improve the result and can damage skin.

Lymphatic massage after facial injectables should only be done if your practitioner has specifically told you to, because unplanned pressure on recently placed product is a way to move it. And expensive post-treatment serums are, for the most part, ordinary moisturisers with a purpose written on the box.

Judging the result, and when to speak up

Do not assess a filler result before four weeks or a toxin result before two. Before those points you are looking at swelling or at partial onset, and the anxiety this generates is one of the most common reasons people ask for correction they do not need.

What you should raise immediately, rather than waiting, is anything in the urgent category: severe or increasing pain, skin that turns white, mottled, dusky or blue, coldness in the area, any change in vision, spreading redness with fever, or discharge. Those are covered in recognising a complication, and they are the reason to have an out of hours number before you are treated rather than after.

The six week to six month view

Beyond six weeks, aftercare becomes maintenance, and maintenance is mostly the unglamorous list: daily broad spectrum sun protection, not smoking, sleep, and a simple, consistent skincare routine that includes a retinoid if your skin tolerates one. Those four do more for the appearance of skin over a decade than any single treatment does in a year.

Keep a record of what you had, where, in what quantity, on what date and by whom. It takes a minute and it is invaluable at every future consultation, particularly if you ever see a different practitioner. The reasons are set out in what a good consultation looks like.