Botulinum Toxin & Dermal Fillers – Hermitage Oral & Maxillofacial Surgery (Nashville, TN)

Rejuvenate Your Look with Cosmetic Injectables: At Hermitage Oral & Maxillofacial Surgery, we’re excited to offer botulinum toxin and dermal filler treatments to help you achieve a refreshed, youthful appearance. These popular non-surgical cosmetic procedures can smooth wrinkles and restore facial volume with minimal downtime. In fact, botulinum toxin is the #1 minimally invasive cosmetic treatment in the U.S., with over 6.2 million botulinum toxin procedures performed in 2021 alone – a testament to its safety and effectiveness. Whether you’re looking to soften frown lines or plump your lips, our expert team is here to provide stunning, natural-looking results in a comfortable oral surgery setting.

What Are Botulinum Toxin and Dermal Fillers?

Botolinum toxin (like Botox®, Xeomin®, and Dysport®) is a purified neurotoxin (botulinum toxin type A) that temporarily relaxes targeted facial muscles. By gently reducing muscle activity, botulinum toxin smooths dynamic wrinkles such as crow’s feet, frown lines between the brows, and forehead creases. Treatment is quick (often 10–15 minutes) and results appear within days, lasting about 3 to 4 months on average.

Dermal fillers (like Versa®, Juvéderm®, or Restylane®) are gel-like injectable products used to restore lost volume and enhance facial contours. Fillers can plump thinning lips, soften deep folds (like smile lines), and refill hollow or sunken areas of the face. Results are immediate and can last anywhere from 6 to 12+ months, depending on the product and area treated. Both botulinum toxin and fillers are cosmetic-only treatments – they improve aesthetic appearance and boost confidence, without surgery.

Quick Benefits at a Glance:

• Non-Surgical Facial Rejuvenation: Achieve a younger, fresher look without surgery or downtime. You can return to normal activities the same day in most cases.
• Fast Treatment & Lasting Results: Injections take only minutes, and results develop within days (for botulinum toxin) or immediately (for fillers), lasting months before a touch-up is needed.
• Minimal Discomfort: Our gentle injection technique and use of topical numbing (or even sedation if desired) make the process very comfortable. Many patients say they barely feel it.
• Boosted Confidence: Smoother skin and fuller contours can help you look and feel younger, enhancing self-esteem with subtle, natural-looking improvements.

Why Choose Us for Botulinum Toxin & Fillers?

Choosing the right provider for cosmetic injections is crucial for safe treatment and beautiful results. Hermitage Oral Surgery offers distinct advantages that set us apart:

• Advanced Facial Anatomy Expertise: As oral and maxillofacial surgeons, our doctors have extensive training in facial anatomy and musculature. This knowledge – gained through years of surgical residency and clinical experience – allows for ultra-precise injection placement. We understand the intricate network of facial muscles, nerves, and blood vessels, which means your botulinum toxin or filler is injected exactly where it’s needed for maximum effect while avoiding unwanted areas. Our surgical precision helps ensure balanced, natural results and reduces the risk of complications.
• Sedation for Your Comfort: A unique benefit of receiving injectables at our oral surgery office is the option for sedation during treatment. We routinely use sedation anesthesia for surgical procedures, and we can offer sedation even for botulinum toxin or filler appointments to patients who are anxious or have a fear of needles. With IV sedation, you can be deeply relaxed (or even asleep) while we perform your injections – you won’t feel a thing! This is especially comforting for nervous patients and is not typically available at standard med spas. Sedation is administered by our qualified team in a fully monitored, clinical environment for the utmost safety.
• Safety & Sterile Setting: As an oral surgery practice, we adhere to hospital-grade sterilization and safety protocols. Botulinum toxin and filler injections are done in our clean, clinical treatment rooms using the same high standards we apply to surgeries. Our surgeons are medically trained to handle any issues and are equipped to manage rare adverse reactions or allergies on the spot. You can have peace of mind knowing you’re in experienced medical hands, with safety as the top priority.
• Natural, Aesthetic Results: Our philosophy is to enhance your features without overdoing it. Thanks to our precise technique and conservative approach, you’ll look like a refreshed, younger version of yourself – never fake or “frozen.” We focus on subtle improvements that complement your natural beauty. During your consultation, we’ll discuss your goals in detail. Every treatment is fully customized – from the number of botulinum toxin units to the type and amount of filler – to achieve harmonious results that align with your facial anatomy and desires.
• Convenience & Comprehensive Care: You can get your cosmetic injections done right here in our office, possibly even combined with other dental or surgical procedures for convenience. For example, some patients choose to have a wisdom tooth removal or dental implant done under sedation and get botulinum toxin/fillers at the same appointment while still numb or sedated. We also provide detailed pre- and post-treatment care instructions (see our guide below) and a follow-up visit if needed. Our team is always available to answer questions during your recovery. We strive to make the whole experience smooth, from scheduling to aftercare.
• Experienced, Caring Team: Our injections are administered by a board-certified oral & maxillofacial surgeon who has specific training by the American Academy of Facial Esthetics in cosmetic facial treatments. We stay up to date with the latest techniques and products. Just as importantly, we listen to your concerns and make sure you’re comfortable every step of the way. Our friendly staff and tranquil office environment help put even the most anxious patients at ease.

What to Expect – Your Treatment Experience

1. Consultation: It all starts with a one-on-one consultation. We welcome all patients (no specific demographic – adults of any age) who are interested in improving their facial aesthetics. During this visit, our surgeon will evaluate your areas of concern (such as forehead lines, eye wrinkles, or thin lips) and determine a personalized treatment plan. We’ll explain which areas could benefit from botulinum toxin vs. fillers, and how each works. Feel free to ask questions – we want you to be fully informed and confident in your choices. We’ll also review your medical history to ensure you’re a good candidate (almost everyone is, with few exceptions like pregnancy or certain neuromuscular conditions).
2. Treatment Day (can be performed day of consult): On the day of your botulinum toxin or filler appointment, you’ll be greeted in our office and made comfortable in a treatment chair. If you’d like numbing cream applied to the injection sites, we can do that beforehand. For those opting for sedation, we’ll follow our standard anesthesia protocols (such as having you avoid food/drink for 8 hours prior, arranging a driver, etc.). Once you’re ready, the injections themselves are quick and nearly painless – you’ll feel only a tiny pinch or pressure. Our surgeon uses ultra-fine needles and gentle techniques to minimize discomfort. If doing botulinum toxin, we may ask you to make certain facial expressions (like frown or smile) to pinpoint the muscles, then a few small injections are made. Filler is injected in small amounts and carefully molded for an even contour. The entire treatment usually takes 15–30 minutes depending on the number of areas.
3. After the Injections: You’ll be able to go home shortly after. One advantage of these treatments is that there’s essentially no downtime – most patients return to work or their normal routine the same day. We will provide you with simple aftercare instructions to ensure optimal results (see below for detailed guidelines). You might have a bit of redness, swelling, or tiny needle marks, but these are usually minor and resolve quickly. Any mild bruising can be covered with makeup the next day. We recommend avoiding strenuous exercise or heavy sun exposure for a day or two (again, see our post-care section). For botulinum toxin, remember that results are not immediate – you’ll notice wrinkles starting to relax in about 3–5 days, with full effect at 2 weeks. Filler results are instant, but do allow a couple of days for any swelling to fully settle and the final look to emerge.
4. Follow-Up and Maintenance: We’ll often schedule a follow-up appointment about 2 weeks after your injections to check your results and take “after” photos. If any touch-ups or enhancements are needed (for example, a bit more botulinum toxin in a certain muscle or you’d like even fuller lips), we can do that at follow-up. Dermal fillers sometimes require a small adjustment, which we usually include as part of your care. Botulinum toxin maintenance: to keep your refreshed look, plan on scheduling botulinum toxin sessions about every 3–4 months (some patients can go 5–6 months, especially with regular treatment). Filler maintenance: depending on the product and area, most patients repeat filler treatments every 6–12 months. We will send friendly reminders when it might be time for a refill. Of course, you are welcome to come in anytime with questions or for additional services – our goal is to support your aesthetic needs long-term.

Pre- and Post-Treatment Instructions for Botulinum Toxin & Dermal Fillers

Patient safety and satisfaction are our top priorities. To ensure optimal results and reduce the risk of side effects, please follow these pre- and post-treatment guidelines for your botulinum toxin or dermal filler appointment. If you have any questions about these instructions, don’t hesitate to call our office – we’re here to help you every step of the way.

Pre-Treatment Instructions

• Scheduling: Try to schedule your injectable appointment at least 2 weeks before any major event or travel. While there’s minimal downtime, some bruising or swelling can occur. Giving a two-week buffer allows any minor bruises to fade so you look your best for the event. It’s also recommended to avoid flying for about a week after treatment, as changes in air pressure could exacerbate swelling.
• Medications & Supplements: For 7–14 days before your treatment, avoid if possible any medications or supplements that can thin your blood and increase bruising. This includes: aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), NSAIDs in general, vitamin E, fish oil/Omega-3 supplements, ginkgo biloba, ginseng, St. John’s Wort, and other herbal supplements known to thin blood. If you need a pain reliever during this time, it’s okay to take acetaminophen (Tylenol), which does not affect bleeding. If you are on prescription blood thinners or have a condition requiring these medications, do not stop them on your own – but let us know, and we’ll plan accordingly. We may also recommend avoiding certain skincare actives (like Retin-A or retinol creams) for 2 days before treatment to reduce skin irritation.
• Alcohol, Caffeine, and Smoking: Please avoid alcoholic and caffeinated beverages for at least 24 hours before your injections. Alcohol can thin the blood and make you more prone to bruising. Also, try not to smoke on the day of treatment; smoking constricts blood flow and can impair healing. Hydrate well with water instead – coming in well-hydrated can actually help you recover faster.
• Health Considerations: If you have a history of cold sores (oral herpes) and are planning lip filler or injections around the mouth, inform us in advance. We may prescribe a preventative antiviral medication to take the day before and day of treatment to prevent a breakout. Reschedule your appointment if you develop any active cold sore, fever, rash, pimple, or infection in the area to be treated – it’s best to receive injections on healthy, unbroken skin. Likewise, if you recently had a COVID-19 vaccination, it’s advised to wait about 2 weeks before or after vaccination to get dermal fillers, just out of caution. Pregnant or breastfeeding patients should postpone cosmetic injectables as a general safety measure.
• Pre-Appointment Prep: On the day of treatment, come in with a clean, makeup-free face if possible. This ensures the injection sites are sterile. You can cleanse gently and avoid heavy cosmetics or lotions. If you are planning on being awake for the appointment, it’s a good idea to eat a light meal or snack and drink water about an hour before your appointment – this helps prevent lightheadedness during injections. Wear comfortable clothing. If you’re anxious, practice some deep breathing or let us know so we can help you stay at ease (remember, sedation is an option if you’re very nervous!).
• Important: Plan to stay upright (no lying down) for about 4 hours after botulinum toxin treatment. This means you shouldn’t schedule any massages, facials, or chiropractor appointments immediately after your injections. Also, avoid dental cleanings or other dental work for about 1–2 weeks after dermal filler injections, and avoid major dental procedures for about 4 weeks after. Dental procedures (especially invasive ones) can potentially introduce bacteria or put pressure on facial areas, so spacing them out from filler treatments is a precaution to prevent any complications.

Post-Treatment Care – Botulinum Toxin

Taking care of yourself after botulinum Toxin will help ensure you get the best results with minimal side effects. Botulinum toxin aftercare is mostly about avoiding activities that might displace the toxin before it fully binds in the muscle.

• Remain Upright: Do not lie down flat for at least 3–4 hours after your botulinum toxin injections. Staying upright prevents the toxin solution from migrating before it settles. So, plan to sit or stand (a relaxed walk is fine) during this time. If you need to rest, use a recliner or prop yourself up with pillows.
• Facial Exercise: While strenuous exercise is off-limits (see next point), you can gently exercise the treated facial muscles in the first hour by making expressions. For example, raise your eyebrows, frown, and smile intermittently if those areas were treated. This is optional, but some providers believe it helps the toxin distribute evenly into the muscle. If you forget, it’s not a problem – the toxin will still do its job.
• No Strenuous Activity: Avoid heavy physical activity, vigorous exercise, or any activity that causes you to sweat or raise your heart rate for at least 24 hours after botulinum toxin. Increased circulation might reduce the efficacy of the toxin or risk bruising. So skip the gym and take it easy for a day. Also avoid bending over repeatedly or doing yoga inversions in that initial 4-hour window post-injection.
• Don’t Touch or Rub the Injection Areas: Keep your hands off the treated area for the rest of the day. Do not massage, rub, or apply firm pressure to your face for at least 24 hours after botulinum toxin. Rubbing could cause the toxin to move from the target muscle to unintended areas. For the same reason, avoid getting a facial, facial massage, or exfoliating scrub for about 1–2 days post-treatment. Avoid hats, visors, headbands, or anything on the head that has the potential to move the toxin.
• Avoid Heat & Sun Exposure: Do not use a sauna, hot tub, or tanning bed for at least 4 hours after treatment (and ideally 24 hours). Also avoid direct sun or heat exposure (like sunbathing or steamy showers) the rest of the day, as heat can increase swelling/bruising. If you must be outdoors, wear sunscreen and a hat. In general, protect your skin – sun avoidance for 1–2 days helps the injection sites heal without extra irritation.
• Alcohol & Blood Thinners: Continue to avoid alcohol, aspirin, and NSAIDs for about 24 hours after treatment to reduce any bruising risk. If you experience a headache (which can occasionally happen after botulinum toxin), use Tylenol (acetaminophen) rather than ibuprofen if needed.
• Makeup and Skincare: It’s best to wait until the next day to apply makeup on the treated areas, if possible, especially if your skin is red or sensitive. If you must use makeup the same day, do so very gently, without rubbing. We advise holding off on Retin-A, retinol, or exfoliating acids for 24–48 hours after botulinum toxin. You can cleanse your face with a mild cleanser and pat dry. Keeping the skin clean and moisturized with a gentle moisturizer is encouraged.
• Common Temporary Effects: You might notice some small bumps at the injection sites or slight redness – these typically resolve within a few hours. Minor bruises can occur; they usually fade in about a week and can be concealed with makeup after 24 hours. Some people feel a mild headache or tight sensation – this should be transient. If needed, an ice pack lightly applied (do not press hard) can help with swelling or discomfort. Always wrap ice in a cloth to avoid direct skin contact, and limit icing to 10-minute intervals.
• When Will I See Results? Keep in mind that botulinum toxin results are not immediate. You’ll start noticing smoothing of wrinkles in about 3–5 days, with full results at 10–14 days post-treatment. It’s normal during that first week to wonder if it’s working – be patient and resist the urge to get additional botulinum toxin “too soon.” We usually schedule a check-up at 2 weeks; at that point, if any area needs enhancements, we can administer more units as appropriate.
• Stay in Touch: If you experience anything unexpected – for example, significant swelling, an uneven result, or any symptoms that concern you – please call us. Serious side effects are exceedingly rare with botulinum toxin. Mild asymmetry can happen if one side’s muscles were stronger, but often this resolves as swelling goes down. We will see you at the follow-up to ensure everything looks great. Remember to avoid new cosmetic treatments on the treated area for at least a week (no facials, laser, etc., for 7 days). And importantly, **do not schedule any facial massage or manipulation for 1-2 weeks unless we give the OK.

By following these botulinum toxin aftercare guidelines, you help the treatment work properly and reduce chances of side effects. Now, let’s cover filler aftercare, which has its own set of instructions.

Post-Treatment Care – Dermal Fillers

Dermal fillers provide instant volume enhancement, but they also require gentle care afterward to ensure the product stays perfectly placed and you heal well. Here’s how to care for yourself after filler injections:

• Do Not Squeeze or Manipulate Treated Areas: It’s critical that you avoid touching, pressing, or massaging the injection sites for at least 48 hours after filler treatment. Fillers are moldable right after injection; poking or prodding could move the product or create unevenness. If we gave you specific instructions to massage (in rare cases for certain lumps), only do so as directed. Otherwise, hands off! For lip fillers, this means no firm kissing, puckering, or using straws for 48 hours after treatment. Also, avoid applying lipstick or lip balm for 24–48 hours, as the pressure can disturb the filler.
• Reduce Swelling & Bruising: Some swelling is normal, especially with lip or cheek injections. Cold compresses can be applied gently for the first day to minimize swelling and discomfort – 10 minutes on, 10 minutes off, as tolerated, for the first few hours. Don’t put ice directly on the skin; use a cloth barrier. Arnica montana (an herbal remedy) can help bruising – you may apply arnica gel to unbroken skin or take arnica tablets if you wish (optional). Over-the-counter bromelain supplements or eating fresh pineapple may also help bruises resolve faster, though results vary. If you have significant bruising, it typically fades in about 7–10 days. You can cover bruises with makeup starting the next day (or 2 days later for lip area). We suggest using a gentle, clean makeup applicator and not tugging at the skin.
• Elevation & Rest: For the first night or two after filler, it’s best to sleep on your back with your head elevated on pillows. This helps minimize swelling and avoids pressure on the treated areas. Try not to sleep on your side or stomach the first couple nights.
• Avoid Vigorous Activity: Just like with botulinum toxin, skip strenuous workouts, heavy lifting, or vigorous exercise for about 24–48 hours post-filler. Elevated heart rate and blood pressure can worsen swelling or bruising. It’s fine to do light walking and normal daily activities, but hold off on that high-intensity gym class or long run for a couple of days.
• Heat & Sun: Stay out of saunas, steam rooms, hot yoga classes, or very hot showers for at least 48 hours after filler. Heat can increase inflammation in the area. Also avoid direct sun exposure on your face for several days; sun and heat can exacerbate swelling and bruising. If you must be outside, use sunscreen and a hat. Once any puncture points have closed (usually within 24 hours), you can apply sunscreen on those areas too. (Using sunscreen regularly will also help maintain your results, since sun damage counteracts all anti-aging efforts!)
• Skincare Products: Do not use harsh or active skincare products on the treated areas for about 2 days. This means no Retin-A/retinol, alpha or beta hydroxy acid products, or exfoliants for 48 hours post-filler. Gentle cleanser and a basic moisturizer are fine (again, avoid heavy rubbing when cleansing). Also avoid very hot or spicy foods for the first day, as your lips may be numb and heat can be irritating.
• Makeup: It’s best to avoid makeup for the first 24 hours after filler, especially on needle entry points. If you need to use it, do so very lightly and ideally after at least 12 hours. Mineral makeup or Arnica-based concealer can be used to camouflage bruises on day 2 onward. Always start with clean hands and clean applicators to reduce infection risk.
• Watch for Lumps or Irregularities: It is normal for the treated area to feel firm or slightly bumpy for a week or two. As the filler integrates and swelling subsides, the area typically softens. If you notice any visible lumps, do not attempt to massage them yourself. Often, what feels like a lump is just swelling. We will check you at your follow-up and can gently massage or even use a touch of dissolving enzyme if needed for any persistent unevenness. Major complications with fillers are rare, but if you were to notice increasing redness, warmth, or severe pain in an area, let us know immediately. This could indicate an infection or vascular issue, which we can treat right away. Again, these are very uncommon in experienced hands, but we’re extra vigilant about safety.
• No Dental Work or Facials for 1–2 Weeks: As mentioned in pre-care, avoid scheduling dental cleanings, dental procedures, or facial massages and skin treatments (like facials, microneedling, etc.) for at least 2 weeks after filler. This precaution helps reduce risk of infection and prevents pressure on the new filler. Also, if you plan to have a vaccination, space it a few days away from filler treatment to avoid confusing any side effects.
• Be Patient with Results: You’ll see an immediate enhancement from your fillers, but remember that final results are seen once swelling has gone down. For some, that’s 2–3 days; for others, it may take up to a week or even two for subtle swelling to fully resolve (especially for lips, which tend to swell more). During this time, one side might appear slightly different than the other – don’t worry, this is usually due to uneven swelling. By the two-week mark, things should look balanced and gorgeous. If you have any concerns at that point, we’ll address them.
• Follow-Up: We typically schedule a follow-up around 10–14 days post-filler to make sure you’re healing well and love your results. If a touch-up or additional filler is needed for symmetry or optimal correction, we can do it at this time. Often, we deliberately under-correct slightly on the first visit (especially for first-time lip filler patients) and add more later if desired – it’s part of our “start conservatively” approach to ensure a natural outcome.
• Long-Term Maintenance: Depending on the type of filler used, results can last anywhere from 6 months to 18 months. We will advise you on what to expect. You might notice the effect gradually diminishing; at that point, you can schedule a maintenance filler appointment. There’s no harm in letting it fully wear off either – you’re in control of how and when you want to upkeep your look. Many patients find that maintaining a small, regular amount of filler yields the most consistent, natural results over time.

Questions or concerns? We are just a phone call away. If you experience anything out of the ordinary – such as intense pain, areas of the skin that look dark or dusky, signs of infection (fever, chills, increasing redness) – contact us immediately. These issues are rare, but we always want to err on the side of caution and see you back if needed. For most mild concerns (minor asymmetry, a small persistent lump, etc.), we’ll likely ask you to wait the full two weeks for things to settle, since time often remedies these. At your follow-up, we can discuss any adjustments.

By following these pre- and post-treatment instructions, you can ensure your botulinum toxin and filler experience is as smooth as possible and enjoy beautiful results. Your comfort, safety, and satisfaction are our priority at Hermitage Oral Surgery. We look forward to helping you look your best!

If you choose sedation

• NPO 8 hours: Nothing by mouth for 8 hours before your sedation start time. No food, milk, gum, candy, or mints. You may take essential morning medications with a small sip of water only unless we tell you otherwise.
• Driver required: Arrange a responsible adult driver who is 18 or older. They must bring you, drive you home, and stay with you for the first night. Rideshare is not acceptable unless the adult escort rides with you.
• Plan the day: Do not plan to work, drive, operate machinery, drink alcohol, or sign legal documents for 24 hours after sedation.
• What to wear and bring: Wear short sleeves or loose clothing for monitoring and IV access. Remove contact lenses and all jewelry. Bring a full medication list and inhalers if you use them.
• Substances: No alcohol or recreational drugs for 24 hours before. No smoking on the day of sedation.
• Health check: Call to reschedule if you develop a cold, cough, wheezing, sore throat, fever, or any active infection. Inform us if you might be pregnant or if you are breastfeeding.
• Policy: If fasting was not followed or you do not have an eligible driver, the sedation appointment will be rescheduled for safety.

If you have any doubts about these instructions or something isn’t clear, please call or text us at Hermitage Oral & Maxillofacial Surgery Phone Number (615) 883-0067. We are also available via email at [email protected]. We’re happy to clarify and guide you. Thank you for trusting us with your care and enjoy your new rejuvenated look!