Considering botox for the first time? "What should you think about before botox" is a sensible question. Here is a complete checklist of preparations, medicines to avoid and questions to ask.
The days before botox
Avoid these medicines 3–7 days before
To reduce bruising and the risk of bleeding (consult a doctor before pausing any medicines):
- Aspirin
- Ibuprofen (Ipren)
- Naproxen
- Fish oil / omega-3 in high doses
- Ginkgo biloba
- Vitamin E in high doses
- Cranberry tablets
- Garlic supplements
Important: Never stop blood-thinning medicines (Eliquis, Waran, Pradaxa, etc.) without a doctor's approval.
Avoid alcohol
24–48 hours before. Alcohol increases the risk of bleeding and the risk of bruising.
The day before
- Sleep at least 7 hours
- Avoid intense exercise
- Drink water — well-hydrated skin heals faster
- Eat properly — an empty stomach can make you unsteady
The day of the treatment
- Eat a light meal 1–2 hours before
- Come without make-up on the treatment area
- Bring ID and medical records if you have allergies
- Wear a top/T-shirt (no tight collars)
Important questions to ask the practitioner
- "What licence do you hold?" — physician, nurse or dentist is a legal requirement
- "Which product do you use?" — Botox®, Azzalure®, Bocouture®, Xeomin® are all approved
- "How many units do I need?" — varies by area and person
- "What does it cost in total?" — ask for a written price quote
- "What is included?" — consultation, treatment, follow-up
- "What happens if I am not satisfied?" — touch-up policy
- "Which side effects should I look out for?"
Who should avoid botox?
- Pregnant and breastfeeding women
- People with myasthenia gravis or other neuromuscular diseases
- People with a known allergy to components of the product
- People under 18 (prohibited by law)
- Active infection or skin condition at the injection site
Realistic expectations
- Botox removes dynamic wrinkles — not deeply etched static lines
- The effect appears gradually over 3–14 days
- Duration: 3–6 months
- The best result is seen after several treatments
The legal requirement — cooling-off period before treatment
Before an aesthetic injection treatment, a cooling-off period of at least two days applies after you have received the information about the treatment. If the same type of injection treatment is repeated within six months, no new cooling-off period is required. During the consultation:
- Physician's assessment of suitability
- Discussion of goals and expectations
- Informed consent
- Written price quote
- Do not touch the area for 4 hours
- Do not lie flat for 4 hours
- No intense exercise for 24 hours
- No sauna / hot bath for 24 hours
- No alcohol for 24 hours
- No facial massage for 2 weeks
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Day-by-day timeline
| Time | What happens | What you can do |
|---|
| –7 days | Preparation | Avoid ibuprofen/aspirin, fish oil, alcohol |
| Before treatment | Consultation and statutory cooling-off period | Ask questions, sign consent |
| Day 0 | Treatment | Avoid make-up, eat a light meal beforehand |
| +4 h | Swelling begins | Do not lie flat, do not touch the area |
| +24 h | Maximum swelling possible | No exercise, sauna or alcohol |
| +3 days | Swelling subsides | Can cautiously resume normal routine |
| +7 days | Interim assessment | Massage lumps as instructed |
| +14 days | Final result visible | Follow-up check + possible touch-up |
| +2 months | Stable result | Avoid professional massage |
+3–6 months (botox)
+6–12 months (fillers) | Effect wears off | Book a top-up in good time |
7 questions you must ask at the consultation
- "Can I see your IVO registration and your licence?" — Mandatory for a reputable clinic.
- "Which product do you use, and can I see the packaging?" — Approved in Sweden?
- "Exactly how much product do you recommend, and why?" — There should be a justification.
- "What is included in the price — consultation, follow-up, touch-up?" — Everything in writing.
- "Do you have hyaluronidase on site?" — Safety equipment (applies to fillers).
- "What is your policy if I am not satisfied?" — Free touch-up within X weeks?
- "Which acute symptoms should I contact you about?" — A trained practitioner explains clearly.
Expert tips — how to maximise the result
- Hydration: Drink 2 litres of water a day for 2 weeks before and after — hyaluronic acid binds moisture.
- Sleep: 7–9 hours helps healing and reduces swelling.
- Sun protection: SPF 30+ daily — UV breaks down filler faster.
- Stopping smoking: Even temporarily — nicotine impairs healing.
- Moderate exercise: Resume after 48 hours, full training after 1 week.
- Keep your head elevated: For the first 4 hours — reduces diffusion of botox.
- No facial massage for 2 weeks: Avoid professional beauty treatments.
Detailed safety analysis
Risk ladder — from mild to severe
| Level | Risk | Frequency | Action |
|---|
| 1 | Swelling, bruising | 70–90% | Heals on its own in 3–7 days |
| 2 | Headache, redness | 20–30% | Paracetamol, rest |
| 3 | Asymmetry in the first week | 5–10% | Assess after 14 days |
| 4 | Lumps, migration | 1–3% | Hyaluronidase / massage |
| 5 | Infection | < 0.5% | Antibiotics, seek urgent care |
| 6 | Vascular occlusion | < 0.1% | URGENT hyaluronidase within hours |
| 7 | Visual disturbance | < 0.01% | 112 immediately |
- 🚨 White, grey or dark blue skin around the injection site
- 🚨 Severe pain that gets worse (not normal tenderness)
- 🚨 Sudden changes in vision or double vision
- 🚨 Difficulty breathing or swallowing
- 🚨 Fever > 38.5 °C + spreading redness (infection)
- 🚨 Marked asymmetry that gets worse
- 🚨 Loss of muscle control far from the injection site
In case of acute symptoms: Call 112 or go straight to the emergency department. For moderate symptoms: contact the clinic within 24 hours. All reputable clinics have an on-call service for such cases.
Checklist — how to verify that a clinic is safe
- Licence: Check the practitioner's licence at legitimation.socialstyrelsen.se. Must be a physician, nurse or dentist.
- IVO registration: The clinic should be listed in IVO's register — search at ivo.se.
- Hyaluronidase on site: Ask directly. If the answer is "no" or unclear — choose another clinic.
- Product name visible: Ask to see the original packaging before the treatment.
- Medical records: Legal requirement. You should receive written documentation.
- Statutory cooling-off period: Before an aesthetic injection treatment, a cooling-off period of at least two days applies after you have received the information about the treatment. If the same type of injection treatment is repeated within six months, no new cooling-off period is required.
- Written consent: Legal requirement. You should sign an informed consent form.
- Follow-up included: Check-up visit after 2 weeks.
- Clear price: Written quote with no hidden costs.
- Credible reviews: Reviews with concrete details about the treatment are the most reliable.
- Pregnant and breastfeeding women: Injection treatment is advised against entirely.
- Neuromuscular disease (myasthenia gravis, ALS, etc.): Contraindicated for botox.
- Blood-thinning medication: Increases the risk of bleeding — requires an additional consultation with a doctor.
- Autoimmune diseases in an active flare-up: May increase the inflammatory reaction.
- Active herpes or skin infection: Wait until it has healed.
- Previous filler complications: Discuss with the practitioner — hyaluronidase may be needed first.
