When it comes to your wedding, there’s no denying that there are many (many) logistics and planning to be done ahead of time. And while it may not be the first thing that comes to mind, your pre-wedding beauty prep plan definitely requires a little foresight and dedicated attention. No matter whether you’re figuring out when to schedule hair color appointments, booking a teeth whitening session or two, or if you are just trying to elevate your skincare regimen, the sooner you can get a jump on things, the better.
That rule holds especially true when it comes to cosmetic injections, such as Botox and fillers. Think of it this way: “You buy your dress a year or so ahead of time, and then go in for several fittings closer to the wedding date. The sample principle applies for cosmetic injections,” says plastic surgeon Dr. David Shafer. Especially if you’re a first-timer, you want to find an experienced, reputable provider and get used to how the injections look and the result they deliver ASAP. Then, you can book the final ‘tweak’ appointments as the wedding approaches, he says.
Meet the Expert
Dr. David Shafer is a double board-certified plastic surgeon in New York City.
Ahead, top experts explain everything there is to know about cosmetic injections—including the type of results you can expect, potential side effects, and, most importantly, when exactly to book them—and weigh in on the one cosmetic treatment that isn’t a great option for brides-to-be.
What it is: “Botox is an injectable that changes or softens muscle movement, reducing and even preventing the formation of lines and wrinkles,” explains plastic surgeon Dr. Sarmela Sunder. “It prevents the release of acetylcholine, a neurotransmitter that all nerve fibers need in order to trigger muscle movement.”
Meet the Expert
Dr. Sarmela Sunder, a double board-certified plastic surgeon in Beverly Hills.
What it can do: Quite frankly, a whole lot. While it’s most commonly known for its wrinkle-smoothing benefits, Sunder points out that Botox can be used to help remodel muscles in the face, ultimately changing the shape of the face itself. It can also be used to make pores appear smaller, and even create the appearance of a lifted brow, she adds.
Who’s a candidate: Given this wide range of benefits—and the fact that it can prevent wrinkles from forming in the first place—pretty much everyone is a good candidate for Botox, according to Shafer. That being said, because of its mechanism of action, it’s most often used to treat dynamic wrinkles, AKA wrinkles caused by repeated muscle movement. Examples include the ‘11s’ or frown lines in between your eyebrows, crow's feet, and horizontal lines on the forehead. “Botox can be very helpful once you see wrinkles that not only appear when you move your face but stick around even after you stop moving,” says Sunder. And even if these lines are deeper and more etched in, Botox can still help soften those, notes Shaefer.
When to do it: Keep in mind that while Botox is a super quick treatment that usually takes only about 15 minutes, its effects are not instantaneous. “The general rule of thumb is that it takes three to five days for the effects of Botox to kick in, and those effects then last three to five months,” says Shafer. However, it takes a full two weeks to see the complete effects of the injectable, notes Sunder. Point being, this isn’t something to be done the week before the big day.
Regardless, both doctors say it’s always a good idea to start Botox injections—particularly if you’re a newbie—as soon as possible. That means at least six or more months prior to your wedding date. “You want to have enough time to do a few sessions so that you can get comfortable with how it looks and feels, and so that you and your doctor can discuss the best areas to treat and the amount of Botox that works best for you,” advises Sunder. (Shafer also notes that if you are trying to smooth out deeper, etched-in wrinkles, it will take more than one session to do so.) As you approach the wedding day, schedule your last Botox appointment for no later than one month prior. This will give you that two-week period for it to take full effect, and you’ll still have an extra two-week buffer in case anything needs to be slightly tweaked, she says.
Aftercare: Both doctors we spoke with point out that the aftercare required is pretty minimal. More important is pre-care, namely stopping any type of blood-thinning medications or supplements for both two weeks before and two weeks after Botox injection. (Though of course, discuss this with your doctor first.) There are many vitamins and supplements that people commonly take—omega 3 fatty acids, green tea, ashwagandha—that thin your blood, subsequently increasing the likelihood of bruising, says Sunder.
Post-injections, avoid putting your head down or upside down—that means no laying down, no downward dog-ing—for four to six hours after. You’ll also want to avoid rubbing the injected area. Both can end up inadvertently moving the Botox and causing it to spread into an unwanted area, cautions Sunder.
Potential side effects: Some minor bruising is the most common, but there are a few other, much more problematic potential issues that can occur if Botox isn’t injected properly. (Consider this just one of the many reasons why it’s imperative to always seek out licensed, experienced injectors for any type of cosmetic injections.) This includes things such as a dropping eye, dropping brow, or even an uneven smile. And while Botox is not permanent (it does wear off eventually), there’s no way of immediately reversing the effects if you’re not happy with the outcome.
Average cost: Botox is priced per unit, but the cost varies greatly based on your geographic location and the type of provider you see. The total cost is based on how many units are used, which depends on the area being treated. However, broadly speaking, the doctors we spoke with referenced a range of anywhere from $200-$1500 for a Botox treatment.
What they are: Fillers, such as Juvéderm, Restylane, and Radiesse, are made of hyaluronic acid, a sugar molecule that’s naturally occurring in the body, says Shafer. The fact that it’s made of a substance that’s already in our body means that they have a very high compatibility, he adds. In other words, they’re very unlikely to cause issues, unlike old-school collagen fillers that were used back in the day.
What they can do: When you think of fillers, think volume. “They can be used in any area where you’re lacking volume or where you simply want more,” says Sunder. There are different types of hyaluronic acid fillers (which essentially differ in terms of viscosity and density), with options that can be used anywhere on the face. The most common areas treated include the nasolabial folds, cheeks, and lips.
Who’s a candidate: Again, anyone who wants to add some extra fullness, volume, or definition to their face. Fillers can be used to plump lips, create a more defined cheekbone or jawline, or even to tweak the shape of your nose, says Sunder.
When to do them: One of the nicest things about fillers is that they last for a long time, especially as compared to Botox. The exact longevity depends on the type of filler, where it’s injected, and how your own body metabolizes it, but think anywhere from one to even two years, rather than the few months you get with Botox. Sunder says it’s best to come in for a filler appointment as soon as you get engaged; this gives you enough time to get used to how the filler looks and feels, she says. And while it may very well last until your wedding day, you can then always come in for a tiny bit more—a top-off, as it were—closer to your nuptials.
The ideal timing for that appointment is about three weeks out. Swelling is very common with fillers, and this gives you enough time for that swelling to fully dissipate, notes Sunder.
Aftercare: Bruising is more likely with fillers than Botox, so the same rule about avoiding blood thinners before and after applies. You should also avoid putting any kind of excess pressure on the injected area, adds Shafer. You want to give the filler at least a few days to fully settle into place, and putting pressure can end up moving it around. Ideally, sleep on your back (so that you don’t smush your face) and steer clear of things such as facial massage and even facial rollers for a few days to a week.
Potential side effects: Again, swelling and bruising are the most common. A more serious complication is vascular occlusion, where, if improperly injected, the filler can end up blocking blood flow. Again, it’s why finding an experienced, licensed injector is paramount. The good thing about filler? It can be dissolved using an enzyme known as hyaluronidase. So, if you do have an issue, or you really don’t like the result, it can be reversed, says Sunder.
Average cost: Fillers are priced by syringe. As is the case with Botox, this cost varies based on location and provider, but our doctors said anywhere from $600-$1500 per syringe is average. How many syringes are needed depends on the area treated, but two to three is common. Point being, you’re looking at thousands of dollars rather than hundreds (though again, the results last longer).
What it is: Kybella is an FDA-approved "fat-melting" injectable administered in the submental region of the body, aka the space between the chin and neck. The key ingredient is something called deoxycholic acid, a modified form of a naturally occurring substance in the body (bile) that helps to destroy fat cells past the point of no return.
What it can do: Kybella is a great option for those looking to decrease excess fat in the chin and neck region, especially if you're hoping to avoid surgery or laser altogether.
Who's a candidate: Anyone who would like to address excess chin/neck fat may receive this treatment.
When to do them: Kybella requires multiple sessions spaced one month apart (generally three to four sessions total, though you may start seeing results after two sessions). Swelling may occur for up to ten days following treatment, so plan for your final session to be at least two weeks out from your wedding day.
Aftercare: Swelling, redness, and tenderness are all common post-injection for about three to five days, according to Dr. Steve R. Fallek, an NYC-based plastic surgeon. However, downtime is minimal, and you can return to work following your treatment.
Potential side effects: Board-certified dermatologist Dr. Michele Green tells our sister site, Byrdie that some patients with skin laxity (when the skin loses elasticity) may find that they experience a droopy appearance in their skin after injections as there is a loss of volume from the dissolution of fat. And, as noted previously, some people may be more prone to swelling which can last for up to 10 days.
Average cost: Green says that in her practice, the average cost is generally $1500 per session, but depending upon the amount of excess fat in the area, you may require more vials than average, which range anywhere from $600-$800 per vial.
There’s one other common injectable procedure—fat grafting, which involves harvesting your own fat from somewhere on your body, purifying it, and injecting it back into your face. As with fillers, the purpose is to add back volume, but both Shafer and Sunder advise against this as a treatment for brides, for several reasons. “Fillers offer a much more predictable result. When fat is injected, it can absorb into the body unevenly. You may put in 1CC, but the body can break down some of that and only a little bit gets left where it’s meant to go,” says Shafer. Similarly, whatever fat does take, those fat cells will shrink or expand if you lose or gain weight, respectively. With brides, some of whom may choose to lose weight closer to the wedding, you can end up losing that volume, he adds. Sunder points out that, while fat transfer is a great option in the right patient and when performed properly, it can take up to a full year for it to really take effect, a timeline that just doesn’t work for most brides, especially given the unpredictable results.
Satriyasa BK. Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol. 2019;12:223-228. doi:10.2147/CCID.S202919
Witmanowski H, Błochowiak K. The whole truth about botulinum toxin - a review. Postepy Dermatol Alergol. 2020;37(6):853-861. doi:10.5114/ada.2019.82795
Signorini M, Liew S, Sundaram H, De Boulle KL, Goodman GJ, Monheit G, Wu Y, Trindade de Almeida AR, Swift A, Vieira Braz A; Global Aesthetics Consensus Group. Global Aesthetics Consensus: Avoidance and Management of Complications from Hyaluronic Acid Fillers-Evidence- and Opinion-Based Review and Consensus Recommendations. Plast Reconstr Surg. 2016 Jun;137(6):961e-971e. doi: 10.1097/PRS.0000000000002184
Shamban AT. Noninvasive Submental Fat Compartment Treatment. Plast Reconstr Surg Glob Open. 2016 Dec 14;4(12 Suppl Anatomy and Safety in Cosmetic Medicine: Cosmetic Bootcamp):e1155. doi: 10.1097/GOX.0000000000001155.
Shih L, Davis MJ, Winocour SJ. The Science of Fat Grafting. Semin Plast Surg. 2020 Feb;34(1):5-10. doi: 10.1055/s-0039-3402073