Medical History Assessment

Neurotoxins

The general, multisystem medical review preceding treatment with botulinum toxins should document medication usage, allergies, other planned procedures, and previous use of neuromodulator or filler treatments. The evaluation should ascertain whether the patient has conditions for which there are contraindications, warnings or precautions to botulinum toxins, such as known hypersensitivity reactions to botulinum toxin or to any ingredient in the formulation and the presence of infection at the injection site.

Getting a complete picture of the patient’s health and medical history is crucial for determining if neurotoxins are appropriate and can be performed safely.

Here are some key questions an injector should ask new patients during a medical history assessment:

• What medications are you currently taking (prescription, over-the-counter, supplements)? This helps identify any medications like blood thinners, muscle relaxers, or aminoglycoside antibiotics that may interfere with Botox.
• Do you have any allergies, especially to any ingredients in Botox like albumin or botulinum toxin? Allergies need to be identified.
• Have you ever had a negative reaction or complication from Botox or dermal fillers before? If so, what happened? Prior experiences help gauge risk.
• Do you have any pre-existing neuromuscular conditions like myasthenia gravis, Lambert-Eaton syndrome, ALS, or muscular dystrophy? Botox is contraindicated.
• Do you have any issues with swallowing or breathing? These can be exacerbated by Botox if injected improperly near relevant muscles.
• Are you pregnant, trying to become pregnant, or breastfeeding? Botox is not recommended.
• What are your goals and expectations for your Botox treatment? Goals should be realistic.
• Do you bruise easily or have a bleeding disorder? This increases risk of bleeding/bruising at injection sites.

Fillers

Here are some important medical history questions an injector should ask patients considering dermal fillers:

• What medications are you taking? Medications like aspirin, ibuprofen, warfarin, etc. can increase bleeding/bruising risk.
• Do you have any allergies, especially to lidocaine or hyaluronic acid ingredients sometimes found in fillers? Identifying allergies is key.
• Have you ever had a negative reaction or complication from dermal fillers before? Previous experiences help determine risks.
• Do you have any autoimmune conditions like lupus, rheumatoid arthritis, or fibromyalgia? There may be increased risks.
• Have you ever had cold sores or herpes infections around the mouth? The infection can be reactivated by filler injections near the lips.
• Do you have any blood or bleeding disorders? These increase the risks of bleeding and bruising.
• Have you ever had keloid scarring before? There is a risk keloids could form after filler injection.
• Are you pregnant, breastfeeding or trying to become pregnant? Most fillers have not been studied sufficiently during pregnancy.
• What are your goals and expectations for treatment? Unrealistic expectations should be addressed.
• Have you ever had facial surgery or implants? Anatomy changes can affect filler placement.

Again, a complete medical history helps assess risks and determine if dermal fillers are appropriate for the individual patient. This helps ensure safe and effective filler injections.