Botox Treatment | Sheperd Integrative Dermatology in Mount Pleasant, SC

So you’re thinking about getting Botox in Charleston or Mt. Pleasant, SC? The popular injectable of botulinum toxin works by paralyzing facial muscles, thus smoothing out lines and wrinkles in the skin. Despite that slightly startling fact, the injectable was one of the most popular aesthetic procedures in 2018, namely because the results are remarkable, the downtime minimal, and the side effects nearly nonexistent. Nonetheless, if you’re considering Botox for the first time, you probably have a lot of questions swirling around in your mind. Below, Sheperd Integrative Dermatology professionals break down everything you need to know before getting Botox.

1. A Consultation Is Crucial

Whether it is the same day or a week before the procedure, set up a consultation with your healthcare professional. It is crucial that you are both on the same page so that you have realistic expectations and are happy with the results. Consultation includes a discussion of cosmetic concerns, treatment options, and risks and benefits. Our experienced professionals at Sheperd Integrative Dermatology in Mount Pleasant carefully evaluate how different areas of your face naturally move when smiling, frowning, and raising your eyebrows so you will have natural-looking results.

2.Botox Is Not The Same Thing As Filler

Botox freezes muscles to stop creases and wrinkles caused by facial expressions. These are typically found in the upper face, such as the forehead and around the eyes (crow’s feet). Fillers, on the other hand, use hyaluronic acid and similar substances to “fill in” plump areas that have lost volume and smoothness. This includes wrinkles around the mouth, thin lips, and cheeks that have lost fullness. They may also be used on forehead wrinkles and other areas that need extra volume for a smoother look.

Because Botox and fillers are different substances designed for different uses, they can sometimes be combined in one treatment. For instance, someone may use Botox to correct lines between the eyes and a filler to correct smile lines around the mouth. Our healthcare practitioners at Sheperd Integrative Dermatology will help you design a treatment plan catered to your individual needs.

3.Blood-Thinning Meds Aren’t The Only Thing To Avoid Pre-injection

During your consultation, one of our Sheperd injection professionals will tell you to avoid anticoagulants (aspirin and ibuprofen) since those types of drugs prevent blood clotting and increase the risk of bruising should the needle hit a blood vessel. Some other seemingly harmless products to avoid include fish oil, multivitamins, green tea, cinnamon, ginger, and red wine a full week before treatment. Interestingly, some antioxidants increase the fragility of blood vessels and prevent clotting. Call us our swing by our Mount Pleasant office at least two weeks ahead of time for a complete list of what to avoid.

4.It Doesn’t Hurt Much

Even patients who are scared of the mere sight of needles can confirm that Botox doesn’t really hurt. You definitely feel the pricks, but the pain isn’t so bad that you need to ask for a break.

5.It’s Not Likely That You’ll Bruise

A common misconception is that Botox leaves bruising. While there’s always a risk of bruising, it’s pretty minimal (especially with our highly experienced SID professionals). Neurotoxins generally require finer needles and are placed more superficially than fillers, reducing the risk to potentially hit a vessel.

6.The Botox Buzz

Botox given between the eyebrows can give a temporary sensation of dizziness or headache. This is usually from slight swelling where the fluid was injected, and resolves within ten to fifteen minutes.

7.You Can Go Right Back To Work After The Injection

You read that right. Besides from providing almost instant results, there’s zero downtime following the injection. While you may experience some swelling and a bit of numbness, you can go back to work or continue with your day right after the appointment. Generally, you can expect the swelling to go down within an hour or two.

8.What Can’t You Do After Getting Botox?

Although there may be no recovery time, there are a few limitations on what you can do right after you leave your appointment so that the injectable doesn’t move from the area where it was administered and to avoid increasing blood flow to your face (exacerbating swelling). This includes heavy cardio, yoga, massages, or hitting up a sauna or a steam room at the gym. Fun fact: intense heat can deactivate Botox. You’re also going to want to avoid flying for several hours after treatment, as there is some concern that change in cabin pressure will affect the spread of toxin to muscles you do not want affected.

9.The Results Last Up To 4 Months

To keep results looking optimal, avoid excess alcohol, smoking, sun exposure and getting stressed which all contribute to accelerated collagen breakdown. Our practitioners recommended retreatment every four to five months.

10.What’s The Best Age To Start Botox?

There’s no right or wrong age to get Botox; it’s a decision that’s ultimately up to you and whether you’re looking to enhance a certain feature and minimize signs of aging. At Sheperd Integrative Dermatology, we treat patients ranging from their late twenties to their early seventies. If you’re starting to see lines in your mid-to-late twenties or early thirties, it’s best to be proactive about it. Put simply, people should be assessed on a case-to-case basis.

Give us a call to learn more about Botox today or visit our website for more information or frequently asked questions!

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Rebecca Repaire


Becky is a board- certified Physician Assistant and has practiced Dermatology for over 18 years. She graduated magna cum laude from her undergraduate degree at the University of Georgia, then completed her Physician Assistant studies at the Medical University of South Carolina. She now practices medical, surgical and cosmetic dermatology. She has done extensive training in the use of a dermatoscope and equally extensive training in surgical techniques for the removal of skin cancers. As her practice and skill have continued to grow, cosmetic dermatology has become a passion of hers and she devotes herself enthusiastically to continuing training to ensure she remains at the forefront of innovations with Botox, fillers, threads, and other techniques. She believes that our skin is a reflection of our overall emotional and physical well-being, and she delights in helping patients find their inner beauty.

Amy Jetter


Amy brings her whole heart to her role on the Sheperd cosmetic team.  A graduate of Elon College and the Medical College of Virginia, Amy has been a board-certified nurse for over 30 years.  Bringing her skills as an ICU nurse into her role in cosmetic patient care, Amy provides a warm, reassuring presence to all her clients, listening to their concerns and collaborating with them in a plan to bring forth and enhance their natural beauty.  A standing member of the American Association of Plastic Surgery Nurses and a past RN trainer in cosmetic and aesthetic procedures, Amy offers all types of laser treatments, botox and dermal filler injections, and chemical peels.

Melissa Mancuso

Body Contouring Specialist

Melissa has six years of experience in body contouring, beginning with her role as the CoolSculpting representative for Maryland, Virginia, and the District of Columbia. Since joining the Sheperd team, she has received additional training and now offers chemical peels, Vivace micro-needling, and Diamond Glow dermal infusion. She loves helping patients feel good about their bodies and teaching them about how the various cosmetic procedures can help them achieve the results they are seeking.

Margaret Gierhart


Margaret, a South Carolina native, is a Licensed Esthetician and makeup artist with over 20 years of experience in the beauty industry. She earned a BA in Psychology from the University of South Carolina. She began her career in beauty as the resident makeup artist for Bobbie Brown cosmetics at Saks Fifth Avenue in Charleston. In order to expand her knowledge, she earned her degree in esthetics from Trident Technical College, graduating with honors. She joined the Sheperd Integrative Dermatology staff in 2014 and is certified in a wide array of cosmetic procedures and skin care products. Her offerings include laser skin resurfacing, IPL, micro-needling, chemical peels, radio frequency, laser hair removal, and body contouring. Her background in both psychology and artistry gives her a deep capacity to care for patients and understand what makes them feel beautiful. A mother of two daughters, Margaret understands beauty as not only external appearance, but also as a manifestation of the inner qualities of kindness, generosity, and well-being.

Madeline Anderson


Maddie is a board-certified Physician Assistant and a Lowcountry native. She obtained her undergraduate degree from Clemson University and then went on to earn a Master of Science in Physician Assistant Studies from the Medical University of South Carolina, graduating with highest honors. While in PA school, Maddie served as a Student Representative for the SC Society of Dermatology Physician Assistants. After graduation, she completed a six-month advanced dermatology internship here at Sheperd Integrative Dermatology. She also completed the Diplomate Fellowship with the Society of Dermatology Physician Assistants. Maddie has a heart for medical missions and is passionate about patient education. Her free time is shared with her family, her friends, and her two fur babies!

AnnaKathryn Keiper


AnnaKathryn completed her Doctorate degree at the Medical University of South Carolina and has seven years of experience in dermatology. She has completed additional training in medical dermatology, cosmetic dermatology, and functional medicine. She provides skin cancer screenings, surgical removal of skin cancers, treatment of precancerous lesions, extractions of cysts, and the treatment of acne. In the cosmetic domain, she provides laser, filler, and neurotoxin treatments. Certified through the Institute of Functional Medicine, AnnaKathryn has a special focus on wellness, including weight loss and diet consulting. She uses her expertise in this field to create an individualized program to help each of her patients achieve optimal wellness supporting them in maintaining vibrancy and vitality throughout their lifespan.

Allyson Harrell-Garrison


Ally is a board-certified Physician Assistant and a Diplomate of the Society of Dermatology Physician Assistants, their highest rating. She is a graduate of Clemson University and earned her Master’s degree in Physicians Assistant studies at the University of Alabama; additionally, she completed a dermatology fellowship at Charlotte Dermatology in North Carolina. For more than ten years, her focus on both medical and surgical dermatology has included identifying and treating skin cancers as well as managing biologic medications for psoriasis and atopic dermatitis. Ally has a strong love of surgical dermatology and she performs surgeries every day in the clinic, including excisions of cysts and skin cancers. She also loves the challenge of a difficult case! On the cosmetic side, Ally is a skilled injector of both Botox and Dysport. She sees compassion and empathy as vital qualities that she brings to all her patient interactions. She is mindful that skin cancer screenings can be frightening or overwhelming; her warm, calm manner and her focus on patient education throughout each appointment make her an outstanding clinician.
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