Not that uncommon

Bruising or lumps the first  few days after Botox is not uncommon. But, it usually goes away within a couple of days.  If it persists, you should probably go see your doctor.

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After Botox injections, it is normal to have temporary swelling - similar to mosquito bite, which resolves after a few hours. This is due to localized swelling around the site of injection. Occasionally, you can have areas of swelling due to small hematomas (bruises) which may take a few days to resolve. These are generally localized and may be tender to the touch. Additionally, you can have areas of swelling from localized infections from the needle puncture. However, these are also self-limiting and should resolve within a few days. On rare occasions, if the Botox paralyzed your forehead so much that your eyebrows dropped lower than your orbital rim (the bone under your eyebrow), the bone may appear as a bump or swelling just above your eyebrow. Finally, if you are pushing and poking the areas aggressively, you may be causing secondary trauma which is prolonging the resolution of the swelling.

You should not have indentations from Botox. Botox does not cause indentations.

Occasionally, patients are not sure what was injected into them. Some doctors inject Botox and Dermal Fillers at the same appointment. It sounds like you know what you had done, but it is important to clarify what was injected.

In any case, it is important that you follow up with your doctor to ensure that everything is okay.

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Bumps after Botox can be the result of swelling, hematoma or muscle recruitment.

Swelling can be the result of localized trauma and will go away shortly.

Hematoma is the result of the needle injuring a small blood vessel and will also resolve within 1-2 weeks.

More likely is the recruitment of muscle that was not paralyzed by the Botox. When muscle is paralyzed, your brain tries to accomplish the same motion by taking unaffected muscle to perform the same function. This can result in the lumps and bumps that you describe. A good treatment is to apply the Botox in a more spread out manner, in order to weaken the muscles that you are now noticing.

Don't worry. Everything you describe is reversible.

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Hello,

Bumps and swelling can occur after facial injections (Botox, fillers) for a number of reasons.

They can occur after Botox due to normal swelling and bruising seen after injection trauma, or due to hematoma formation (rare but possible - this means a collection of blood organizes under the skin). Bumps and swelling from Botox can also occur due to the saline that is mixed with the Botox - although by four days out this would be unusual to see.

Best thing to do is to go see the Physician that did the injections. They know exactly what they did during the injections and are familiar with your anatomy already. If you don't get adequate answers or resolution for your concerns then certainly a board certified Plastic Surgeon would be able to lend their expertise in your situation.

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