Botox After Care?

Do I really have to sit up for 4 hours after Botox? Do I need to make the required facial gestures continuously for 4 hours? Why do I have to do this? What if I don't? What if I lay down? What will happen?

Doctor Answers (15)

Aftercare for Botox


Physicians have generally advised over the past decade or so that patients not lay down flat or rub the affected area for 4hrs, and to use the muscles for the first little while (whatever that means). Some physicians advise a longer period of time, while many others don't feel there is much of a difference whether you follow this advice or not.  Most likely, there is no real aftercare required, but I would follow whatever your physician injector has advised you.

Toronto Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Botox After Care?

I tell my patients that you want Botox to stay where it is meant to stay for maximum effect.
Activities that disperse botox are to be avoided. Any activity that increases the rush of blood to the area may 'wash away' botox from the area. Physically exerting pressure on the injected area can spread Botox to the surrounds and hence dilute its action. 
So no physical activity for 24 hours, no massage or manipulation of the area for 24 hrs and do not lie on the area for 24 hours.

Naveen Somia, MBBS, PhD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 27 reviews

Restrictions after Botox?


The theory of not lying flat or bending over for a few hours after Botox or Dysport was mentioned by some of the pioneering doctors who developed the clinical uses of botox.  It was thought that the positional changes might induce diffusion of the Botox to unwanted nearby regions and cause unwanted relaxation of other muscles. 

It was also mentioned that purposeful contraction of the muscles that cause the overlying unwanted wrinkles, could help bring the neuromodulator into the muscle-nerve junction which is how Botox blocks the signal from being transmitted and the muscle then doesn't contract.

Neither of the above recommendations have been proven to be necessary but many doctors still recommend them.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Botox and facial gestures


You should not rub or massage the treated area for 4 hours after your injections to prevent spreading of your Botox.  You are supposed to sit upright so you don't fall asleep and rub by accident.  It is advisable to make facial gestures to help Botox get into the treated muscles effectively. 

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 16 reviews

Botox after care


We have been using Botox in our practice for over 12 years. We do not have the patients do anything special after treatment, although we still advise them to not lie down for up to 4 hours afterwards.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Botox aftercare


After Botox treatment there is no specific after care required. Obviously we ask our patients not to massage or manipulate the areas for the first day but no facial exercises or physical restrictions are required

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Botox is bound to the muscle after 90 minutes.


Botox is bound to the muscle after 90 minutes.  I generally recommend to sit upright for the first 90 minutes to minimize the risk of diffusion.  This is a very remote possibility, but has been documented. I do recommend not to rub or massage the area. Otherwise, there are no restrictions after treatment. 

Mary Hurley, MD
Dallas Dermatologist
4.0 out of 5 stars 5 reviews

Botox After Care


The rationale for the recommendation to sit up comes from Allergan who advises that by doing so reduces the probability that toxins will move down to the eyelids.  This is a rare but documented occurence.

We generally recommend common sense. Minimize massage and manipulation of the injected areas. Otherwise, you can proceed with your daily activities.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 16 reviews

Patients can do anything after Botox except have the area massaged afterwards!

Patients can lie down, exercise, go to sleep or anything they want after Botox treatments. The only thing they should avoid after an injection is direct massage to the area treated for 48 hours.

Carla R. Retief, MD
Nashville Dermatologic Surgeon
3.5 out of 5 stars 5 reviews

I let my patients do anything they want after botox


i have been injecting Botox almost since it was approved. i have never limited any activity

after the injection. i let my patients get facials and go to the gym and i have never had a problem. i think there is little to no evidence that you can affect the Botox after it is injected.



david berman md

David E. Berman, MD
Sterling Plastic Surgeon
5.0 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.