Cosmetic injections of neurotoxins (Botox, Dysport, Xeomin) or hyaluronic acid fillers are arguably among the easiest ways to achieve fairly dramatic results with minimal downtime. Often considered “lunchtime cosmetic procedures,” these injections are usually quick, straightforward, and relatively painless, with minimal (if any) aftercare required. That being said, there are a few key things you should avoid in the hours, days, and weeks afterward in order to minimize the chance of unwanted side effects before you resume all of your normal activities. (When in doubt, make sure to ask your provider for detailed aftercare instructions.) Ahead, experts weigh in on what not to do after Botox and what not to do after filler.
What not to do after Botox injections
Don’t participate in intense cardio
Plan on taking that Spin class before you head to your appointment. Intense physical activity causes increased blood flow throughout the body, including in the face. This can theoretically move the injected neurotoxin before it has a chance to bind to the intended muscle in the treated area, causing it to weaken additional nearby muscles that were not the target, warns Dr. Dara Liotta, a board-certified facial plastic surgeon in New York City. In other words, the effects of Botox can end up showing up in places where you don’t want them. She suggests waiting at least 12 hours before doing any kind of exercise that’s going to get your heart pumping. FYI, the same rule applies to fillers, since this type of strenuous exercise increases your blood pressure and, subsequently, your risk of bruising, notes Dr. Whitney Bowe, a board-certified dermatologist in Briarcliff Manor, New York.
Don’t work on your yoga practice
That being said, a chill yoga class isn’t necessarily a better option. Dr. Bowe says it’s important to remain upright and not do any type of activity where you’re lying flat or your head is inverted (e.g., a downward dog) for at least four hours after injections. That also means no napping or getting a facial or massage.
Don’t apply makeup
Neurotoxin injections can leave small, red marks at each injection site. While this probably isn’t a concern if you’re getting Botox in your underarms to treat excessive sweating, it’s understandable that you don’t necessarily want these marks showing upon your face. The good news? These are temporary and easily covered with makeup—just make sure to wait at least 30 minutes before doing so, advises Dr. Bowe. “While they’re very small, each of these marks is still a little puncture wound. There’s a direct and open channel, and you don’t want to risk [introducing] any bacteria that may be in your makeup into your skin,” she explains. Waiting half an hour gives your skin enough time to re-epithelialize, essentially a fancy way of saying that it can close up that little wound, she says. Similarly, wait the same amount of time before applying any type of skin-care products, too.
Don’t use facial tools
Save your jade rollers and gua sha tools for another time. Both experts we spoke with agree that using these immediately after injections can make the neurotoxin diffuse into unwanted areas. Dr. Bowe suggests waiting four hours post-injection; Dr. Liotta recommends giving it 12 hours. You’ll want to avoid these after getting fillers too; more on why in a moment.
Wait two weeks to get your COVID-19 vaccine
“While we don’t suspect any type of negative interaction between the vaccine and Botox, we haven’t had enough experience with the two to really know for sure,” says Dr. Bowe. She says it’s better to err on the side of caution and schedule your vaccine for two weeks before or two weeks after neurotoxin injections. (As far as fillers go, there have been some reports of increased swelling in areas of filler after the vaccine. Dr. Bowe suggests separating the vaccine and filler injections by four weeks.)
What not to do after filler
Don’t get a massage
There are several reasons these are off-limits for at least two weeks after fillers. Lying on your stomach, with your face pressing into the “donut” on a massage table, can greatly increase swelling, especially if you’ve had filler in your tear troughs or cheeks, notes Dr. Liotta. While it won’t necessarily affect the final results, it will prolong the healing time, she adds. Similarly, any type of facial massage, especially a deep lymphatic massage, is a major no-no, says Dr. Bowe. “I once saw a case where the aesthetician ended up pushing some of the hyaluronic acid filler out of its intended spot and into the lymphs, resulting in persistent swelling of the patient’s face,” she says. To that point, gua sha tools and jade rollers are also off-limits for at least two weeks.
Don’t visit the dentist
No, this is not a free pass to cancel your annual appointment. But it is an important example of what not to do after lip fillers, specifically. Steer clear of any type of dental work, even a basic cleaning, within four weeks of filler injections. As is the case with massage, there’s a risk of the filler being displaced if it’s been injected around the mouth, in areas such as the lips or nasolabial folds, explains Dr. Liotta. And no matter where the filler has been injected, there’s some evidence that the increased bacteria in the blood that results from dental cleaning or dental work can seed on newly placed filler, causing a kind of chronic infection in the areas of filler placement, she adds.
Don’t wear glasses or goggles
This one is fairly specific, since it pertains only to a nonsurgical nose job, in which filler is used to camouflage a bump on the bridge of the nose. But in this case, wearing glasses all day can cause repeated pressure on the injected area, resulting in a small indent that then needs to be fixed with more filler, says Dr. Liotta. In this type of situation, it’s best to wear contacts for two weeks or, at the very least, minimize the amount of time your glasses are sitting on the bridge of your nose, she advises.
Similarly, the pressure from swim or ski goggles, scuba masks, even virtual reality headsets can displace filler that’s been placed in the tear trough or cheek areas, notes Dr. Liotta.
Don’t enjoy a few cocktails
It’s not a great idea to head straight from your injection appointment to drinks with friends. There’s a little blood clot that forms under the surface of the skin after filler injections, and alcohol can dissolve that clot, resulting in bruising, says Dr. Bowe. “I’ve seen it firsthand: someone has no bruising at all right after filler injections—but then I see them later that night, and by the time they’re on their second glass of wine, there’s a bruise forming,” she says. To play it safe, avoid any alcohol intake the day of your appointment. In related news, it’s also a good idea to avoid OTC painkillers that are also blood thinners, ibuprofen being one of the most common examples; opt for Tylenol instead.
