Should I delay my Botox treatment following a recent facial injury? (Photo)

Question

I experienced mild head trauma due to an accident 2 days ago. There is a small, mildly tender hematoma just above my right eyebrow, with dark bruising over my eyelid crease. There is mild yellowish bruising above the brow, but the swelling is pretty mild. I have been icing and applying arnica cream with no drastic improvement. I am scheduled for facial botox in 2 days. Could the hematoma adversely affect my Botox results and/or would it be harmful to inject near the area at this time?

Shanthala Shivananjappa, MD · Answer

The depth of Botox injection is varies from  forehead area to the glabellar and crows feet area. Since you still have the bruising and swelling, the diffusion of injected botox might be unpredictable and the results may not be accurate. It is best for you to wait till the bruising is cleared.
Best wishes
Dr. Shanthala

Nirmal Nathan, MD · Answer

Dear AzizMa,After a facial injury, it is best to wait until you have recovered. The layers within the face become disrupted after facial injury, and the Botox may move around in unpredictable ways after injection. Just wait until the bruising and swelling have recovered and you should be fine. Nirmal R. Nathan, M.D.Certified, American Board of Plastic SurgeyrMember, American Society of Plastic Surgeons

Aldo Guerra, MD · Answer

You may want to wait until the swelling, bruising and any other symptoms of the head trauma have resolved before undergoing any additional treatments.  Once you've recovered, go ahead an schedule an appointment with your injector!  Hope you feel better soon!Best Wishes, Dr. Aldo Guerra

Aaron Capuano, MD, FACS · Answer

Hello and thanks for your question.  In my opinion, you should never undergo any elective cosmetic procedure if conditions are not optimal.  This includes injection of Botox shortly after a trauma.  The hematoma and surrounding edema may make accurate placement of the toxin more difficult.  Additionally, injection into the hematoma may introduce bacteria from the skins surface resulting in the hematoma becoming infected.  Once the swelling and hematoma have resolved, you should be able to have the injection performed, and your results will be more predictable.  Hope this helps.  Please be sure to make sure that your injector is a Board Certified Plastic Surgeon.

Melvin Elson, MD · Answer

Since you have swelling and bruising it would be difficult to accurately place the Botox so i suggest you wait until you have healed

Pamela Stuart, MD · Answer

Your facial injury should have no impact at all on your Botox treatment. However I typically do advise patients to wait a few days if they are able because the movement of your facial muscles is best assessed once you’re completely healed.  But if it isn’t possible to wait for some reason, I would have no issue with completing your treatment.Best wishes,

Alex Eshaghian, MD, PhD · Answer

Thank you for your question and for sharing your photograph AzizMa. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam where the entire medical history is reviewed. However, I hope the information provided here is useful.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.If I have a patient with any sort of active concern in an area to be treated, I recommend that she wait until it has resolved prior to a treatment. For example, injecting product into an area where there is a  bruise could possibly worsen the bruise and the product may not be able to get to the target muscle as it normally does.After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids as described above. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific recommendations. Good luck!

Leonard Grossman, MD · Answer

Having had facial injury will not affect the way Botox works on you, however it would be best that you receive the treatment a little later as long as the movement in the muscles is normal so that the doctor can compare both sides. Good luck from New York City

Should I delay my Botox treatment following a recent facial injury? (Photo)

Answers (8)

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