Should Botox Be Administered While You Are Lying Down or Sitting Upright?

Thank you for your question. I do not think it matters much which position the Botox is injected so long as the injector can assess the underlying musculature.  I tend to do the majority of my injections with the patient in the upright position.

The risk of diffusion may be minimized when sitting up, therefore generally it's better to have the patient sitting up or slightly reclined. Lying down may be okay, but the patient should sit up right after the treatment.

The insertion sites of botox are related to your muscular and bony landmark anatomy and doesn't change with position. Many doctors have been trained to inject aesthetic fillers with the patient sitting or reclining at a 45 degree angle but not less, so that they can see the effects of gravity and a more natural position of the folds and creases, which do change if one were to lie down. There has been no study to indciate if the injection of botox in a patient who is lying down will cause the botox to move to undesired muscle recipients in the adjacent area. 

It really doesn't matter, usually just based on the Dr administering preference.  I prefer all my patients sitting up, as this is how I examine them. 

However, this is not set in stone.  I think there is room for more than one opinion on this issue.  At the end of the day, the real question is: Did your doctor do a good job with the treatment.

Less than optimal results is from not buying enough botox to adequately do the job rather than what position you received the botox in.  If it is very cheap botox then you are probably not getting FDA approved Botox or too few amount to correctly do the job right.  Expect to pay about $300 per area.  Sincerely,

David Hansen,MD

We don't believe the patient's position matters with regards to outcomes; however, for aesthetic purposes, we find having a patient in an upright position to better evaluate animation is the better option.

The position of the patient during the injection does not affect the efficacy or safety of the Botox. However, the evaluation and marking of the patient should be performed in the sitting up position.

I prefer to evaluate and mark a patient while they are sitting up, then inject in a reclined position.  I do not think that lying down during the injection increases the risk of diffusion.  I do have patients sit up immediately after the procedure and advise them to avoid lying down or taking a nap for 3-5 hours after treatment.  

Patient position should not have an affect on Botox Cosmetic results. Most plastic surgeons and dermatologists have the patient recline in the chair a little. Choose whatever position that is most comfortable for you. Best of luck.

Dr. Chaboki