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 20

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. 

Dallas Dermatologist
4.2 out of 5 stars 5 reviews

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.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 53 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
4.9 out of 5 stars 108 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 42 reviews

Botox Aftercare

You don't have to sit up, but don't lie down.  Don't rub the area as this may cause the toxin to drift into other

areas and cause undesirable side effects like eye droop.  The eye droop can last for 2-3 months.....

I don't know if making a lot of gestures really helps, but it is possible this aids in the uptake of the toxin

into the muscle.  Good luck and best of health,  Dr. S

Bruce Saal, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Botox After Care

We recommend that you not lie down or rub the injection area for 4 hours after treatment. This prevents the Botox from spreading. We also recommend no exercise for up to 1 day. No facial exercises are required.

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews


Botox is a treatment that can be done on your lunch break. There is no down time. For 4 hours post treatment it is recommended not to lie down(sitting or standing or walking is fine), no exercise, and no massaging the area. You do not need to continuously work the muscles treated but exercising them here and there post treatment is fine. I tell my patients to go about their regular day as they normally would. Results will be seen 2 - 3 days after treatment with maximal effect after 2 weeks.

Omar Fouda Neel, MD, FRCSC, FACS
Montreal Plastic Surgeon
4.9 out of 5 stars 24 reviews

Botox after care

I advise my patients to not rub the injected areas for a few hours.  Other than that, I have no restrictions post-injection.

Clyde Mathison, MD
Knoxville Facial Plastic Surgeon
5.0 out of 5 stars 8 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 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.