Reaction to Botox. What could this be?

Thank you for sharing these details. From what you describe, it sounds like you experienced swelling and fluid accumulation in the nasal and periorbital area shortly after your Botox injections. While Botox is generally considered safe, some people can experience localized reactions. A few points to consider:

Localized swelling or edema: It’s possible that the injections triggered temporary inflammation in the soft tissues around your nose and eyes. Feeling fluid when pressing on the sides of your nose or eyes can indicate mild fluid retention or edema.

Allergic or inflammatory reaction: Though rare, some individuals may have an unusual sensitivity to Botox or one of the components in the injection solution, which could manifest as swelling or nasal congestion.

Sinus or vascular effects: Botox injections around the forehead and glabella region can occasionally cause minor changes in lymphatic drainage or circulation, which might contribute to temporary puffiness in nearby areas.

Infection: While less common, any swelling that is persistent, warm, red, or painful could indicate an infection and should be evaluated promptly.

Since your swelling has persisted for several weeks, especially inside the nose and around the eyes, I would recommend monitoring for any signs of worsening (increasing redness, pain, vision changes, fever). If these occur, urgent evaluation is warranted. Even without those symptoms, persistent swelling beyond a few weeks may need assessment by a healthcare provider familiar with post-Botox reactions to determine the cause and whether any intervention is needed.

It’s understandable to feel concerned—post-procedure changes in the face can be unsettling—but most reactions are temporary and manageable.

If you want, I can also explain why swelling might linger longer in some areas and what steps can help reduce fluid accumulation. Do you want me to go over that?

Thank you for your questions. Mild swelling post Botox treatment is common, but considering this is day 3 your symptoms should be subsiding by now. It is very unusual to have these symptoms after Botox. In your case, the swelling might be an incidental issue unrelated to the Botox- though I recommend a follow up with your injector. Avoid sleeping face down or sideways and use a few extra pillows to keep your head elevated. In amy case- Botox is temporary and any effect will wear off. A true allergy is rate, but if this happens at your next injection this may be the case. Hope this helps.

We have not seen any allergic reactions to Botox in over 25 years. The maximum number of units of Botox that we have used at one session is around 200. Show photos of your swollen nose and cheeks to your neurologist. If this is indeed an allergic reaction, it should be reported to the company. I hope this is helpful. Sincerely, Dr Joseph

Botox injections should not cause swelling of the nasal passages. This may be coincidental and unrelated to your Botox treatment. I encourage you to visit with your injector or primary care physician for an evaluation.