How long should I wait after Rhinoplasty to have Botox?

Question

Hi, I've recently had rhinoplasty (reduce hump, smaller bulbous bit) away from home, and wanted to have botox around my crows feet and forehead while I'm here. Is 6 days post rhinoplasty too short a waiting period? Should I just wear it and come back another time? I'm on day 2 post op now and very swollen around the eyes.

Michael I. Echavez, MD · Answer

In my opinion, it should not be a problem to have Botox to the forehead and crow's feet 6 days after a rhinoplasty.  As long as the wrinkles you want treated are visible, the treatment should be able to be done.

Amiya Prasad, MD · Answer

Thank you for your question. You’re describing a situation where you’re away from home for a rhinoplasty for hump reduction and tip surgery for a bulbous tip. You are asking if 6 days after is too early to get Botox® for crow’s feet and forehead lines. You are now at day 2, and your eyes are fairly swollen.
I can share with you how I would advise any patient who comes to me with a comparable situation, and how I guide my patients who I operate on with the timing of an injectable procedure like Botox®. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I belong to the first group of doctors to use Botox®, using it for my patients since 1993, so I have a lot of experience with helping people with Botox®. 
The better question to ask is this the optimal situation to get Botox®, so now the question of whether or not you can or cannot do something is dictated after a surgical procedure, like you’ve undergone. You state that you had significant swelling around your eyes. Botox® is not a filler, but a neurotoxin. That means you need the toxin is effectively delivered to the nerves that go to the muscle causing the wrinkles. This is in contrast to a filler like a hyaluronic acid filler to treat under eye hollows or tear trough. If a person is swollen, then that procedure becomes difficult because you cannot really appreciate the contour improvement when there is swelling. I typically wait until some swelling related to surgery, allergies, or anything else, first goes down to get the optimal orientation. 
With Botox®, I’ll start first with the crow’s feet areas since your eyes are swollen. I would be concerned about the dilution of the Botox® in the area of swelling because the fluid and dosage could interact in a way that you might not get the full benefit. It is important to see how swollen you are at day 6. More than likely, Botox®would probably be safe enough to do as long as you don't have significant swelling. 
In terms of the relative swelling, the doses for Botox® for the crow’s feet lines are relatively low, therefore a problem with migration of Botox®to another area is relatively small. If the Botox® floats down to the muscles responsible for facial expression, based on the dosages are not likely to be an issue but again, you have to ask yourself,  if it’s worthwhile to have a diluted effect or a potential migration away from the target.
If you don't have much forehead swelling, chances are you should be okay to do that. I think it will be okay for your doctor to decide if they are comfortable with doing the Botox® for you. Most of the time, it’s the clinical scenario that dictates when we do anything in this field. Understanding there’s a lot or significant swelling, then it’s suboptimal for Botox® or an injectable filler. You want to work with maximal predictability. I don't think there’s much of a loss of opportunity if you are doing this at a place where you traveled for surgery, to then come back to where you live and get the Botox® procedure done locally. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Mark Chariker, MD · Answer

Botox injections after your rhinoplasty surgery should not be a problem at this point in your recovery. 
Thank you for your question.

How long should I wait after Rhinoplasty to have Botox?

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How long should I wait after Rhinoplasty to have Botox?

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