Did Facial Massage After Botox Ruin Results?

Question

I think I have made a bad mistake. I had botox in my forehead and above my eyebrows approx 3 weeks ago, and after 4 days had a facial massage which I wasn't told to avoid, then 2 days later the skin above my eyelids went really puffy and sagged. There is still no improvement after 2 weeks. My eyes look terrible as though I have been stung. Did the massage cause this and is it permanant? HELP!

Otto Joseph Placik, MD · Answer

I would agree with my colleagues, in that irrespective of the massage, the Botulinum toxin was not likely "displaced" by the facial massage. However, the effects of the Botox on facial muscles may alter the effects of the massage on your face. I would discuss your complaints with the treating practitioner.

Ron Shelton, MD · Answer

Botox takes several days to two weeks to peak in its effect.You're probably seeing the botox working now regardless of the massage.Don't have a facial massage in the first day after Botox!  It's possible that it was placed in an area that affected muscles that are not normally injected but it is temporary. See your doctor for evaluation.

Joseph A. Eviatar, MD, FACS · Answer

It&rsquo;s recommended that the face not be massaged immediately after treatment. But usually after a few hours, it doesn&rsquo;t matter. It really depends on how diluted the BOTOX is when injected. Most of the time we use concentrated BOTOX so the aliquots of liquid are very small. Therefore, after a couple of hours you can do anything normally and the product will not move around.

Peter A. Aldea, MD · Answer

Physiologically, Botox attaches to the muscle receptor of nerve endings immediately and irreversibly. We ask people not to engage in activities that may spread Botox out of the injection area for up to 36 hours out of abundance of caution but the attachment is very quick. By 3-5 days we expect to see near complete effects of the Botox action. Massaging the area 4 days later would NOT have displaced Botox (because all of it has attached by then).

	The reason why "the skin above my eyelids went really puffy and sagged." is because of the way the Botox was injected: "I had Botox in my forehead and above my eyebrows " Injecting Botox above the eyebrows weakens the muscle which lifts the brows and they sag creating excess eyelid skin.

	This effect would last as long as the Botox effect lasts 4-5 months and then normalize. I suggest you may want to think about getting a Plastic surgeon to do your Botox injections in the future.

	To read the MOST comprehensive web page on Botox on the Internet, please go to the link below-

Marc Cohen, MD (retired) · Answer

A massage 4 days after a Botox injection should have no effect on the results of the treatment. It often takes a week or so for Botox to work. I suspect that your drooping eyelid are due to the fact that you eyebrows are drooping from the Botox injection. If this is the case the problem will reverse as the Botox wears off. I would suggest going back to see your cosmetic surgeon to be sure that there is no other problem.

Did Facial Massage After Botox Ruin Results?

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