1 week PO. I feel pulling and have a headache and dizziness. Will it worsen? Advice? (photos)

Question

Botox 7 days ago in my forehead, side of eyes, and frown lines~32 units. Noticed effects around day 3. I started feeling a pulling sensation on the top of my forehead. The pulling feeling continued to move further back on my forehead. Today at day 7 it’s at the mid back of my head. The sensation moved down the side of my face. Headache since day one. My brows are lower I can’t hardly lift them at all. Day 3 and 4 I also had brief dizziness. I also haven’t felt well. Will it worsen? Advice?

Camille Cash, MD · Answer

Patients sometimes report a heavy feeling to their brow or forehead after treatment.  This typically resolves over the first few weeks.  A headache lasting one week and the dizziness are not typical.  I encourage you to contact your injector for a follow up.

Alexander Golberg, MD, DO · Answer

Thank you for your question. I suspect that the ‘pulling’ sensation is just the feeling of the muscles relaxing, which sometimes produces a feeling of heaviness and is a strange sensation for someone having Botox for the first time. In terms of the feeling of illness, this isn’t something I’ve encountered after Botox injections and I would monitor your condition to see if it worsens. If it does, contact your doctor immediately and possibly try a lower dosage of Botox next time if your body reacts to it in this way. In my experience, any symptoms after Botox will subside after a few days and you will start to enjoy the full results of your treatment.

Rediscoverd U - Bainbridge Island · Answer

First off--let me say I am very hopeful that since this question was posted over a week ago, that your symptoms have subsided and it is but a distant memory now!  Still--it was likely more than you were expecting, so worth checking in on!
Many people report a heaviness after neurotoxin injection, especially their first time. The job of the neuromodulator (Botox, Dysport, Xeomin) is to prevent contraction of a specific muscle group.  Interestingly however, is that by calming one group, you may get "hyper recruitment" of adjacent groups (i.e. a nearby muscle overacts in response).  My guess is that you had both the experience of non-movement in your target region as well as a bit of hyperactivity nearby (the "tug").  It will ease up as the toxin wears off.  If you decide you want to try again, consider going with a little lower dose next time but understand the effects may not last as long with a lower dose. 
Another consideration is to use other modalities for softening of fine lines and wrinkles, such as skin resurfacing with the LaseMD or microneedling to keep your collagen levels high.  This isn't as effective as neurotoxin for wrinkles of animation, but it can help reduce the lines at rest.  
Also, you mentioned "I don't feel well"--this isn't super common, but flu-like-symptoms are listed on the adverse effect profile for all toxins.  They are typically pretty short lived.  Headache is a more commonly reported response--and interestingly, Botox is also used to treat headaches.  Go figure!
Again--hope you are feeling better, less heavy, and without tugging.  (And can I say, your forehead looks fabulous!)
Kind regards
Teri Scott, ARNP

1 week PO. I feel pulling and have a headache and dizziness. Will it worsen? Advice? (photos)

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1 week PO. I feel pulling and have a headache and dizziness. Will it worsen? Advice? (photos)

Answers (3)

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