Why do I have a lump on my forehead 4 days after Botox injections? (Photo)

Question

Why do I have this lump? It wasn't there the first 2 days it stated Saturday night. I got Botox on Thursday and the lump showed up Saturday night. What is this lump and what should I do?

Monica Boen, MD · Answer

I appreciate your concern. While swelling for a few hours immediately following injections is normal, swelling two days later is not. I recommend a phone call to your provider to schedule a follow-up assessment. Since the issue is not likely urgent, waiting through the weekend should not be a problem. You might even see the swelling subside by Monday. However, a call is warranted in this case, since this is not a common side effect of the treatment.

Kimberly Butterwick, MD · Answer

While it is difficult to make an assessment from a photo alone, it does appear you might have developed a hematoma after your Botox injections. A hematoma is merely a collection of blood, which may be caused by a damaged blood vessel. It is quite common and should resolve on its own within a week or so. If it doesn’t or you develop additional symptoms, I would schedule an appointment with your injector for a follow-up. Best wishes on your recovery and final results!

William Groff, DO · Answer

Swelling this long after Botox injections is not common and should be checked out by your doctor. However, I don’t believe it’s an urgent issue that can’t wait until your doctor’s office is open once again. It is likely the swelling will go down on its own, but always better to have it evaluated to be on the safe side. Make sure you work with a board-certified dermatologist who is also an expert Botox injector in the future to avoid potential complications.

Elham Jafari, MD · Answer

Hi and thank you for your question! The bump could be related to swelling or hematoma, but it is usually not expected to emerge after two days and it might be unrelated to Botox as well. There are other rare possible causes such as infection but we normally expect to see many more signs such as redness, heat or pain with infection. With a painless, non-tender bump that is stable or shrinking in size, there is less cause for concern, but you should still monitor it closely and check with your injector for a follow up evaluation. I hope it helps and good luck!

Jason Emer, MD · Answer

If you're feeling pain, you should follow up with your injector / physician. Or see an experienced cosmetic dermatologist to get a formal evaluation, resolve the issue, and develop a new treatment plan to address your acne scars. Best of luck, Dr. Emer

Camille Cash, MD · Answer

It is not common to have a lump develop days after Botox treatments.  I recommend a visit to your injector for an examination.  At times minor bumps from injection occur, but they typically resolve over the first few hours.

Selena Lantry, MD · Answer

Assuming your Botox was injected properly, the lump is most likely caused by a collection of blood from the injection site. This kind of  swelling is normal after Botox injections and should go down in several days.  You can ice the lump to help manage the swelling.  If after two weeks, you continue to have concerns or the lump has not gone away, I would recommend scheduling a follow- up visit with your provider to go over your results.

Harlow Hollis, MD · Answer

Almost assuredly this is a collection of blood  (hematoma) from a blood vessel being entered by the Botox needle. Location looks a little bit lateral but........Should resolve spontaneously. A recheck with the person who did the Botox injection would be a good start if you feel the need for more insight. Most hematoma's become colored  (bruise) and sometimes the color shifts away from the original site due to gravity pull. This is not dangerous.

Katrinka L. Heher, MD · Answer

Usually a lump means there is a collection of blood at the injection site. It doesn’t always look black and blue but may be tender to touch. You do not have to worry that this is an unusual reaction. Should improve quickly. Good luck!

Alain Michon, MD · Answer

Thank you for your question and picture. Although it is hard to comment without a formal assessment, it does look like it may be a hematoma. This is benign and should resolve within a week or so. Arnica cream or tablets may help. I recommend following up with your injector. All the best, Dr Michon

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