Is It Normal to Have Swelling After Botox?

Hi Claudia,
I agree with Dr. Lupo. I have never seen what you are describing in thousands of injections. I have seen very small hematomas (bruises) that may form a small lump for a few days, but not everywhere as you state.
Your statement that "the Dr. that did it this time is qualified, but is a GP" is an oxymoron. You should have Botox and fillers injected by cosmetically trained specialists (plastic surgeon, facial plastic surgeon, dermatologist, and oculoplastic surgeon).
If what was injected was FDA approved Botox then your symptoms will likely resolve. Return to your doctor and find out what was injected and how much. Good luck.
Dr. P

Thank you for your question. Swelling is possible everytime a needle penetrates the skin. Having said that, I typically find that the degree of swelling varies based on the treatment and location. For example, swelling after Botox is usually minimal (unless you bruise). I would go visit with your injector to be assessed to rule out an allergic reaction versus different muscle activity giving the illusion of swelling.  In the future, I would recommend that you stick with a board certified dermatologist or plastic surgeon who is experienced with injectables.

Since Botox is injected in small volumes with a tiny needle, persistent swelling or bruising are uncommon.  However, any injection carries a small risk of swelling, bleeding or bruising.   It is best to contact your doctor if you have any concerns about swelling after the procedure.

It's unusual
for patients to have lumps, bumps, and swelling four days after botox
injections. Although it's impossible to know the exact cause of this swelling
with certainty without physical examination, several possibilities exist. These
include persistent edema, hematoma formation, and abnormal muscle contractions
due to an uneven distribution of the botox.

Under these
circumstances, this problem should resolve spontaneously, but if the problem is
due to poor injection technique a consultation with a board-certified plastic
surgeon might be appropriate. This surgeon should be able to formulate a plan
that addresses your concerns and corrects your lumps and bumps.

It sounds like the Botox was placed unevenly and maybe too forcefully causing the swollen areas. You should follow up with your doctor as it is usually possible to smooth this out. Wait at least 2 weeks as it may smooth out on it's own.  If you don't want to go back to that doctor, see a physician very experienced with Botox, usually a dermatologist or plastic surgeon.

Hi Claudia. The bumps you are describing sound more like an allergic reaction than anything else. The problem is that this type of reaction usually occurs immediately after injection when it does. And it has only occurred in 2 patients (out of thousands) that had grown resistant to Botox or have an allergy to Albumin - a preservative in Botox.
Because these bumps are appearing days after the injections, we are not sure that this would be the type of allergic reaction we note here and suggest a visit back to your injector or another practitioner for evaluation.

If the muscle has been weakened in an unusual pattern, it maybe that you are experiencing visibility of contracting muscle segments between the weakened segments but my guess is that this is highly unlikely.
Within all likelihood this will resolve on its own with no intervention or side effects but I would advise you to seek the advise of your injecting physician.

After Botox injections, it is normal to have temporary swelling - similar to mosquito bite, which resolves after a few hours. This is due to localized swelling around the site of injection. Occasionally, you can have areas of swelling due to small hematomas (bruises) which may take a few days to resolve. These are generally localized and may be tender to the touch. Additionally, you can have areas of swelling from localized infections from the needle puncture. However, these are also self-limiting and should resolve within a few days. On rare occasions, if the Botox paralyzed your forehead so much that your eyebrows dropped lower than your orbital rim (the bone under your eyebrow), the bone may appear as a bump or swelling just above your eyebrow. Finally, if you are pushing and poking the areas aggressively, you may be causing secondary trauma which is prolonging the resolution of the swelling.
You should not have indentations from Botox. Botox does not cause indentations.
Occasionally, patients are not sure what was injected into them. Some doctors inject Botox and Dermal Fillers at the same appointment. It sounds like you know what you had done, but it is important to clarify what was injected.
In any case, it is important that you follow up with your doctor to ensure that everything is okay.

Thank you for your question! Since Botox is injected in small volumes with a tiny needle, persistent swelling or bruising are uncommon. However, any injection carries a small risk of swelling, bleeding or bruising. It is best to contact your doctor if you have any concerns about swelling after the procedure. Best of luck! 

Botox is a powder mixed with saline or water in order to inject it. This fluid can leave small temporary bumps that look like bug bites until the water or saline is fully absorbed into your tissue. This normally takes a few minutes to half an hour at most. Any swelling that reappears after that is unexpected and not normal. Swollen areas that leave indentations afterwards are definitely not normal. You may be potentially allergic to a preservative being used in the mix, or you may be getting small under the surface bruises that can heal with indented scarring over time. I recommend seeing a board-certified dermatologist or experienced plastic surgeon to evaluate bumps from Botox that appear days later.