How Long After Botox is Necessary Before Facial Massage?

Most of my colleagues recommend four hours or less to avoid bending, lying flat or vigorous facial massage after Botox treatment, but this is not based on any studies of which I'm aware. The theory is to avoid diffusion to unwanted areas, but most doctors believe that the Botox is anchored to its region almost as soon as it's injected.

There are definitive answers, simply because there are no good clinical studies examining this.  I usually recommend no heavy physical activity for about 3-4 hours after the injection, but regarding facials or directly rubbing the area, I tell my patients to wait until the following day.  The theory there being that, physical activity or massaging may actually cause the Botox to affect other nearby muscles that we don't want to affect.  But again, this is still just theory, not fact.

We generally advise no rubbing of the face for 4 hours or essentially the same day. For a facial, the next day is probably fine, but I'd still prefer people generally wait 3-4 days before a facial - why take any chances.

You should not massage the areas that have received Botox injections for 4 hours, but you should wait until the next day before having a facial.  There is a potential for small bruises with Botox injections and they would be evident by the next day.  If you see bruises, wait a few more days before having a facial.

We recommend waiting 24 hours.  This is fairly arbitrary, like the recommendation for remaining upright for 4 hours after injection.  The most important area to be cautious is the glabellar region.  You do not want to massage the Botox into the upper eyelid region.  This could result in a drooping eyelid.  You should ask your injector what they believe is prudent.