Can Botox Migrate in Human Faces?

Question

I just read, "Animal studies have shown that botulinum toxin can spread to a distance of 30-45 mm from the injection site." In your experience, does Botox migrate to other muscles in humans? Is there a way to help prevent this from happening, like trying not to move the muscles for 24 hours or avoid doing Yoga?

Sammy Sinno, MD · Answer

Botox can absolutely migrate. It is important to avoid strenuous exercise including yoga, tight-fitting glasses or headbands, and sleeping on your face or to either side for 1-2 days after injection.

Eric Seiger, DO · Answer

Yes, it can, but if it is injected properly these risks are minimal. To minimize risks further I recommend my patients avoid strenuous exercises and applying pressure to the region for at least 1-2 days following the procedure.

Jason Emer, MD · Answer

There can be some diffuse migration, which is extremely negligible. It's important to see an expert for Botox injections for the best outcomes. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Kenneth D. Steinsapir, MD · Answer

This ability of botox to diffuse is taken into consideration in the design of botox treatments.  It is one of the reason we see unwanted effects and surprising facial effects.  It is precisely why I developed the Microdroplet Lift®.  This is a cosmetic botulinum toxin brow lift technique that does not freeze the forehead.  It is based on injecting very small volumes of botulinum toxin solution between the skin and the muscles of facial expression that insert into the skin at the eyebrows.  This results in a very precise treatment that prevents the unwanted effects that can occur when these products drift in an uncontrolled fashion.

Christian N. Ford, MD · Answer

Thank you for your excellent question.  It is possible for Botox to migrate to an unintended muscle causing unwanted side effects, but this is extremely unlikely if the procedure is performed by an expert injector.  To minimize this risk further, I recommend that my patients avoid bending, lying flat, heavy lifting and strenuous activities such as going the gym or yoga for 24 hours after the procedure.  This is a good example of the benefits outweighing the risks.  There were millions of Botox procedures performed in the US last year and that number is rapidly increasing.  Please be sure to see an expert injector for the best results.  Hope this helps and best wishes!

Johnson C. Lee, MD · Answer

Yes, botox can spread into a larger area, especially shortly after injection but this varies on the concentration and amount of botox injected. If injected correctly, the risk is minimal. Just to be safe, I recommend to my patients to avoid pressing the area for the rest of the day, lying flat for 2 hours, and any activity that increased circulation or sweating (exercise, yoga, sauna, hot tubs) for at least four hours or for the rest of the day. Hope this helps!Johnson C. Lee, MD Plastic Surgery

Steven F. Weiner, MD · Answer

There is spread with all the neuromodulators. It is generally dose related. The average spread is about a centimeter circle around the injection. Avoiding exercise, hot tubs, rubbing the site, wearing a hat, yoga for the first 4 hours is essential to minimize the spread of the Botox. After that time period, the Botox should be absorb and activity restriction is lifted in my patients. So docs say 24 hours is needed to limit activity.

John Louis Ratz, MD · Answer

I suggest you google "Botox side effects". By doing so you will verify that Botox can indeed migrate to distant sites, thus causing the side effects.

Melvin Elson, MD · Answer

The 35 mm or so movement is an extremely small amount. The diffusion is proportional to the amount of diluent used and the standard is 2.5 cc to 100 units.  even if more is used it is not likely at all that it will flow to a distant site. it is best not to massage the area for 24 hours after injection as that increases the chance it will not remain completely in the muscle

Drew Varano, MD · Answer

If Botox diffuses it is to the adjacent muscles. In over 15 years of performing injections I have yet to clinically see this become a issue in a patient . Movement of the treated muscles after a treatment is actually encouraged . Excessive exercise or (yoga) should be refrained for a few hours after injections if diffusion is a concern

Can Botox Migrate in Human Faces?

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