Botox Question: Recovery Time of Treatment?

My concern is getting Botox and accidentally twitching/rubbing the area (without knowing or realiziang it) within the 4 to 6 hr recovery time. What are the realistic chances that the Botox will, for sure, migrate to other areas and cause droopiness? I hear from some medical folks that it's not that likely to migrate but Doctors like to "be safe than sorry". What is the truth behind the likelihood? Also, I have back issues and need to sleep without a pillow. Is that fine after the 4 hr recovery?

Doctor Answers 23

Botox Does Not Migrate

This is a common question in our clinic. Botox is a really remarkable medication in that it does exactly what it is supposed to do and nothing more - weaken muscles. How much weakness depends directly on the dose you inject. It stays only in the place you inject it without migrating and it is gone in 3 months. There are no allergies, no reactions and the only side effects are due to incorrect dosage or placement. The only limitation I recommend after Botox treatment is to not get a massage where you place your face into a circular pillow for a few days. Its OK to lie down, touch your face and resume all activities after injection. Sleeping without a pillow is fine.

Botox and migration.

Despite lots of advice online, there is no scientific evidence that shows twitching or rubbing the treatment area after Botox injections causes it to migrate to other areas. Seek out a highly trained and skilled injector and you will be fine. The chances of Facial droopiness because of Botox injections are very unlikely.

Anil Sharma, MD
Edmonton Otolaryngologist
5.0 out of 5 stars 1 review

Botox recovery

It's ok to touch your face after Botox. It's not ok to have something like a facial or facial massage right after. I tell people that's it's fine to just be normal. I have found zero difference if people work out, lie down, etc. and I've injected Botox for about 20 years. The effects and outcomes are dependent on the experience of your injector.


Botox is one of the best things around for eliminating fine lines and wrinkles such as the ones you have in the crow’s feet area. Rather than "plumping" like collagen and fat, Botox blocks the impulses that nerves send to muscles, essentially paralyzing the muscles and diminishing their ability to tense. Using a very fine needle, the surgeon injects Botox in small doses where the facial muscles are most active--between the eyebrow and at the sides of the eyes, or beside the mouth. After receiving treatment, you're forbidden to lie down for several hours, because the medicine can absorb unevenly. It takes one to three days to see the effects, and the treated area will continue to improve for up to two weeks. That's when I schedule my patients to return, to see if a touch-up is needed

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.5 out of 5 stars 8 reviews

Botox and Recovery Time

The main Botox rules is to keep your head upright for 4 hours after injections and to refrain from exercise after injecting for 24 hours. Please consult an expert to have the best cosmetic results. Best, Dr. Green

Botox recovery time

Thank you for your question. A simple, non-surgical procedure used to smooth persistent lines. Botox relaxes the muscles that cause lines to the forehead, around the eyes and between the brows by repeated facial expressions. Results are noticeable within a few days and results last approximately 4 months. Just remember to be injected by a board certified plastic surgeon with experience. Best of luck!Dhaval M. Patel Double board certified Plastic surgeon Hoffman Estates Barrington Oakbrook Chicago

Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 78 reviews

Can I rub botox and create a side effect

Botox rarely moves from it's intended site. And no true evidence that rubbing or twitching will do that.

Jeffrey M. Joseph, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 11 reviews

Botox Post-Procedure Care

In our clinic, we recommend our patients to not lie down for three hours following botox injections to prevent possible migration of the product. However, it is fine to lie down after this three hour window. Likewise, we also recommend to not participate in rigorous workouts right after. There is no harm in simply touching your skin once you get your injections but it is best to try and simply avoid the area it if possible. It best to consult your cosmetic surgeon on his or her specific post-procedure instructions.

Vu Ho, MD
Plano Facial Plastic Surgeon
4.7 out of 5 stars 36 reviews


It is very rare for Botox to migrate to other areas, as long as it is done correctly. You can not rub Botox to such an extent where it moves. 

Ben Behnam, MD
Santa Monica Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Botox migrating to another area

Every injector has post injection instructions that they can give you so that you do not have to worry about Botox traveling into another area. A simple touch of the face or application of moisturizer or sunscreen should not be a problem. While there is a chance of it migrating to another area of your face, the chances of that happening are quite rare. You will be fine without the use of a pillow if it is after the 4 hr recovery window.

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.