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 18

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.

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 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.


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 22 reviews

Botox Treatments

Great question! Botox is a safe and effective treatment for targeting fine lines and wrinkles, with very little down time. It’s okay to touch your face after receiving Botox injections; however you want to avoid facial massage or rigorous activity for the few hours following your treatment. It’s always best to check with your injecting physician for any specific post-injection instructions, but generally speaking sleeping without a pillow will not be a problem. Best of luck!

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 5 reviews

Botox Recovery Time

Hi Cici.  Your concerns are reasonable; at the time please note that Botox is an effective and popular intervention (millions of injections around the world annually).  Patients are advised to avoid massaging or rubbing the area for a few hours after treatment; patients are also advised to avoid lying down (laying flat) for a few hours after treatment.  As you mentioned, these are thought to avod the Botox "migrating" to another area. 

Hope this is helpful.  Best wishes.

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Botox Recovery Time

Botox is one of the easiest treatments available on the market today as long as you choose an experienced and qualified injector. There is little that you could do to change the results post-injection, most people can carry on their day as normal and do not need to worry. However, it would be advisable to avoid a facial or microdermabrasion treatment etc on the same day.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 87 reviews

Don't worry about it...there's relatively little you can do to mess up botox...

once the botox has been injected, there's relatively little you're likely to do to change the ultimate spite of lots of advice on what to and what not to do, none of the recommendations have the backing of science...get it injected correctly and then you can pretty much do what you want...even go to the gym...don't worry about rubbing the area and certainly by the time you go to bed, the botox isn't going to move around...don't worry...

Ken Landow, MD
Las Vegas Dermatologist
4.5 out of 5 stars 9 reviews

Botox and activity right after injection

After Botox injection it has always been thought that massaging the skin may cause it to migrate, although I haven't seen this happen.  I don't tell my patients to change their activity after injection, but I would advise against massaging the skin on the day of injection. I have seen rare cases of Botox migrating into the eyelid and causing droopiness, but this was with injection for eyelid spasms where the drug was injected fairly close to the eyelid elevating muscles.

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 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.