Lying Down Directly After Botox, Is This Not Recommended?

Although there is no scientific research that speaks to post-Botox instructions that discourage strenuous exercise, massaging, or lying down for a short time after treatment, our theory is that, if it could only help - why not?  Anything is possible, and the recommendation (it's just that - a recommendation) is not difficult to follow. 

Whether or not the patient follows these recommendations is an individual choice.  However, if we are able to make suggestions to help maximize the financial investment of the treatment and maintain good outcomes, then it seems like a very small inconvenience.

Thank you for sharing your concerns. The bumps are definitely not from lying down. You should follow up with your doctor if they do not resolve. Good luck.

Thank you for your question. I typically focus my aftercare on restricting activities that make you hot, sweaty or flushed: Examples include strenuous activities, alcohol, saunas, hot baths, etc… This will increase your chance of bruising. If no bruising, by the next day, the you should be good to go. If there is, then I recommend another day to make sure the bruise is not getting worse. I am not as worried about the not laying down after four hours.

There have been no studies that investigated the positional changes after Botox and studied the number of hours after which it is safe to do normal activity. This has been a theoretically-based recommendation to minimize the chance of the Botox moving to the adjacent area and affecting muscles that shouldn't be treated.  We recommend not to lie down flat (on the back or stomach) or to bend over at the waist for four hours after Botox, but again, this has not been proven to be a problem if those restrictions were not followed by the patient. Possibly the bumps might be more noticable because you increased the blood pressure in the head when lying down but this should go away quickly.

While our practice doesn't recommend lying down directly after a Botox treatment for about four hours (just in case), there isn't any comprehensive information on this subject.  Someone from my office has a story, however. A patient from another practice decided to get a massage immediately after she got her Botox treatment.  She placed her head face-down on the head rest, which applied pressure to the forehead for about an hour.  As a result, her Botox was not evenly distributed and she returned a week later for a touch-up.

I have not found that not lying down or any activity restrictions have changed the results or how long botox lasts for my patients. 

As you can see from many of these answers we recommend staying upright but there is no hard and fast regulation or proof that lying down does any harm. We like patients to have the best results. We know that remaining upright, avoiding strenuous exercise and not massaging the injected area is best practice and gives you the best outcome. However I know patients who have done all of these things after treatment and have not come to any harm whatsoever. 
As you have stated your face was not massaged. Although it was not recommended to you,  I am sure you will be fine. The little bumps normally go away fairly quickly after treatment. I am sure they will settle in time. You may find that you might bruise more if you were quite warm with the massage, but I think you will be fine. 
If you have any concerns whatsoever pop in to see your doctor for a review and certainly attend your 2 week followup. 
I hope this helps. 

Thank you for your question GTinSingapore. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids as described above. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific recommendations. Good luck!

You are at no risk of the Botox migrating to an unwanted area. At my practice I recommend no exercising for the remainder of the day after Botox treatment and no laying down for 4 hours after treatment. Thank you for the question

In my practice I always advise my patients to not lie down or massage there face for up to 4 hours after Botox injections. Massaging the face or lying down may result in the Botox to shift to other areas of the face. The bumps like mosquito bites you are having are from the needle injections and should go away in the next few days.