Lying Down Directly After Botox, Is This Not Recommended?

I had Botox injections 2 days ago. I wasn't given post-care instructions. Immediately after the treatment (half an hour after) I had a massage, where I lay down for 2 hours. My face was NOT massaged. Two days later, I still have bumps (like mosquito bites) in each of the places where Botox was injected into my forehead. I now realize that some doctors recommend their patients not to lie down for 6 hours after. Will this effect go away soon? Did I do something wrong?

Doctor Answers 11

Can I lie down after Botox injections?

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 Yes, of course you can lay down, roll over or whatever else you want.  I have injected Botox for over 20 years and am always amazed at the nonsensical instructions often given to Botox patients elsewhere.  Botox is injected as a solution that's rapidly absorbed by the tissues into which it's injected.  The solution isn't capable of moving around, so there's no need to avoid any positions or movements IMO.  I always massage the injected Botox solution into the desired location (target area) immediately after it's injected. 

I personally don't think it make any difference.

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Ten years ago I told my patients not to lie down and to move their muscles for the first day after Botox.  Over the past 6 years I have not given my patients these instructions.  I see no difference in efficacy or side effects, so at present, I don't think it's a big deal if you lie down or not after Botox.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Botox and Post-Treatment Position?

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No, I do not think you did anything wrong. Botox should be  injected directly into the muscles involved;  is hard to imagine (even theoretically) that position change after the treatment  will make a difference. I doubt that you will see any difference in the efficacy of the treatment you have received.

Best wishes.

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Lying down after Botox treatments

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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.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
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Laying down and post-care with Botox

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Generally speaking we advise moving/using your muscles in the first 1 hour, and not laying down for 4 hours or rubbing the area for 4 hours. That said, I know of many patients in whom this message was not followed and they didn't seem to have any ill effects. Although there is not much scientific evidence to support the counselling we give for post-Botox, there is enough theoretical benefits that we still encourage it.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Lying Down After Botox

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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.

Ava Shamban, MD
Santa Monica Dermatologic Surgeon
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Lying Down Directly After Botox

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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.

Hardik Soni, MD
Summit Emergency Medicine Physician
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Lying down after Botox

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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.

Restrictions after Botox

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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.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Lying down after Botox

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I could not agree with Dr. Palmer more. There are so many ridiculous instructions given to patients post Botox and injectables. The truth is that your body is going to absorb it the same way whether you lay down, stand up, or do a headstand for three hours. You didn't do anything wrong by getting a massage. Any bumps you had should have resolved after a few days; it was probably a tiny bit of swelling at the injection sites only. 

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.