Will Massage 2 Hours After Treatment Affect Botox?

I have just had my first Boxtox treatment done between my eyebrows. I was advised not to lie down for 4 hours but nothing was mentioned about applying pressure on the area. I have since been massaging the srea and have heard a crackle under the skin. I am now concerned, as I have read that this could encourage the Botox to travel to unwanted areas of the face. What will be the outcome of this massaging. I am worried I have ruined the treatment!

Doctor Answers 20

Just don't do it next time

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Lacey, Most dermatologists tell patients not to rub the area or massage for about four hours after injection. I know of no controlled study and think that we just fear that the product might be moved with rubbing to area where it is not wanted causing lid droop. That being said, I am sure that many people unconsciously rub their eyes all the time and have no ill effects. If you have a problem it will be temporary and you will not do the same thing again. 

Botox massage

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It's not advisable to massage the treatment areas after Botox injections, but best to leave it alone and allow time for the muscles to absorb the product so it can do what it was intended to do.

Do not massage the face after BOTOX

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Yes, there is a chance of making the toxin spread a little bit with massage. It is best not to handle the treated area at all, except for gentle application of sunscreen/ makeup.

Don't bend or massage the botox area for four hours after injections

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This is the suggestion, but it has never been studies so don't stress and just wait and see. You might have a most wonderful result despite not adhering to the suggested restrictions post Botox injecions. What's done is done and you can't change it now, but you may not have anything to worry about.

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

Botox instructions

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You most likely have not ruined your treatment, however it is not recommended to massage the treated areas for up to four hours following Botox injections.

Andrew P. Giacobbe, MD
Buffalo Plastic Surgeon

Massaging after botox is not advisable...

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In response to your question, it is not advisable to massage after botox injections.  Patients are recommended to wait 24 hours before putting any pressure on the area.  Massaging the injection site can cause the botox to travel in unwanted areas such as the eyes.  If it does travel to the eyes, you may get a droopy eyelid for a few weeks - it will resolve as the Botox effects weaken.  For best results you should always follow your plastic surgeon's instructions as carefully as possible.  If you don't notice any improvement within a week, then I would make a follow up appointment  to discuss further treatment.

Don't massage your Botox

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Massage after Botox injections may cause the Botox to migrate and possibly effect other muscles. Dysport is known to migrate more than Botox, even without massage. Thus, don't massage, just leave it alone. Botox can take days to weeks to become fully effective.

Todd C. Case, MD
Tucson Plastic Surgeon

It can, here's what I'll tell most patients

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Generally, because such small needles are used and Botox is injected into the muscle, there is not much disruption to the skin surface. That being said, it is safest to avoid rubbing the treating areas (no creams, facial massages, etc.) for 3-4 hours after Botox treatment . Manipulation or rubbing of the muscles a short time of injection can potential spread the Botox into areas that you do not want. Most importantly, the eyelids, causing the unfortunate eyelid droop. Also, any strenuous activity (heavy exercise for example) should be avoided for maybe 6-8 hours, just to decrease the chance of bruising which can be unsightly temporarily (especially when treating around the thin eyelid skin). By 12 hours after treatment, you can pretty much resume all creams, facials, and activity you want.

Manu Gujrati, MD
Palo Alto Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Will Massage after Botox Affect results?

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Hi Lacey.  Based on our experience, it is possible to affect the dispersion (how far it spreads) of Botox by having a facial or massage immediately after injections.  This is why we recommend not doing anything to the area for at least several hours.  As the other practitioners have mentioned, this is not based on scientific study, but experience.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Botox and massage/lying down

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While there are many post-procedure guidelines after Botox treatment, most of these recommendations (including lying down, avoiding exercise, etc.) are not backed by scientific evidence. Massaging the area unlikely affected the outcome of your injections, but it is advisable not to perform any massage on the treated areas, especially within the first few hours after treatment. 

Alison Stallings, MD
Tarrytown Dermatologic Surgeon

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.