Can rubbing my eyes on the day of Botox cause negative side effects like ptosis or asymmetry?

Question

I plan to get Botox in the following areas: glabellar lines, forehead muscles, and lateral orbital lines. I have seasonal allergies and often unintentionally rub my eyes due to itchiness. I have tried all kinds of medications to control without too much success. On the day of Botox administration, is it likely that I will unintentionally migrate the Botox to unintended areas by rubbing my eyes? I’m concerned about having a bad aesthetic side effect like ptosis, asymmetry, etc.

David Gilpin, MD · Answer

Thank you for your question!  I do recommend to my patients that they not lie directly on his/her face or rub with a lot of pressure after Botox injections, for about 24 hours.  However, gently rubbing the eyes, the day after Botox treatment should be okay and shouldn't cause problems.  I would speak with your injector if you are having any issues or concerns, though.  I hope that this helps!-David Gilpin

Luis Villar, MD, FACS · Answer

If you get ptosis or assymetry it will likely occur from the injection. Ptosis typically occurs when the needle  gets down to the deep tissue planes and the injection pressure forces it down these planes to the levator muscle which pulls up the upper eyelid. Experienced injecters place Botox/Xeomin/Dysport into the muscle layer and push the plunger as the needle is removed to avoid high injection pressures which can force neurotoxin into veins, arteries, or along tissue planes into unintended sites.  Unfortunately, far too many injecters do not know the anatomy or how neurotoxins work, and that every patient is different.  The good news is that the effects are temporary and though scary, they will wear off and you will be OK.Wait one week and go back to touch up significant assymetries.  Wait ptosis out.  It will go away.

N. Bill Aydin, MD · Answer

Hi, Thank you for your post. I have not come across any problems with rubbing your eyes after botox. I would try to avoid rubbing any areas where botox was injected to avoid migration.

Jessica Lattman, MD · Answer

In my experience, rubbing your eyes after botox does not cause it to migrate.  I would avoid rubbing right after the injections, but an hour or two later should be OK.

Katrinka L. Heher, MD · Answer

No worries what's so ever!! You will be fine and can rub all you want.  I know there are many recommendations as to what to avoid after botox, but I have never seen migration associated with something a patient did shortly after the injections.  I hope you obtain the desired results!

Jessica H. Kim, MD, FAAD · Answer

As long as you are not directly massaging over the injection sites, you will not be moving the botox around.  This potential migration is also only relevant for up to 4 hours after the treatment.

Eric J. Culbertson, MD · Answer

I think rubbing your eyes is unlikely to have a significant effect on migration of the Botox. The most important factor in avoiding these issues is the technique used for the injection and ensuring proper placement.

Amy J. Holland, MD · Answer

This is a great question and I have never experienced this.
To be on the safe side, best definitely not rub first hour post treatment and try to keep to a minimum first 5-6 hours post treatment.
Hope this helps, Dr.Amy

Can rubbing my eyes on the day of Botox cause negative side effects like ptosis or asymmetry?

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