How long does it take for botox to attach to the nerve?

If I massage the area the next day? Would I have caused the botox to migrate or not work? In the area I was treated for the 11 lines, I had 25 units and it did not get rid of them but has dropped an eyelid and brow. The dr said it was properly injected and that most likely when washing rash and rubbing area moved it but I was beyond careful for the first 24 hours?

Doctor Answers 9

How long before the Botox won't move

Hello Liliruss,

For my patients I recommend not to bend over for the first 4 hours and no exercise for that day.  I also tell them not to massage the area like we do with fillers.  Beyond that time I have them do whatever they like.  It sounds like you followed the directions I have my patients follow.  As far as washing your face unless you were doing a vigorous massage I would not anticipate you moved the Botox (but if you were really scrubbing hard that night you may have).

I can never comment on how or where another injection was performed but in my experience your result was not because of your actions.  Only the person who injected you knows where the Botox was placed.  I tell my patients by staying at least 1 centimeter away from the bony rim around their eye we can reduce the risk of a droopy eyebrow or eye to less than 1% (but never no risk).  With that technique and my instructions above I have not had a patient who has had any ptosis or droopy eyelids/eyebrows. 

I hope this helps and good luck. 

The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Botox and post-care instructions

Botox is fabulous for the wrinkles that you described.  I always recommend that my patients do not exercise for 24 hours after the procedure and remain upright for at least 4 hours after the procedure.  Any negative side effects will dissipate in a few weeks to 3 months.  Please keep us posted.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews


Thank you for your question. I tell my patients to avoid massage, exercise, facials and touching the area for the remainder of the day of the injection. There is also, no laying down for 3 hours. It takes 3 hours for Botox to do it's magic. 

Hope this helps, 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 469 reviews

Botox complication

As long as you don't lie down or massage for 4 hours, the risk of migration is very low. There are many factors that can cause this in addition to dilution, units used, placement and overall bad luck. This complication can occur in 2% of patients so overall hard to say exactly why it occurred.  Be sure to get an experienced dermatologist or plastic surgeon consultation for your treatment on your next treatment.

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
4.9 out of 5 stars 15 reviews

Avoiding complications from Botox

Greater than 3 hours after treatment, there is little risk of anything you do causing migration.  Potential migration has more to do with dilution and injection technique than it does your activity level hours after treatment.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 58 reviews

Botox and Time To Results

Botox if injected properly goes directly into the muscles.  Massaging, movement, exercise doesn't change the chance of migration -- which in my opinion is due to technique or frank bad luck.  Botox takes 10-14 days to work and will be gone in 3-4 months.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Botox migration and onset

Thank you for asking. Treatments like Botox and Dysport setup mostly in hours but there may be ongoing effects a bit longer. I advise patients to avoid significant rubbing, massage and similar positional activities for a day or so. The full onset of these products can be seen a week or so out from the treatment. It is quite uncommon to have a dropped position of an eyebrow or eyelid if the product is placed properly and the product did not drift or move outside the treated area. There may be treatment options if an eyelid or brow is dropped. Talk with your doctor about possible options. Best wishes

David C. Yao, MD, FACS
Phoenix Plastic Surgeon
4.8 out of 5 stars 7 reviews


it can take a full week to get effect of Botox. It can migrate if massaged or you work out which is why I recommend no work out for 24 hours. Talk to your plastic surgeon if you're experiencing eyelid droop. 

Levi J. Young, MD
Overland Park Plastic Surgeon
4.8 out of 5 stars 60 reviews

Botox migration

The Botox does not usually migrate after several hours even if your rub. With that said, if the Botox happenes to be injected at just the right plane it can migrate laterally and effect the muscle which lifts the brow or eyelid. It is probably not the doctor's fault, because he gave you the proper dose in that area. There is always the chance that your physician was inexperienced and simply injected the wrong location. Many questions about Botox on RealSelf deal with getting the best price. This is why you should select an advanced injector rather than the cheapest. Do not worry, the droop will resolve within a month. Good luck. 

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 144 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.