Does rubbing upward on one's forehead immediately after Botox cause any potential problems? My nurse just did this?

I just received 25 units of botox on my forehead. 15 for my glabellar lines and 10 on the upper forehead. Immediately after the forehead injection the nurse that did my injection began rubbing my forehead upward about 10 times. I said "I thought you're not supposed to rub the area for a few days" and she said that is true for a downward fashion. What about the botox being pushed upward towards anything else... and can it go to your brain? I'm worried about her pushing it around at all!

Doctor Answers 4

Massage after Botox

Thank you for your question needtoknowSKIN. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression. With any Botox treatment there is the possibility that the Botox may spread to nearby muscles. In the forehead area it may spread to muscles that elevate the eyelids and cause droopiness. This can be treated with eye drops. I always massage the area after a Botox treatment to distribute and spread the Botox to the desired areas. In the forehead the massage is always done upward to avoid this aforementioned adverse effect. Botox can be place on the bridge of the nose or on the sides of the nose to address horizontal lines on the bridge of the nose or bunny lines on the sides of the nose, respectively. Botox should not travel to the sinuses nor should it affect the sinuses. Please consult with a doctor for specific recommendations. Good luck!


Encino Physician
5.0 out of 5 stars 1 review

Massage or not to massage after Botox

It is funny because the Cruthers, the husband and wife team who are considered the Godfather/Godmother of Botox disagree on this subject. Massaging after Botox by the physician is supposed to smooth the forehead injection. It is fine to to in an upward fashion. No harm is done whether is done or not. I used to massage but now I use multiple small doses of Botox to create a more uniform injection of the forehead.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Botox Injections and Migration

Botox will not be affected by manipulation after injected in my opinion.  I suggest you see an expert if you are concerned.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 166 reviews

It is not a helpful maneuver.

I think you are ready to find a new injector who is not a turkey.  The maneuver may do nothing or it may cause a problem.  Typically the injectors use 0.1 ml volume injections.  These relatively large volume injections can drift anywhere.  Commonly when done in the glabellar area the botulinum toxin drifts into the forehead causing central forehead paralysis.  I developed the patented Microdroplet Lift® which uses 0.01 ml injections just below the skin which traps the product very precisely preventing drift.  The result is a treatment that is concentrated just at the eyebrow and results in a very natural brow lift without a frozen forehead.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 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.