If Botox migration occurs within the first day (4-6hrs), why do adverse effects occur days later?

Question

I am reading testimonials about botox migrating outside of the intended treatment area and causing adverse effects anywhere from 5-12 days later. If adverse effects can occur 5-10 days later, why is it recommended that exercise, laying flat, wearing hats, etc. be avoided only for the first day?

Kenneth D. Steinsapir, MD · Answer

The adverse effects of botox is not so much form migrating outside the intended area hours later.  That is said to shift responsibility of the injector to you, the patient.  This is not accurate.  The migrating is due to how the injection is performed and occurs almost immediately at the time of treatment.  Very quickly, the fluid associated with the serivce is absorbed.  We recommend avoiding exercises immediately after treatment to reduce the risk of bruising.  Like all botulinum toxin effects, the effect does take a couple of days to reach maximal effect.

Rajat Gupta, MD, MS, DNB · Answer

Botox only starts acting after 3-4 days even where it is desired to act. The results start showing only after 7 days. So even if the Botox migrates to a wrong place, the results will start showing only after 4 -7 days.  Botox is temporary and starts loosing its effect after 6 months. In some cases, it can even lose effect as early as 3-4 months.

Jason Emer, MD · Answer

if migration occurs you will have to wait 2-4 months for it to resolve. I suggest you see an expert injector.  Best, Dr. Emer.

Camille Cash, MD · Answer

Migration refers to the product traveling and affecting an unintended muscle.  This is not common, but if it occurs it's soon after injection .  The effects of Botox, both good and bad, however are not seen for several days after injection.  If Botox migrated on the first day its effects won't be seen until days after.  Botox is considered in full effect 14 days after treatment.

Monika Soni, MD · Answer

Thank you for your question. Botox is a very safe procedure. Botox settles into place in the first few hours after injection but can take 7-14 days to take full effect. You only need to avoid lying flat, massaging the treated area and wearing hats until the Botox has settled into place. However, I do advise not exercising for the first 24 hours after treatment. However, there is no standardized post treatment guidelines. I hope this helps!

Gordon Andan, MD · Answer

Thank you for your question. While there is some anecdotal evidence of BOTOX® migration occurring during the days following an injection, for the most part, your BOTOX® should be set in place within only a few hours. However, if you’ve combined BOTOX® with dermal fillers, it’s possible that BOTOX® may have tracked to other areas of your face along with the fillers. Remember to visit a medical spa for your injections to ensure top quality results.

Hardik Soni, MD · Answer

Thank you for your question. Botox is a very safe procedure. Botox settles into place in the first few hours after injection but can take 7-14 days to take full effect. You only need to avoid lying flat, massaging the treated area and wearing hats until the Botox has settled into place. However, I do advise not exercising for the first 24 hours after treatment. However, there is no standardized post treatment guidelines. I hope this helps!

Melda A. Isaac, MD · Answer

When Botox is injected into a muscle, spread or diffusion of the medication should be anticipated by the experienced physician to both limit potential complications and optimize on the benefits of Botox treatment.  It takes about a week for Botox to reach maximum effect as the receptors on the muscle become occupied by the Botox molecule thereby reducing contraction of the muscle and wrinkles of facial expression.  If too much Botox is injected or if Botox is injected at the wrong site, Botox can spread to areas not intended to be treated causing an undesirable effect. Although Botox binds quickly, it takes time for the receptors on the muscles to become saturated with Botox and this is why it takes time to see  both bad and good results from treatment.  I hope this answers your question.

Sameer Bashey, MD · Answer

Botox can migrate if injected close to certain anatomic structures or if too much fluid volume of the botox was injected. Depending on where the injection took place- there can be several annoying issues that are seldom dangerous. There may be a brow or eyelid drop, mouth drop, etc. Most of these issues are temporary and would go away in 2-4 months.

Melvin Elson, MD · Answer

The Botox may migrate during the first few hours, but just like its positive effects taking a few days to manifest as the muscles have to respond, the side effects also take time to develop

If Botox migration occurs within the first day (4-6hrs), why do adverse effects occur days later?

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