How Long Do You Sit Still After Botox?

Botox techniques and amounts injected have changed over the years so now we have found that it doesn't make any difference what you do after getting your Botox shots.   

You do not really have to sit still after Botox injections.  In fact most people come in on their lunch break and go right back to work.

Normal activities can be resumed immediately after treatment. You should avoid strenuous exercise or massaging the area for 4 hours following treatment

You don't have sit still after Botox.  I just would not go and exercise or drink alcohol as this may increase your risk of bruising and swelling.  In addition, I would not recommend any manipulation of the injection region asides from putting cold compresses to reduce the chance of bruising.

The post treatment
instructions following botox injections are designed to minimize migration of
botox. When botox migrates to surrounding structures complications can occur
including droopy eyelids. In an effort to avoid these complications, a series
of steps should be taken to avoid displacement of botox.

Patients don't
have to sit still following botox treatment and should be able to resume most
of their normal activities. However they should avoid strenuous activities and
heavy lifting for at least 24 hours following botox injections. Exercise can
increase blood flow and theoretically decrease the effect of botox.

In addition
most providers recommend avoiding massage or manipulation of injected areas
because this might cause migration of botox. Conversely many providers advise actively
contracting these muscles to accelerate the onset of the response to botox.
Although some providers recommend not lying down for four hours following botox
injections, there is no scientific evidence to support this practice.

It's important
to discuss these issues with your injector. In most cases patients should be
able to resume normal activities after botox injections.

There is no need to sit still after your treatment, however it is important that you avoid strenuous physical activity for the rest of the day. 

Botox can migrate. Our office recommends Bruisestick ointment after Botox to reduce the risk of bruising and swelling after Botox. 

Despite there having been no formal study involving the movement of Botox as a result of bending over, most physicians insruct their patients not to bend for four hours after the treatment. A few might be limiting this to one hour.

You should move your facial muscles frequently after your BOTOX treatment. I have my patients perform specific facial exercises the day of their procedure to enhance the effect of BOTOX Cosmetic. I'm not sure this is necessary, but it certainly can't hurt.
I allow my patients to exercise with unrestricted activity 4 hours after their BOTOX Cosmetic procedure.
I hope this is helpful for you.

Because there is no concensus on this issue, and no scientific data to support any specific practice, physicians who inject Botox rely on their own logic, recommendations from the manufacturer, or similar practice by peers. As you can see from the answers, you will continue to get a variety of perspectives.
I personally do not suggest sitting still, or keeping the head elevated. I ask patients to move the involved muscles for about a half an hour after injection, in order to gently disperse the med and encourage it's binding to the receptors that light local activity would stimulate. I do not like patient massage. I limit activity only to avoid intense physical activity for 4 hours after injection, because logic tells me that the extra blood supply such activity stimulates might wash away the drug before it can bind. All opinion, no fact.
I believe Allergan distributed a survey to physicians about a year ago, in order to pinpoint suggestions of this nature. The majority of doctors, if I remember correctly, it was at least 70 to 90% for these questions, limit activity to some degree post injection, avoid patient massage, and otherwise don't restrict head position, elevator rides, alcohol. You can probably get that information from Allergan if you contact them.

Dear Clopes
Interstingly, some doctors thought that it was important to move the treated muscles. Now we understand that these restriction make absolutely no difference to the outcome of treatment. In my office, I recommend that patients wait 24 hours before returning to their work out. This stems from an experience I had with a patient who had a BOTOX treatment and immediately did a spin class. She developed a whopper of a black eye (she swears it was the spin class and not the boy friend). To be on the safe side I now tell people not do work out until the day after treatment.