Can Botox cause painful lumps even after two weeks? (photos)

Question

I got 16 units of Botox between my eyebrows and forehead exactly two weeks ago. I noticed some swelling at first but now they just look like lumps and it hurts when touched. This was my first time and I don't even think it did anything to the wrinkles. It gave me headaches and you can see the red dots where she injected. She also did this immediately after a micro pen service....

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Botox is very effective in diminishing the appearance of frown lines, forehead furrows and crow's feet. The results last about three to six weeks, but typically take two to five days to show their effect. While each patient has a different healing process and timing for healing, I suggest that you discuss your results with your board certified facial plastic surgeon. It would be helpful to see before photos as well.
Best wishes,

Monika Soni, MD · Answer

Thank you for your question. Swelling can occur for 1-2 hours after Botox injection. However, this may be due to your microneedling treatment. I recommend following up with your injector for an evaluation and possible treatment. Best of Luck!

Melvin Elson, MD · Answer

Botox should not leave lumps at any time. some swelling may occur immediately afterwards but that is about it. See a board certified dermatologist to see what is going on and make sure in the future you are seeing a board certified dermatologist or plastic surgeon

Hardik Soni, MD · Answer

Thank you for your question. Swelling can occur for 1-2 hours after Botox injection. However, this may be due to your microneedling treatment. I recommend following up with your injector for an evaluation and possible treatment. Best of Luck!

Steven F. Weiner, MD · Answer

Having bumps this far out from treatment is not normal. I would be concerned about an infection. Your provider needs to see you. Also, I would never do the procedure after microneedling. There is a risk of the Botox spreading due to edema of the area. I would wait a few days after microneeding for the swelling to go down to get Botox in general. I think the problem is related to the microneedling and not the Botox.

Jo Herzog, MD · Answer

Sorry to hear that you are not happy. I do not think that you would have swelling from Botox after two weeks. Would be good to have before photos. Sometimes when the wrinkles are gone and the skin lies flat the boney prominences of the forehead are more apparent . This might be what you are seeing. If your brows raise and are more pointy than you like(like Spock) that can be fixed by an experienced injector. I think it is fine to do injections after needling.

George Taylor, MD · Answer

Hello,
Immediately after Botox injections you may see swelling and lumps from the fluid injected but this absorbs and subsides in a few minutes, unless bruising occurred. It is uncommon for lumps to remain two weeks later. There should not have been a problem to inject Botox post micro needling and micro needling does not usually cause lumps but can cause breakouts occasionally. I would recommend following up with your provider for further evaluation.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question rolias89. I am sorry to hear about your
situation. Botox is a purified protein used to address wrinkles associated with
facial expression. Swelling can occur for 1-2 hours after a Botox injection. This may be related to the microneedling. Please follow up with your doctor for specific recommendations. Good luck!

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