Can Strenuous Excercise (Inversions) Cause Botox Migration?

I sent in a question about botox around my eyes and the droop in my mouth recently. I think I figured out what went wrong but wanted to double check my 'self' diagnosis. Right after botox, I went to a yoga class where I did inversions (upside down with blood and pressure in my head/face) for awhile. Stupid of me, I wasn't thinking! I am sure this is what may have caused the spread. Is that possible? If so, could it have migrated internally toward my brain? Sounds silly, but nervous??!

Doctor Answers 7

Don't exercise for 4 hours after Botox injections.

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I advise patients not to exercise for 4 hours after their Botox injections.  Excessive massaging or pressure could potentially cause some spread of the Botox to nearby surrounding muscles during this time, but it will not spread to your brain.

Toronto Dermatologist

Strenuous Excercise after botox

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Botox migration is possible and most experienced and expert injectors recommend that patients should be aware the risks that certain activities such as strenuous activities can have. If you have any questions regarding if an activity is recommended ask your injector.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Strenuous exercise following Botox

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It is possible for Botox to migrate slightly after strenuous exercise that you are describing.   If you had side effects from Botox only after doing yoga the same day, I would not recommend taking the day off in the future. 


Typical side effects from Botox injections are::

1) Slight bruising
2) Swelling
3) Temporary ptosis (drooping of the eyelid)
4) Allergic reaction at the injection site
5) Muscle stiffness near the injection site
6) Headache


Thanks, and I hope this helps!

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Can Strenuous Excercise (Inversions) Cause Botox Migration?

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In our practice after Botox injections we tell our patients not to do any strenous exerise, lay down or bend over for at least five hours after the injections.  Also no harsh rubbing of the face where the injections were either. Yes, the Botox can migrate shortly after injections if not using caution.

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

Botox and Strenuous Exercise

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While it was believed for some time that patients shouldn't do things like exercise or lie down after Botox, recent studies have shown that Botox doesn't migrate and stays in the muscle it was injected into. The only way I've ever seen it move is with excessive pressing on that area, which is why we tell people not to get facials or press on the area for about 24 hours. But exercise alone shouldn't have moved it. If you think it's moved, you really need to return to your injector for an evaluation. And no, it hasn't spread into your brain.

Botox migration

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Botox can migrate within the first hours after is has been injected, especially when too much pressure is applied to the area of the injection or because an unusual position, like upside down. It is a recommendation not to work out the for at least the first 4 hours after the injection and not to apply any excessive pressure over the injected area.

Yoga and Botox

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Once botox is injected it stays in the area of injection. Small volumes minimize the likelihood of diffusion. Headaches can happen and usually are treated with Tylenol. No brain compromise to worry about. Stay flexible.

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 127 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.