Is There New Protocol for Rubbing a Botox Injection Site?

Question

I had Botox last week between and over my eyebrows and the nurse gently massaged two of the sites. I mentioned to her that my last injections lasted about 8 or 9 months, now I'm wondering if she did that so I'd have to come back sooner. It has been 6 days and I still have lots more movement than I usually do by now. I really like the nurse and the practice, am I just being paranoid? Spending that money is such a luxury, I want to make sure I'm getting what I pay for.

Michael I. Echavez, MD · Answer

Massaging or rubbing an area after a Botox treatment is a matter of preference by the injector. Some injectors prefer not to do it and others prefer to do it. Whether it is done or not should not affect the longevity of the result. The amount of units used and the placement of the injections can affect the result.

Paul S. Nassif, MD · Answer

Whether or not massage is performed depends on your provider. To get the most out of your treatment with minimal side effects, proper injection technique is essential. Sometimes the Botox can take up to one week to take effect. I would recommend waiting a little bit and visiting your provider if you are not satisfied with the outcome. A touch up may help. In general, the Botox will last 3 months on average. I hope this helps, and I wish you the best of luck.

Donald B. Yoo, MD, FACS · Answer

You are likely just being paranoid because massaging or not massaging the area will not change the duration of the Botox. With an experienced injector in an established practice, you're probably getting what you paid for.

Sam Naficy, MD, FACS · Answer

It's not uncommon for an injector to hold pressure and push on the treatment somewhat, especially if you're bleeding it's always indicated to hold pressure. If you're visiting a well-trained and reputable injector and practice, you're likely getting exactly what you paid for. There is no correlation between massaging the product versus not massaging with relation to efficacy and longevity.

Evan Ransom, MD, FACS · Answer

This is a great question and practice patterns vary. In my practice, I do not massage the areas I have injected. It is my feeling that this can spread the Botox toward unwanted or unintended areas, and since I plan all of my injections based on my assessment of the specific strength and location of muscle activity, this would compromise the result. I recommend that patients take it easy for the rest of the day after injections (no weight lifting, yoga, etc.) and I provide disposable icepacks for those who want them.

David J. Myers, MD · Answer

There isn't much I can add to the excellent posts. Botox usually lasts 3-4 months. The long lasting benefit could have been from atrophy of the muscles after treatment. Massaging usually is only mildly helpful. Depends on the location and the person doing the massaging. At 6 days, massaging will not affect any spread. Good luck.

Lee P. Laris, DO · Answer

In my office we hold gentle pressure after the injections to prevent bruising, I do not recommend aggressively massaging the area as it can move the product, however this would not decrease the effectiveness. Botox can take up to 2 weeks for the optimal results as the botox begins to bind to the receptors and relax the muscles. I am surprised that you experienced 8-9 months of results with your first injections, but this is not the norm as botox is FDA approved for 3 months. If you are still experiencing excessive movement I would follow up with the injector, sometimes a "touch-up" is needed.

Richard W. Maack, MD · Answer

I agree with the general concensus that this is provider technique and will not effect how long the Botox with last.  Botox typically lasts 3-4 months.

Steven Wallach, MD · Answer

Botox does not last for 8 months. Usually it lasts for 3-4 months.  Rubbing it at 6 days will not do anything.

Rick Rosen, MD · Answer

Whether or not someone massages the area has no effect on how long the botox will last. Botox usually takes 6 days to take effect, and you may need a small amount of additional product to achieve the results you want.
	I am not aggressive with the massage as I do not want to move the product too far from where the planned injection site is. gentle is okay.

Is There New Protocol for Rubbing a Botox Injection Site?

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