After Botox: Aftercare Instructions and Common Myths

What should I do in the first hours after injection?

The aim of early aftercare is to keep the product in the intended muscles, so it does not spread to neighbouring ones, and to reduce bruising. Details vary slightly between doctors, so always follow your own doctor's advice. Common instructions are:

• Do not rub or massage the injection sites on the day of treatment.
• Stay sitting or standing for about 4 hours, and avoid lying down or sleeping during that time.
• Leave strenuous exercise, saunas and hot baths until the next day.
• Do not wear a tight hat or headband pressing on the forehead on the day of injection.
• Make-up can usually be applied gently after a few hours unless your doctor says otherwise.
• Postpone facials, massage and other facial treatments for about two weeks.

When does Botox start working?

The effect usually begins after 2 to 5 days and is complete in about 10 to 14 days. So do not judge the result in the first few days; one side may seem to work faster than the other before they even out.

Many doctors arrange a follow-up visit after about two weeks to assess the result and make a small adjustment if needed. The effect usually lasts 3 to 6 months, then movement gradually returns; this varies with the person, the area and the amount used.

What side effects are normal?

You may notice small red dots or slight bumps at the injection points that settle within an hour or two, and a small bruise that fades within days. Some people have a mild headache on the first day.

Occasionally a temporary droop of the eyelid or brow occurs, or the tail of the brow lifts more than expected. These are uncommon effects that improve with time, and your doctor can sometimes reduce them. To lower the risk of bruising, ask your doctor before treatment about supplements or medicines that increase bleeding, and never stop a prescribed medicine without advice.

Common Botox myths, and the truth

There is a lot of inaccurate information about Botox, which makes some people afraid of it for no reason, or expect things it cannot deliver. The most common myths are:

• Botox freezes your face: a frozen look usually comes from too much product or poor placement; the aim is to soften wrinkles while keeping expression.
• If you stop, wrinkles get worse: when the effect wears off, the muscles gradually return to their previous movement, and stopping does not cause more wrinkles than would have appeared naturally.
• Botox builds up in the body: the body clears it gradually, which is why results need topping up every few months.
• More product means a better result: carefully judged amounts give a natural look, while too much can cause heaviness in the forehead or eyelids.
• Facial exercises speed it up: evidence for this is limited, and you do not need special exercises unless your doctor asks you to do them.

Who should postpone Botox?

Botox is not recommended during pregnancy or breastfeeding, or when there is inflammation or infection at the injection site. People with neuromuscular conditions, or who take certain medicines such as some antibiotics, need a specific assessment.

If you have an occasion such as a wedding or Eid, have your injections two to four weeks beforehand so the effect is complete and there is time for any adjustment.