Occasionally there will be bruising and patients may need to use makeup to help hide it. There are little bumps at the injection sites that settle down within an hour of treatment. This is the fluid that is absorbed. Botox^® injection can be done over a lunch hour.

Although practitioners have recommended limiting activity and bending over for a few hours after injection, this does not have a scientific basis. I do not recommend any limitations on activities after injection.

Some doctors recommend that patients actively contract their muscles after treatment. The theory is that this will help the nerve endings take up the toxin. Whether this really happens is an open question. I don't instruct my patients to do this.

"Can I have a facial right after having Botox^®?"

It is generally recommended that the areas not be massaged after injection to limit possible diffusion of the Botox so it does not get taken up by adjacent muscles, such as the muscle that elevates the upper eyelid ("levator palpebrae superioris"). It's preferable to have the facial (or microdermabrasion) first, then Botox^®.

Resistance to Botox^®

Some patients may be resistant to Botox^® treatments, possibly due to the development of antibodies. I have encountered this in a single patient whose corrugator function is resistant to Botox^® injection.