Post-Operative Instructions: Botulinum Toxin (BOTOX®, Evolus™)

1 Hour After Receiving Botulinum Toxin Treatment

• You will want to practice gentle facial exercises for the first hour after receiving Botox (frowning, smiling, raising your eyebrows, moving your mouth). They help the toxin bind as intended to the areas treated.

3–4 Hours After Treatment

• No straining, heavy lifting, or vigorous exercise.
• Botox takes approximately 2 hours to bind itself to the nerve and begin working. Maintaining a relaxed heart rate and limiting circulation allows it to bind to the intended areas and not get washed away and affect other areas of the face. If you must exercise, wait at least 24 hours to work out. It also increases the risk of bruising. It is important that you sit up for the first 4 hours after botulinum toxin injections and avoid bending or lying down, as it could spread the toxin and promote bruising.

Do Not Manipulate the Area

• Avoid straining and vigorous exercise. You should avoid doing a facial, massages, peel, or microdermabrasion. Make sure your botulinum toxin appointment is scheduled for after any of these services if on the same day. Avoid touching, rubbing, or physical pressure on the affected area. Leave the treated area alone.
• To avoid spreading the toxin, don’t touch your face for at least 1 day. Try your best to avoid sleeping on the injected areas. This will minimize the physical pressure and let the botulinum toxin settle into your muscles.

2–10 Days After Treatment

• Cosmetic botulinum toxin usually takes about 2–10 days to take its full effect. For TMJ relief treatments, the effects usually take 4–6 weeks. We ask that the patient returns for a follow-up visit after 2–6 weeks to ensure the desired effect was achieved, and to answer any follow-up questions.

Stay Out of the Sun

• Avoid sun exposure for at least 4 hours. The heat can promote flushing and increase your blood pressure, which may encourage bruising. To be extra safe, avoid the sun for 24–48 hours.

Avoid Other Forms of Heat Exposure, Including But Not Limited To:

• Tanning beds
• Hot tubs
• Hot showers or baths
• Saunas

Return to Your Normal Activities

• There is NO recovery time from getting botulinum toxin and you will not need to miss work. You can resume your usual activities immediately when finished.

Go Makeup-Free

• If you received botulinum toxin injections in your facial area, do not apply makeup for 24 hours. Applying makeup will rub the skin, potentially dispersing the toxin.

Don’t Drink Alcohol

• Avoid alcohol for 24 hours. Alcohol increases the risk of bruising.

After Getting Botulinum Toxin

• It is not uncommon to have bruising, redness, tenderness, and swelling. These will usually disappear within 1 day. You can apply ice packs for relief. Some bruising can last for up to 2 weeks.

These following side effects are very rare, but they warrant immediate medical attention. If you notice any of them, call our office immediately:

• Muscle weakness
• Trouble swallowing
• Difficulty speaking
• Difficulty breathing
• Poor bladder control
• Vision changes