What to avoid after Botox: how long swelling lasts and when to see a doctor
Restrictions after Botox: for the first 24 hours, do not keep your head lowered, do not do yoga or headstands, and do not touch or massage the injection area; for the first 3 days, avoid steam rooms. Also covered: swelling after injection as described on the manufacturer's label, when the effects begin, and the signs that mean you need to see a doctor right away.
After a Botox injection, there are three groups of restrictions. In the first 24 hours, avoid lowering your head, do not do yoga or headstands, and do not touch or massage the injection sites. In the first 3 days, avoid steam rooms and do not massage the injected areas. Tell your doctor right away if you notice any dangerous signs. This is the official aftercare guidance of BonBoz Clinic (licences 11113/HCM-GPHĐ and 10036/HCM-GPHĐ, Ho Chi Minh City Department of Health). At the clinic, Dr. Bùi Thị Kim Kha, a Specialist Level I physician (practising certificate 009784/ĐL-CCHN), personally examines and injects patients.
The sections on swelling and reactions after injection are based on the manufacturer's prescribing label, not on word-of-mouth experience. If you are having jaw-slimming (masseter) injections, the article where to get jaw-slimming Botox and how long it takes to show has separate timelines for the masseter muscle. If you are having filler rather than Botox, the restrictions are quite different; see the article what to avoid after filler. The mechanism, injection areas and who should not be injected are covered on the page Botox (botulinum toxin) treatment.
What to avoid after Botox: summary table by time period
The rows for the first 24 hours, the first 3 days and warning signs in the table below reproduce the meaning of the post-injection Botox care instructions the clinic gives to clients. The row for the follow-up visit is advice so that the doctor can assess your result before making any adjustments. The last column is the purpose to keep in mind, so that when you face a situation not in the table you still know what to do.
| Time after injection | What to avoid | What to remember |
|---|---|---|
| First 24 hours | Avoid lowering your head; no headstands, no yoga; do not touch, rub, press or massage the injection area | Leave the freshly injected area alone and keep your head upright |
| First 3 days | Avoid steam rooms; do not let anyone massage the injection area | No spa visits yet, and no facial treatments that involve rubbing or kneading |
| Until the follow-up visit | Do not get extra injections elsewhere on your own | Wait for the doctor to review the result before deciding on any adjustment |
| At any time | Do not ignore warning signs | Redness, inflammation, swelling, prolonged pain, ptosis (drooping eyelid), difficulty swallowing, difficulty breathing: tell your doctor right away |
Two points people often ask about: "lowering your head" means positions where your head stays tipped down for a while, such as bending over to mop the floor, picking things up from under furniture, or washing your hair leaning forward; "not touching the injection area" includes habits such as resting your chin or forehead on your hand while working at a desk. If you need to wash your face or apply makeup that day, do so gently and avoid pressing on the exact injection points.
Why leave the injection area alone for the first 24 hours?
Botulinum toxin type A is injected directly into the muscle, which weakens muscle contraction for a period of time. In the boxed warning section, the manufacturer's prescribing label states that the effects of all botulinum toxin products may spread away from the injection site and cause symptoms resembling botulism. These symptoms have been reported from a few hours to several weeks after injection. This is why the dose and injection points must be determined by a doctor, and why difficulty swallowing, speaking or breathing always fall into the group of signs that require immediate medical attention.
The clinic's restrictions for the first day all share one principle: do not apply pressure, do not rub or knead, and do not suddenly change your head position over the area just injected. The guidance does not require you to lie down all day or take time off work; what matters is avoiding exactly the things in the table.
One small point that is often overlooked: the drug label advises that if you experience muscle weakness, blurred vision or drooping eyelids after injection, you should not drive, operate machinery or do other dangerous activities. If you had injections around the eyes and drove yourself home, pay attention to how your eyes feel over the following days.
Do I have to avoid certain foods or drinks after Botox?
In the aftercare document the clinic gives to clients, the Botox section has no list of foods to avoid. The 3-day food restriction list (sticky rice, banana, sweet potato, seafood, beef, chicken, bamboo shoots, fermented fish sauce) in the same document is for BAP, a different type of injection; do not apply it to Botox just because you heard others say so.
What really needs attention is medication, not food. The patient medication guide in the manufacturer's label advises:
- Tell your doctor about all medications you are taking, including over-the-counter drugs, vitamins and herbal supplements.
- Tell your doctor if you have had any botulinum toxin product in the past few months, and give the exact product name.
- After your injection, if you see another doctor and are prescribed a new medication, tell that doctor you have just had a botulinum toxin injection.
If you are taking anticoagulants or medication for a chronic condition, do not stop on your own to "be safe for the injection." Bring the names of your medications to the consultation so the doctor can decide.
How long does swelling last after Botox?
The prescribing label does not give a general number of days for swelling, so this article does not set one either. What the label records, from three controlled clinical trials with 911 people injected in the frown area:
- The most commonly reported injection-site reactions include swelling, facial pain, folliculitis, bruising around the eyes, bruising, pain, small lumps and itching at the injection points.
- The most common side effect is headache, about 2 in 100 people. Brow ptosis and eyelid ptosis each occurred in fewer than 1 in 100 people.
- Most side effects appear in the first week after injection and are usually temporary, but in some cases they last several months or longer.
Read in practical terms: small swelling, redness or bruising at the needle point usually shows up early and gradually fades; you should watch its direction rather than count days. Swelling that shrinks and pain that eases gradually is the usual course. Swelling that grows, redness that spreads, warmth, or pain that increases or does not subside is no longer "normal swelling": the clinic's guidance places redness, inflammation, swelling and prolonged pain at the injection site in the group that must be reported to the doctor right away.
Swelling with itching, hives or wheezing is something else
The drug label lists allergic reactions to botulinum toxin, including itching, rash, hives, wheezing, difficulty breathing, dizziness or feeling faint; severe reactions may come with soft tissue swelling. If you have these signs, especially wheezing or difficulty breathing, go to the emergency room immediately, then inform the doctor who injected you. Do not take antihistamines on your own and wait to see what happens.
Dry, gritty or light-sensitive eyes after injections around the eyes
The label states that botulinum toxin may cause dry eyes, reduced tear production and reduced blinking. If you have eye pain, a gritty feeling, sensitivity to light or changes in vision, tell your doctor; symptoms that persist need an eye examination.
How long until Botox works, when is it assessed, and when can I be injected again?
The drug starts to show an effect after a few days (the label does not give a specific onset in days). According to the manufacturer's label, the effect is fully assessed at week 4, and the interval between two injections should be no shorter than 3 months. At BonBoz specifically, the clinic schedules a follow-up visit about 2 weeks after injection so the doctor can review and adjust if needed (this is the clinic's appointment schedule, not a milestone from the drug label).
| Time point | What usually happens | What you should do |
|---|---|---|
| First few days | Muscles begin to contract less; needle marks, swelling and redness, if any, gradually fade | Follow the restrictions table; do not rush to judge the result |
| About 2 weeks | The clinic's follow-up visit | The doctor checks symmetry and decides whether adjustment is needed |
| Week 4 | The point the manufacturer uses to assess effectiveness | Compare before and after photos, taken from the same angle and in the same lighting |
| From 3 months onward | The earliest point for repeat injection according to the label | Book a check-up when you see the muscle moving as before; there is no fixed injection schedule |
Why not get more injected right away when it looks "not enough"? Because in the first few days the drug has only just started to work. Whether further adjustment is needed is the doctor's decision at the follow-up visit, after seeing how far the muscle has responded. The label also advises the doctor to take the total dose into account if you have used or are using another botulinum toxin product; so always be honest about where, when and with what product you were injected.
If you need results for a specific date such as a wedding, the article planning Botox before a wedding or event helps you work backwards to plan your schedule.
After Botox, which signs mean you must seek care right away?
There are two levels, so you know whom to call first.
Go to the emergency room immediately, then tell the doctor who injected you, if you have any of the signs that the drug label says need immediate medical care:
- Difficulty swallowing, difficulty speaking, slurred speech, hoarseness or loss of voice, difficulty breathing. The label stresses that these symptoms can appear hours, days or weeks later.
- Generalised muscle weakness, double vision, blurred vision.
- Wheezing, hives, dizziness to the point of fainting.
Call the doctor who injected you right away, according to the clinic's guidance:
- The injection site is inflamed, red, swollen, or the pain does not go away.
- Ptosis, or a drooping eyelid. The drug label also records eyelid and brow ptosis as uncommon side effects.
When you call, remember to say which day you were injected, where you were injected, and what name is on the product box. If convenient, take a photo of your face from the same angle as your before-injection photo and send it along.
Before injection: what to tell your doctor
Many "restrictions" actually begin before the injection visit. According to the manufacturer's label, do not get injected if you have ever had an allergy to any botulinum toxin product or have a skin infection at the planned injection site. The label also lists conditions to tell your doctor about beforehand:
- Diseases affecting nerves and muscles, for example myasthenia gravis.
- Having had side effects from a previous botulinum toxin injection.
- Having or having had problems with breathing (such as asthma), swallowing, bleeding or the heart and circulation.
- Currently having ptosis, weak forehead muscles, previous facial surgery, or planned surgery.
- Having had dry eyes after a botulinum toxin injection.
- Being pregnant, planning to become pregnant or breastfeeding: the label states it is not known whether the drug can harm the unborn baby or pass into breast milk.
The consultation at the clinic is when the doctor asks about these again and examines your muscles as you smile, frown and raise your eyebrows, before deciding whether to inject and how much.
Botox at BonBoz: check the product before injection
The Botox (botulinum toxin) at BonBoz Clinic is declared by the clinic to be genuine, imported from South Korea, with labels and certificates; clients check and open the box themselves before injection. You should make use of this right: check the label, the expiry date and that the box is intact before the injection step. Take a photo of the box, because the product name on the box is information the doctor needs if you have a reaction later, or when you are injected again next time.
The clinic is at 66–68 Võ Văn Tần, Xuân Hòa Ward (formerly District 3), Ho Chi Minh City. A price range by injection area is on the page Botox cost by area; the doctor gives a specific quote after the examination, because the dose differs for each person. If you want to ask before coming in, you can use the contact page.
Frequently asked questions
What should I avoid in the first 24 hours after Botox?
According to BonBoz Clinic's guidance, on the first day keep your head upright (avoid lowering it, and avoid yoga and headstands) and leave the injection area alone: do not touch or massage it. The guidance does not require you to take time off work; just avoid these things.
How long after Botox can I use a steam room or have a facial massage?
For the first three days, according to the clinic's guidance, avoid steam rooms and do not let anyone massage the injected area. If you plan to have a facial treatment with strong rubbing or kneading after this point, ask your doctor at the follow-up visit.
Do I have to avoid certain foods after Botox?
The Botox section of the clinic's care document does not list any foods to avoid. The list of restrictions on sticky rice, seafood, beef and so on is for BAP and does not apply to Botox. What you need to do is tell your doctor about all medications, vitamins and herbal supplements you take.
How long does swelling last after Botox?
The manufacturer's label does not give a general number of days; it states that most side effects appear in the first week and are usually temporary. Swelling that shrinks is the usual course. If swelling grows, or there is redness, inflammation or prolonged pain, tell your doctor right away.
How long until Botox starts working?
The drug starts to show an effect after a few days; according to the label, the effect is fully assessed at week 4. The clinic schedules a follow-up adjustment visit after about 2 weeks.
How long after Botox can I be injected again?
The drug label specifies that two injections should be at least 3 months apart. When to be injected again is decided by the doctor, based on whether your muscle has returned to contracting as before.
What should I do if my eyelid droops after Botox?
Call the doctor who injected you right away, and do not rub or massage the eye area yourself. While waiting to be seen, do not drive if your vision is blurred or the drooping eyelid blocks your sight. If it comes with difficulty swallowing, speaking or breathing, go to the emergency room immediately.
References
- Hugel, Inc. LETYBO (letibotulinumtoxinA-wlbg) for injection — Prescribing Information and Medication Guide, FDA-approved label, issued 02/2024. This article cites the label as a reference for the botulinum toxin type A class; the product used for you is the one named on the box opened in front of you: accessdata.fda.gov.
- BonBoz Clinic — Post-injection care instructions for Botox, HA/Filler (internal professional document given to clients after injection).
Updated 11/11/2026. This article helps you take care of yourself after injection and know when to call your doctor; it does not replace an examination. Each person has their own dose and injection points, and only a doctor who examines you in person can make that recommendation.
This article was written by Specialist Level I physician Dr. Bùi Thị Kim Kha and the BonBoz Clinic professional team.
This article is for reference only and does not replace an in-person examination or a doctor's diagnosis. Actual results vary by individual condition.
