Congratulations on investing in your appearance with injectable treatments. Whether you have just received Botox, dermal fillers, or both, the hours and days following your treatment play an important role in determining your final results. Proper aftercare minimizes side effects, reduces downtime, and helps ensure you get the most beautiful, long-lasting outcome from your procedure.
This comprehensive guide covers everything you need to know about post-treatment care for both neurotoxin (Botox, Dysport, Xeomin) and dermal filler treatments, including what to expect at each stage of your recovery and the warning signs that warrant contacting your provider.
Botox Aftercare: The First 24 Hours
Botox aftercare is relatively straightforward, but the first 24 hours are the most important period. During this time, the botulinum toxin is binding to the nerve endings at the injection site, and certain activities can interfere with this process or increase the risk of side effects.
What to Do
- Stay upright for 4 hours: Avoid lying down or bending over significantly for at least 4 hours after treatment. This helps prevent the Botox from migrating to unintended muscles.
- Gently move the treated muscles: While this is debated among providers, many recommend gently frowning, raising your eyebrows, or squinting (depending on the area treated) periodically during the first hour. This may help the Botox bind to the targeted nerve receptors.
- Apply cool compresses if needed: If you experience mild swelling or discomfort at the injection sites, a cool (not frozen) compress applied gently for 10-minute intervals can help.
- Resume normal activities: You can return to work, run errands, and go about your day immediately after treatment. Botox is a truly "lunchtime procedure."
What to Avoid
- Intense exercise: Avoid vigorous physical activity, hot yoga, or heavy lifting for 24 hours. Increased blood flow and elevated body temperature can cause the Botox to disperse beyond the intended area.
- Touching or massaging the treated area: Do not rub, massage, or apply pressure to the injection sites for at least 24 hours. This can push the Botox into adjacent muscles.
- Alcohol: Avoid alcohol for 24 hours before and after treatment, as it increases bruising risk and can cause vasodilation.
- Saunas, hot tubs, and steam rooms: Avoid heat exposure for 24 hours, as it promotes blood flow and may affect Botox distribution.
- Facials and skin treatments: Avoid any facial treatments, microdermabrasion, chemical peels, or laser treatments for at least 2 weeks after Botox.
Dermal Filler Aftercare: The First 48 Hours
Dermal filler aftercare requires a bit more attention than Botox, primarily because fillers cause more swelling and bruising. The product needs time to settle into its final position, and improper aftercare can lead to asymmetry, migration, or prolonged recovery.
What to Do
- Apply cold compresses: Gently apply wrapped ice packs or cold compresses in 10-minute on, 10-minute off intervals for the first several hours. This significantly reduces swelling and bruising. Never apply ice directly to the skin.
- Sleep with your head elevated: For the first 1 to 2 nights, sleep with an extra pillow to keep your head above your heart. This reduces swelling, particularly for lip and under-eye filler treatments.
- Stay hydrated: Hyaluronic acid fillers attract and bind water molecules. Drinking plenty of water helps the filler integrate naturally into your tissues and maintain optimal hydration.
- Take arnica if recommended: Many providers recommend arnica montana (oral or topical) to help reduce bruising. Begin taking it before your appointment if possible.
What to Avoid
- Touching or manipulating the area: Avoid pressing, massaging, or playing with the treated area for at least 48 hours (unless your provider specifically instructed you to massage for product distribution). Filler needs time to set, and manipulation can cause displacement.
- Intense heat: Avoid saunas, steam rooms, hot baths, and direct sun exposure for 48 to 72 hours. Heat causes vasodilation and increased swelling.
- Strenuous exercise: Avoid vigorous activity for 24 to 48 hours to minimize swelling and bruising.
- Dental work: If possible, avoid dental procedures for 2 weeks after facial filler, particularly after lip or nasolabial fold treatments. The pressure and stretching involved in dental work can displace filler.
- Blood thinners: Avoid aspirin, ibuprofen, fish oil, vitamin E, and other blood-thinning supplements for 24 to 48 hours after treatment (ideally discontinue these 1 week before your appointment, with your physician's approval).
- Makeup at injection sites: Avoid applying makeup directly over injection sites for at least 6 hours to reduce infection risk. After that, gentle makeup application is fine.
Timeline of Results
Botox Results Timeline
- Day 1-3: No visible change yet. The Botox is beginning to bind to nerve receptors, but muscle activity has not yet been affected.
- Day 3-5: You may begin to notice the treated muscles are harder to move. Fine lines start to soften.
- Day 7-10: Significant improvement is visible. Most patients see the majority of their results by this point.
- Day 14: Full results are achieved. This is the standard time for follow-up assessment and any touch-up treatments.
- Month 3-4: Results gradually begin to fade as nerve function returns. Most patients schedule their next treatment at this point.
Dermal Filler Results Timeline
- Day 1: Immediate volume is visible, but swelling makes the area appear larger than the final result. This is normal. For lip fillers, expect significant swelling.
- Day 2-3: Swelling typically peaks at 48 hours and begins to subside. Bruising may become more apparent before it improves.
- Day 5-7: Most swelling has resolved. Bruising is fading. You are beginning to see your true results.
- Day 14: Filler has fully settled and integrated into the tissue. This is the best time to assess your final results and determine if any adjustment is needed.
- Month 6-18: Duration depends on the product, treatment area, and your metabolism. Lip fillers typically last 6 to 9 months; cheek and jawline fillers can last 12 to 18 months or longer.
Normal Side Effects vs. Warning Signs
Normal and Expected
- Mild to moderate swelling at injection sites (especially lips and under-eyes)
- Bruising ranging from small dots to larger areas of discoloration
- Tenderness or soreness when touching the treated area
- Minor asymmetry during the swelling phase (one side often swells more than the other)
- Small bumps that are palpable but not visible (these typically smooth out within 2 weeks)
- A feeling of heaviness in the forehead or brow area after Botox (temporary as muscles relax)
Contact Your Provider Immediately If You Experience
- Blanching or white patches on the skin: This could indicate vascular occlusion, where filler has compressed or entered a blood vessel, cutting off blood supply to the skin.
- Severe, disproportionate pain: While some discomfort is normal, intense or worsening pain that is not relieved by over-the-counter pain medication is a warning sign.
- Dusky, blue, or gray skin discoloration: This may indicate compromised blood flow and requires immediate assessment.
- Visual changes: Any vision changes, including blurriness, double vision, or loss of vision, after facial filler treatment require emergency evaluation.
- Signs of infection: Increasing redness, warmth, pus, or fever developing days after treatment may indicate infection.
- Significant asymmetry that persists beyond 2 weeks: While mild asymmetry during swelling is normal, major asymmetry that does not resolve may need correction.
Follow-Up Appointments
Your provider will typically schedule a follow-up appointment 2 weeks after your treatment. This appointment is important, even if you are happy with your results. It allows your provider to assess the outcome, document your results with photographs, address any asymmetries with touch-up injections if needed, and plan your next treatment session.
Do not skip your follow-up. It is a critical part of the treatment process and ensures you receive the best possible long-term results.
At Facial Injectables, our training programs teach practitioners how to provide comprehensive aftercare education as part of every treatment. Proper aftercare communication builds patient trust, reduces anxiety, and improves outcomes. Explore our Botox Certification Course and Advanced Botox and Filler Training to learn more about building a patient-centered injectable practice.