There are specific guidelines that we need to adhere to immediately after our Botox treatment as this will ensure a reduction in potential side effects and improve the overall treatment results.
“Immediately after placement it has been shown that Botox will diffuse or spread from the treatment area.” – Dr Alek Nikolic
This diffusion circle will vary depending on the type of neurotoxin used and the dilution used but as a rough guideline Botox® can spread as much as 1.5cm from the treatment point while Dysport® can spread as much as 4cm from the treatment point. What this means is that this spread can affect muscles we do not want ‘treated’ so to reduce possible side effects such as an eyebrow or eyelid ptosis (drop) the following rules should be followed:
- Do not lie down for 5 hours
- Do not exercise for 5 hours
- Do not press, massage or rub the treated areas for 5 hours. This includes washing the face, wearing a tight cap or helmet, or leaning your face on your hand.
If we do not follow the above five-hour rule one could increase the diffusion circle allowing the Botox® to spread to the upper eyelid muscle which will cause the eyelid to droop (eyelid ptosis). Treatment for this will include the use of Iopidine eye drops that will help to lift the eyelid until the Botox effect has worn off which typically takes 2 to 4 weeks. If, however the eyelid muscle was directly injected or treated with Botox the drop would last for the full 3 to 6 months.
“The world wide reported incidence of eyebrow and eyelid ptosis is 0.1% of all treatments.” – Dr Alek Nikolic
What has been shown is that side effects to Botox such as ptosis reduces over time (with ongoing treatments) which is most probably related to the experience of the injector and patients learning to follow the five-hour rule.
Post Botox Tip:
The following are not considered contra-indications following a Botox treatment:
- Bending (but I would avoid excessive bending)
- Alcohol intake
Another post treatment rule I ask all my patients to do is to exercise the treated muscle with ten forceful contractions and this is typically done in my treatment room. The theory behind this is that by forcing the muscles and the nerve endings to work there will be a greater uptake of the Botox® resulting in a faster onset of action and a longer duration. According to the Consensus Recommendations, published in the American Society of Plastic Surgery Journal, 78% of the worlds most experienced injectors ask their patients to forcefully contract the treated muscles.
Finally, it is a good idea to stick to your treatment regime to maximise the results over the long term and this typically will range between every 3 to 6 months. My recommendation is to set your next appointment as muscle movement starts and the best area to gauge this is the glabella or frown area. If the frown was not treated, then as soon as you see an increase in the number of wrinkles with active movement (such as around the eye area with active smiling) one should make your next appointment.
I hope you have found the above article interesting and helpful in not only deciding if you should have a Botox® treatment but more importantly how to help reduce the chance of a ptosis and improve your overall treatment experience. If you have any questions you can refer to our Botox FAQ page or feel free to leave some comments below.
Dr Alek Nikolic