Swelling after Botox - normal or a dangerous consequence?

How to recognize the problem

Swelling after Botox may well be due to the body's natural reaction to the insertion of a needle. In this case, there is no need to panic. As a rule, swelling will begin to subside within the first day. And after two or three days they will disappear completely.

You should be concerned in the following cases:

if after the above period the problem remains;
if such signs appeared 7-10 days after the injection;
When swelling under the eyes is accompanied by painful sensations, the effect of a drooping eyelid occurs - ptosis.

What to do if you have severe bags under your eyes?

If you are not sure that your bags under the eyes are caused by various diseases, then you can try standard, traditional methods. First, normalize your sleep schedule. Sleep more, improve your quality of sleep. Give yourself more time to rest, drink more fluids. Try to eat less salty foods, and do not eat such foods before bed. In addition, you should limit yourself in consuming smoked and spicy foods. It's best not to drink coffee before bed. If you have swelling in the morning, you can put cotton pads soaked in green tea or tea bags themselves under your eyes. In addition, slices of cucumbers and masks made from grated potatoes can help you. If these methods do not save you at all, you can start using cosmetics. Place patches under your eyes and apply creams that are designed to remove swelling. If all these methods do not help, contact a cosmetologist. Maybe you have it hereditary, and you can only get rid of it with the help of cosmetology, or maybe you have a disease. If the option of diseases is completely excluded, then the cosmetologist will advise you on procedures that can correct the problem. Usually this is a biorevitalization procedure. In addition, manual and hardware techniques can be used. Microcurrent therapy can be performed. Lymphatic drainage will be enhanced.

The mechanism of edema

In a normal healthy state, tissues are promptly supplied with oxygen and nutrients. The products of cell metabolism are removed. This happens due to good blood supply, outflow of lymph and venous blood.

As for the influx, the heart is responsible for this. Outflow is possible due to negative pressure in the chest cavity during inhalation and muscle contractions.

If for some reason muscle tone decreases, if there is heart disease, if hormone levels fluctuate, the risk of edema increases.

Since botulinum toxin causes temporary muscle paralysis, its role in the formation of swelling is most direct: muscles do not contract, lymph stagnation occurs in the tissues and venous blood in the vessels

Swelling after Botox: removing the consequences of injections

Botulinum toxin injections to smooth out wrinkles from year to year remain the most popular service in aesthetic cosmetology, not only among women, but also among men. That is why all their side effects deserve special attention.

Swelling after Botox, Dysport or another similar drug can negate the entire positive effect of the procedure and will remain a reminder for a long time of a failed attempt to erase the first age-related changes from the face.

Why do they occur, how long do they last, and in what cases should you sound the alarm? What to do with “swollen” upper eyelids and eyes? TecRussia.ru understands all the nuances of the problem, and eminent metropolitan cosmetologists share their own experience:

↑ Risk factors: what you should warn your doctor about at the first consultation

Not every swelling is considered a complication/side effect of Botox or Dysport injections. In the simplest case, this is a completely normal reaction of the body to damage received from the insertion of a needle. Already on the first day it begins to subside and disappears without a trace within 2-3 days after the procedure.

More serious lymphostasis (caused by disturbances in the circulation of lymph and venous blood) edema appears on the 7th–10th day - at the time when the drug “gets up”, that is, it begins to immobilize the muscles. They can last from 1-2 weeks to two or more months and require special procedures in order to quickly return a healthy appearance to the face. The main diseases and conditions of the patient’s body, which are very likely to provoke the formation of problematic swelling after botulinum toxin injections:

diseases of the liver, kidneys, cardiovascular system;
fatty hernias of the eyelids;
early recovery period after plastic or other surgical surgery;
individual predisposition;

You should definitely inform your cosmetologist about all these nuances, who will advise the necessary preventive measures or suggest refraining from the procedure for a certain time.

↑ Mechanisms of edema formation after “beauty injections”

For normal provision of tissues with nutrients and oxygen, timely removal of cell metabolic products, it is necessary that the blood supply, outflow of venous blood and lymphatic drainage be balanced. The flow of arterial blood is carried out due to the work of the heart. The outflow of venous blood, as well as lymphatic drainage, is stimulated by the following actions:

during inhalation, negative pressure is created in the chest cavity, due to which air enters the lungs, venous blood and lymph enter the heart;
during muscle contractions, venous blood and lymph are “pushed” through the vessels to the heart.

The balance between fluid entry into tissues and its removal may be disrupted:

decreased muscle tone and contractility;
the presence of diseases of the cardiovascular system, kidneys;
hormonal imbalance in the body, etc.

In each of these cases, the development of problematic swelling is very likely. Let's take a closer look at why this happens and what the role of botulinum toxin is:

The influence of muscle tone on the development of edema

When Botox or Dysport is administered, paralyzed muscles in the target subcutaneous areas stop contracting, which in some cases can lead to stagnation of venous blood and lymph in the tissues. In this case, swelling most often forms around the eyes, most often on the upper eyelids. This is due to the structural features of the skin - here it is thinner than in other areas of the face, does not have a supporting bone frame, and lies on a layer of loose fatty tissue. And small venous vessels, which are located in the eyelid area, are easily pinched by edematous tissue.

As a result, a “vicious circle” is formed: the greater the swelling, the worse the further outflow of venous blood and lymph. In particularly complex cases, the described mechanism can lead to the formation of persistent or persistent (occurring from time to time) swelling of the upper and/or lower eyelids, and sometimes of the entire face.

Impact of diseases of the cardiovascular and urinary systems

The development of heart failure leads to a decrease in the heart's ability to pump blood through the vessels. This leads to overflow of the venous bed. In this case, part of the blood seeps into the tissues and accumulates there. Swelling forms, which appears from time to time, but can be permanent.

They appear on the legs and rise higher as heart problems develop. What does this have to do with face? It turns out that it is direct. Any exposure that would not cause adverse changes in a healthy person may lead to complications in a patient with heart failure. If the outflow of venous blood is already weakened, after injections of Botox, Dysport or another similar drug, muscle inactivity can lead to swelling of the upper eyelids and the face as a whole.

With most diseases of the urinary system, the ability of the kidneys to remove excess fluid and mineral salts is reduced to some extent. The latter “settle” in the tissues, which also leads to the formation of edema. With kidney failure, swelling most often appears in the face. If you “turn off” the auxiliary effect of muscle contractions on the outflow of venous blood and lymph, they become stronger and more noticeable.

Impact of hormonal imbalance

The ability of tissues to retain fluid is influenced by female sex hormones. For many, mild facial swelling may appear on certain days of the menstrual cycle. Almost all pregnant women experience swelling. If before the onset of menstruation the face becomes puffy, then the risk of similar problems appearing after anti-aging injections is also very high.

↑ Where should and should not be administered Botox and Dysport?

There are certain areas of the face in which swelling is more likely to develop when botulinum toxin is injected: the forehead, with the exception of the bridge of the nose, and the crow's feet area. This does not mean that you need to give up injections. It is necessary to choose the correct injection points for the drug, since turning off some muscles will lead to the elimination of wrinkles and a change in the position of the eyebrows, while others will lead to the development of edema:

For example, immobilizing the upper part of the orbicularis oculi muscle has a good effect. This allows the frontalis muscle to raise the eyebrow upward and make the overall facial expression more alert and open.
In the lower eyelid area, administration of the drug is possible only subcutaneously and in no case intramuscularly, using a minimum dose. With the intramuscular option, swelling around the eyes cannot be avoided.
In some cases, it is necessary to completely abandon injections in the forehead area, so as not to provoke the formation of edema, limiting ourselves only to turning off the facial muscles associated with the bridge of the nose. This is usually more than enough to smooth out wrinkles on the upper part of the face.

Knowledge of all such nuances forms the basis of a cosmetologist’s qualifications, so the result of the procedure will largely depend on the correct choice of a doctor. Nowadays, botulinum toxin preparations are administered both by specialists with many years of experience who know well the structure and location of facial muscles under the skin, and by girls without medical education at all (sometimes even at home), who at seminars were given a diagram of the approximate location of the injection points to obtain certain changes. Of course, the likelihood of getting certain complications, including swelling, is much higher in the second case. Risk factors also include:

improper preparation of the face for the procedure and non-compliance with skin care recommendations during the recovery period;
incorrect choice of dosage (see also the article “How many units of Botox do you need?”). A competent cosmetologist begins working with a new patient with a minimum amount of injected drug: after assessing the result and the individual reaction of the body, you can always inject a few more units, but if you receive an overdose, nothing can be done; you will have to wait several months until the effect of the already injected botulinum toxin wears off.

↑ How can non-compliance with doctor’s recommendations affect the development of edema?

At least one day before the scheduled procedure, you will need to refuse:

physical activity and long stays in an inclined position;
massage and other procedures in which you have to lie face down;
alcohol.

After the procedure, the doctor gives each patient an additional list of recommendations that must be followed. Very often, swelling can appear precisely because of an underestimation of its importance or misunderstanding between the doctor and the patient. For example, the ban on bending applies not only to heavy types of physical labor, for example, weeding beds, but also to such simple actions as trying on several pairs of shoes in a row, caring for pets when they are on the floor, etc. It would seem , an insignificant detail, but it is precisely this that can cause problematic “side effects”, which you will then have to spend your time and money fighting against.

↑ How to remove swelling after botulinum toxin injections?

Depending on whether swelling is the patient’s only complication or whether there are other adverse consequences, you can choose two options:

purposefully eliminate stagnation of lymph and blood;
develop a comprehensive program for the speedy restoration of normal muscle activity.

In the first case, diuretics and cosmetic procedures with a lymphatic drainage effect (both manual massage and hardware effects) are most effective. At the same time, in some patients, due to individual characteristics and the body’s reactions to botulinum toxin, it is not possible to achieve complete muscle relaxation and eliminate wrinkles without causing swelling. These “lucky ones” will have to either stop using Botox or immediately after the injections sign up for a course of lymphatic drainage procedures.

Possible side effects after Botox injections
Swelling after hyaluronic acid fillers: what to do?

If, in addition to swelling, other side effects appear, such as ptosis of the upper eyelid, strabismus, drooping corners of the mouth, etc., it is necessary by all available means to block the activity of the drug and restore the mobility of facial muscles. The following are best suited for this:

manual and hardware lymphatic drainage massage;
the use of succinic acid orally and as injections into the problem area;
hot compresses and masks;
mesotherapy using drugs such as DMAE, rutin, artichoke, hibilan, green tea, ginkgo biloba;
use of neuromedin and proserin micropapularly at the injection points of Botox or Dysport;
hardware photorejuvenation.

Some forums recommend drinking alcohol when complications arise after Botox, as it supposedly helps to quickly remove the toxin. In fact, this “methodology” only provokes the formation of new swelling on the face, which can seriously aggravate the problem.

↑ Expert opinion

Ivanova Irina Nikolaevna cosmetologist-dermatologist, doctor of the highest category, DoctorPlastic clinic:

Swelling after botulinum therapy does occur, although very rarely, mainly in people who are prone to this due to their facial structure. However, when the procedure is performed by an experienced certified specialist in a good clinic, using proven drugs, this risk is reduced to almost zero.

If the swelling is concentrated in the area between the eyebrows and/or slightly on the upper eyelid, then this can be considered as normal. It is highly likely that everything will go away within 2 weeks without additional intervention. It is more difficult in the area around the eyes, where problems often arise due to excess amounts of the drug or incorrectly selected injection points. This is primarily due to the ability of retrobulbar fiber to attract water. If a certain portion of the orbicularis oculi muscle is excessively relaxed, hernias of the lower eyelids may appear more clearly, which visually looks like swelling.

The fact is that before carrying out the procedure, the doctor must evaluate not only the depth of wrinkles, but also the presence of hernias, the severity of subcutaneous tissue, the activity of facial muscles and other individual factors. And it happens that illiterate specialists conduct such an assessment incompletely or incorrectly, as a result the patient receives a result that is completely different from what he expected. In this case, there is no need to panic; as muscle activity is restored, the face will return to normal. If the patient is unhappy and does not want to wait for the gradual natural reduction of this effect, procedures can be performed to improve lymphatic drainage and stimulate muscle activation, in this way the problem is usually solved very quickly.

What to do if real swelling appears, and not the visual effect that we talked about above? Our body is designed in such a way that lymphatic drainage is activated when muscles work. And when the muscle doesn’t work, lymph circulation also worsens. As I mentioned, this may be a variant of the norm, but if the swelling does not go away for a long time, then there are physiotherapeutic procedures that improve lymphatic drainage and stimulate muscle activity.

In general, the botulinum therapy procedure looks quite simple and low-traumatic for the patient, but it requires the doctor to have serious knowledge of anatomy and physiology. Therefore, we always encourage women to turn to professionals and not trust “kitchen masters”. In a reputable clinic, the patient must at least sign an informed consent for the procedure, where the specialist also signs, and in addition, the injection points and dosage are noted on a special picture form.

At DoctorPlastic, we are sometimes contacted by patients who had injections “in their apartment, with a private specialist” and received some undesirable effect. To prescribe adequate physical therapy, you need to know what was done and how exactly it was done. Therefore, I advise patients to keep their own “diary”, where they would write down when, where, in what quantity and what drugs were administered to them. If unwanted side effects or, God forbid, complications occur, it will be much easier for us to prescribe treatment if we know the patient’s anamnesis (history).

Vishipanova Nadezhda Leonidovna
cosmetologist at the Frau Clinic, Ph.D.:

Swelling after injections of Botox and its analogues may appear due to the patient’s failure to comply with post-procedure recommendations, facial structure, or uncontrolled diffusion of the drug. As a rule, they disappear within 2-4 weeks. If this period is prolonged, measures are taken to stop the action of botulinum toxin.

Places of swelling

80% of swelling after Botox is under the eyes. This is due to the peculiarity of the skin in this area of the face. Firstly, this place has the thinnest skin. Secondly, it does not lie on a bone frame, but on a layer of loose fatty tissue. It is not difficult for swollen tissues to squeeze small vessels. The greater the swelling, the more the vessels are pinched, the worse the outflow of lymph occurs - this is how a vicious circle turns out. It can be broken by qualified medical assistance. Alas, and only she – the situation will not improve on its own.

The remaining 20% of cases of swelling are all other areas where botulinum toxin can be injected. And the reason for them is, first of all, ignorance of the rules of subcutaneous interpenetration of liquids by the specialist performing the injections. But it’s difficult to call such a person a specialist.

Incorrect dosage of the drug

A competent specialist will first inject the client with a small amount of botulinum toxin. And only if the result is satisfactory, a few more units of the drug will be added. If an overdose occurs, side effects cannot be avoided and you will have to wait several months - only then will the effect of the drug weaken and only then will the facial tissues return to their original state.

External manifestations of complications

Any incorrect actions can provoke the following number of side effects:

deformation of facial expressions;
lack of blinking leads to dryness of the mucous membrane of the eyes;
facial asymmetry;
paralysis of the orbicularis muscles, often leading to difficulty swallowing;
ptosis of the upper eyelids;
puffiness under the eyes or the entire face.

Swelling, redness and burning usually disappear within 4-7 days without additional measures. If the cause of edema is an allergic reaction, the doctor prescribes antihistamines to alleviate the condition. More persistent complications resolve within 2-3 months through metabolic processes.

Client's inattention

Swelling also occurs if the client neglects the specialist’s recommendations:

During the first hours after the injections, he lowered his head - in fact, it is necessary to carefully ensure that the head is in a level position. Also, you should not sleep with your face in the pillow;
rubbed and massaged the face - especially do not touch the area into which the drug was injected;
took alcoholic drinks - it should be noted that swelling occurs even with a minimal amount of alcohol;
took antibiotics - if any disease occurs, you should definitely consult a specialist. Self-medication in this case is not the best idea;
allowed temperature changes - an unpleasant consequence appears if the patient recently visited a bathhouse or solarium. Sports activities are also excluded at first, as they sharply increase body temperature.

About risk factors

One important component of a successful result should be understood: silencing or ignoring contraindications to botulinum therapy leads to dire consequences. Unfortunately, there are often cases when a woman strives to become young and beautiful by any means. Yes, indeed, Botox injections quickly and for a long time provide excellent results, but just as quickly they can lead to troubles with your appearance. Therefore, it is at least stupid to decide on the procedure rashly.

No one knows our own body better than ourselves. Therefore, take into account all the features of your body; if you have the slightest doubt, tell your doctor about it. And remember that prohibitions exist for a reason, but in order to protect every patient

Often, swelling after Botox is a consequence of ignoring contraindications to injections. Patients at cosmetic clinics are at risk if they:

there is an intolerance to botulinum toxin - in this case, we will talk not only about swelling, but also about lacrimation, dizziness, and weakness. However, the probability of such trouble is no more than 1%;
diseases of the heart, blood vessels, kidneys, liver - especially if they are chronic. Weak blood flow or poor fluid removal will certainly create swelling under the eyes;
hormonal imbalance - if before the onset of menstruation the face becomes puffy, the woman is at risk. In such a case, bags will probably appear even after beauty injections;
there is a hernia in the upper eyelid - it is possible that it was simply not detected before visiting the cosmetologist’s office. But after the injection it will definitely become noticeable. And if your eyes swell after Botox, there is a high probability that the cause is a hernia.