What Not to Do Before Botox: The Ultimate Pre-Treatment Checklist

Your injector can place the perfect dots on a map of forehead and crow’s feet, but your choices in the 7 to 10 days before treatment often decide whether you bruise, whether the doses land well, and how natural your results look. I have watched flawless plans derailed by a turmeric smoothie, a last-minute micro-needling session, or an intense hot yoga class the morning of. Botox is precise, but the canvas matters. Think of this as your pre-flight protocol, built from clinic experience, not just theory.

Botulinum toxin type A needs a stable, quiet environment in the tissue to bind properly to nerve terminals. Anything that thins blood, inflames skin, increases blood flow, or shifts muscle behavior can alter both the placement and the onset. Bruising is not the only risk. If you swell, your injector’s depth judgment and your expression during dosing can change. If you arrive dehydrated after a night of cocktails, you may be more sensitive to injections and more prone to headaches afterward. Small details lead to noticeably better outcomes.

Here is a concise, high-impact checklist I give to first-time clients and veterans who want consistently clean results.

Those five lines prevent most avoidable problems. Everything below fills in the nuance so you can adapt to your life, your face, and your goals.

Most people know aspirin can increase bruising. Fewer realize that common supplements act like mild blood thinners. Fish oil at typical doses, turmeric in wellness shots, and high-dose vitamin E all lengthen bleeding time. That thin ooze from a forehead injection is enough to disperse product within the superficial tissue, leave a yellow-purple spot for a week, or both. If you take these for general health, pause for a week if safe. If you have cardiovascular reasons for aspirin or a medically necessary anticoagulant, do not make changes without your physician. Bruising is a cosmetic inconvenience, not a reason to risk your health. Tell your injector. We can adjust technique with smaller-gauge needles, ice, pressure, and slower deposits.

Alcohol makes capillaries more fragile and dilated. The effect shows up in cheeks and around crow’s feet, where skin is thinner and vessels sit close to the surface. Even a couple of glasses the night before can be the difference between no bruises and three obvious ones.

Caffeine does not thin blood, but it makes some patients tense and animated. I want your brow and periocular muscles at rest during mapping and dosing, not bouncing with conversation. If coffee is essential, keep it light and early.

Topical retinoids and strong acids drive healthy cell turnover, but they also leave skin more reactive under a needle. Once a week I see a patient who used a retinol night cream up to the appointment, then flushed and stung with every injection. Stop prescription tretinoin 3 to 5 nights before and pause over-the-counter retinol and exfoliating toners for at least 3 nights. Moisturize normally. On the morning of treatment, wash with a gentle cleanser, skip makeup around the treatment zones, and apply only a bland moisturizer. This keeps the antiseptic wipe from reacting with residues and reduces risk of post-injection contact dermatitis.

If you wax, thread, or dermaplane, give the area at least 5 to 7 days before Botox. Hair removal lifts the outer skin layer and can create micro-abrasions. Combine that with injections and you are more likely to develop small pustules or prolonged redness.

Combining procedures without proper spacing is one of the fastest routes to compromised results. Needling, peels, and lasers create temporary inflammation and change the way tissue feels and behaves. I have seen perfect glabellar dosing drift into slightly asymmetrical brows after same-week microneedling because swelling altered the injection depth and angle.

You do not need to live like a statue, but I advise avoiding intense workouts, saunas, steam rooms, and hot yoga the day of. Elevated heart rate and vasodilation increase the chance of bleeding and swelling at each injection site. A brisk walk is fine. Save your heavy lifts for the next day. On the morning of, hydrate, eat a normal meal, and arrive with a clean face. Faintness and post-procedure headaches are more common in dehydrated, fasted patients.

If you tend to bruise, freeze a few gel packs the night before. Use light icing just before and immediately after each treated area for 2 to 3 minutes at a time. This shrinks superficial vessels and reduces leakage.

A good consult should feel like a dialogue about your baseline muscle activity, your facial expressiveness, and your camera habits. The worst decisions often come from chasing a number or mimicking a friend’s dosing plan. Do not push for more units than your anatomy and goals require. Natural looking botox results come from custom botox dosing that respects strength differences between the frontalis, corrugators, and orbicularis oculi.

If you are new, go light on your forehead. Average botox units for forehead commonly range from 8 to 20 depending on height of the forehead, brow position, and how much you recruit the frontalis to keep lids open. Combine that with glabella dosing for frown lines, often 15 to 25 units, and crow’s feet at 6 to 12 units per side for an expressive face that still moves. Light botox vs full botox is not about a trend, it is about how much muscle you need to preserve to avoid a flattened look, how heavy your brow is, and whether your lids tend to hood. If you want lift, the injector must protect the lateral frontalis fibers and deliberately soften depressors. Asking, can botox lift eyebrows, is valid, but the lift is subtle, usually 1 to 2 millimeters when done right.

The right question is not, how many units of botox do I need, but rather, which muscles are overactive and which are doing compensatory work. A tall forehead with a low-set brow needs less forehead relaxation and more targeted glabella control. Someone with strong crow’s feet but thin skin benefits from lower dosing with careful spread to avoid smile changes.

Bring specific, functional questions. These guide dosing better than discussing unit counts alone.

This is the second and last list in this article. Keep it handy. It trims the guesswork and builds accountability on both sides.

Let’s separate botox myths and facts. Can botox migrate? Not in the dramatic way social media suggests. Product does not travel across the face on its own. Diffusion happens within a predictable radius, influenced by dose, dilution, depth, and post-injection pressure or massage. Rubbing the area vigorously in the first few hours can push superficial product along tissue planes, especially near the eyelids. That is one reason we ask you to avoid facials, face massages, or sleeping face down the first night.

Can botox cause headaches? A mild headache in the first 24 to 48 hours occurs for some patients, especially those prone to tension headaches. Needles, micro-bleeding, and transient muscle adjustments can trigger it. Hydration, magnesium if you already take it, and simple acetaminophen help. Avoid NSAIDs if you are bruise-prone unless advised by your physician.

Can you sleep after botox? Yes, you can sleep normally. The old advice to sleep upright all night has relaxed. I suggest avoiding pressing directly on freshly treated areas for the first few hours. After that, side sleeping is fine. Can you exercise after botox? Keep it light for the rest of the day. Intense workouts are fine 24 hours later. How soon can you wash face after botox? Gentle cleansing is fine within a few hours. Pat, do not rub, and skip hot water that night.

Botox cost per unit varies by market, often in the range of 10 to 20 USD per unit in many US practices, sometimes higher in boutique clinics. Prices reflect injector experience, overhead, and product sourcing. A forehead-glabella-crows session can span 30 to 60 units for natural motion. The average botox units for crow’s feet often sit around 6 to 12 per side. Younger patients or those seeking prevention may do well with lighter dosing, sometimes half of that, repeated more frequently.

Botox dosing explained well begins with muscle strength testing and visualizing vectors. Your injector should ask you to raise your brow, frown hard, close eyes firmly, and smile big. We watch for recruited zones: does your lateral frontalis overwork to balance a heavy medial brow, do you elevate the brow to see clearly because of mild hooding, do you pull down the nasal tip when you smile? Custom botox dosing aligns unit numbers not to a cookbook, but to those observed patterns. Treat the depressor anguli oris for a downturned mouth with 2 to 4 units per side. Soften platysmal bands in the neck with small aliquots along the band path, understanding that swallowing and speech can be affected if dosing is sloppy or too deep.

How to avoid frozen botox starts with a clear conversation about where you want movement preserved. I tend to preserve lateral frontalis activity while softening the medial frontalis. That keeps brows animated, avoids the “shelf,” and reduces the risk of brow droop. For crow’s feet, I like to target the superior and lateral fibers while protecting fibers that elevate the cheek with a smile. Small unit adjustments, 1 to 2 at a time, make a big difference in expressive faces.

Signs of overdone botox to watch for in the botox near me first week include eyebrow heaviness, asymmetric peaks, a flat or strained smile, and blinking that feels incomplete. If you notice them, return to your injector within 10 to 14 days. Micro-corrections with a unit or two can rebalance. Patience matters. Full onset often takes 7 to 14 days, so do not judge results on day two.

A tiny pink bump at each injection site is normal and usually settles within 20 to 60 minutes. Botox swelling how long? Mild puffiness can linger for a few hours, occasionally up to a day in sensitive skin. The botox bruising timeline varies by vessel hit and your biology. Dot bruises from superficial capillaries fade in 3 to 5 days. Larger bruises take 7 to 10. Arnica can help some people. Ice helps everyone. If you are photosensitive or bruise easily, plan your appointment 2 weeks before photos or events. Makeup can cover most bruising the next day.

Botox touch up timing is typically 10 to 21 days after the initial session to allow full onset. I often stage first-time treatments with a conservative first pass, then refine. It is safer and yields better natural looking botox results.

A botox maintenance schedule commonly runs every 3 to 4 months for most facial areas. Some patients metabolize faster and need closer to every 10 weeks. The opposite happens too. With consistent dosing, some can stretch to 5 to 6 months, especially in the forehead if they learn to relax habitual raises.

Long term effects of botox on muscles include reduced strength in the targeted fibers while the product is active. Does botox weaken muscles permanently or thin muscles? Prolonged, frequent dosing can lead to some atrophy in overtreated areas, which is sometimes the goal, such as in masseter reduction for facial slimming. Elsewhere, too much atrophy can create imbalance and collateral recruitment of nearby muscles. That is why planning matters across years, not just a single session.

Botox for facial contouring is most obvious in the lower face when treating masseters for a wide jaw appearance. A course of treatments every 3 to 4 months over a year can soften a square face and create a more oval face outline. The dose is higher than cosmetic forehead work, and chewing endurance can dip for a couple of weeks after each session. For expressive faces, a conservative approach reduces the chance that can botox affect chewing or speech. It can, if dosing hits adjacent muscles or goes too deep in perioral zones, which is why experience matters.

Botox for tension headaches and shoulder tension targets trapezius and cervical muscles. Relief does not mean no risk. Weakness in a muscle used for posture can change mechanics temporarily. Botox for posture correction is an indirect effect at best. For true medical conditions like blepharospasm and hemifacial spasm, dosing patterns are different and managed by neurologists or ophthalmologists. The cosmetic take-home is this: the same molecule can help many problems, but cosmetic dosing requires restraint near muscles that control blinking, smiling, and speech. Can botox affect blinking? Yes, if the orbicularis oculi is overdosed or if diffusion reaches the levator complex. Good mapping avoids this.

Subtle shaping tools like botox for nose tip lift, lip asymmetry, downturned mouth, marionette lines, chin projection softening, and platysmal bands each demand tiny doses placed with a steady hand. Overcorrect and you risk a flat smile, lip strain, or a wobbly chin. Under-correct and you waste time. This is where light botox vs full botox is more about function than units.

Neuromodulators relax dynamic lines. They do not rebuild collagen, shrink pore size dramatically, or improve skin texture on their own. Botox for skin texture and botox for pore size get tossed around, but the visible improvements usually come from reduced motion and better light reflection, not direct collagen production. Botox and collagen production are not directly linked. If you want smoother skin, pair treatments with retinoids, vitamin C, and sunscreen, then time peels or lasers in between your toxin sessions.

Botox and retinol use can play nicely if you respect that 3 to 5 day pause before and 2 to 3 days after treatment. Botox and microneedling or chemical peels need spacing, as noted earlier. With lasers, avoid treating directly over fresh injection sites for a week to prevent heat-related diffusion.

If you have photos coming up or a wedding, build a schedule backward. Book your consult 6 to 8 weeks before the event, treatment 4 to 5 weeks out, and a touch-up 2 weeks before. That timeline handles outliers like slow onset, small asymmetries, or a bruise that overstays.

Botox during stressful periods is a mixed bag. Stress tightens expression habits and makes mapping tricky if you are grimacing more than usual. If your sleep is poor and caffeine high, your face moves differently. Your results will still work, but if you are particular, schedule when life is steadier.

People ask for a bottom line: botox cost per unit times the expected units. It is a starting point, not the full equation. The value comes from refined mapping, honest restraint, and a follow-up plan. If you cannot pause your blood thinners, if you have a big trip with sun and high activity the next day, or if you just had a peel, wait. Better to delay two weeks than fix heaviness or bruising for ten.

Even though this is a pre-treatment guide, a few after notes complete the loop. What not to do after botox echoes many of the same ideas: do not rub treated areas for the rest of the day, avoid heavy workouts and heat until tomorrow, delay facials and masks for 48 hours, and limit alcohol that night. These steps reduce unintended diffusion and bruising, the same factors you managed well before the appointment.

A clean week before Botox keeps the canvas calm and the map true. Pause non-essential blood thinners and irritants. Space out procedures. Show up hydrated and steady, not flushed from a workout or caffeine jolt. Ask targeted botox consultation questions that focus on function, not hype. Agree on a conservative plan if it is your first time, accept a touch-up window, and do not chase unit counts. The reward is simple: natural movement, smooth lines, and fewer surprises.

If you prefer numbers: plan 8 to 20 units for the forehead, 15 to 25 for the glabella, 6 to 12 per side for crow’s feet, with real adjustments based on your muscle strength and face shape. Expect 3 to 4 months of effect, earlier for heavy expressers, longer for lighter movers. Budget per unit in your market, but invest most in the hands and eyes guiding the syringe.

Pre-treatment discipline is not glamorous. It is quiet, ordinary, and reliable. That is exactly why it works.