A very common question I get from patients is how soon they can exercise after Botox. The concern is that it will have a negative impact on their treatment.
There are two main issues to consider.
The first is that when we exercise it will increase our blood flow. When the blood flow increases to the area of a damaged blood vessel – for example around the site of injection – it can theoretically make a potential bruise worse.
The second stems from the concern that Botox can spread to an adjacent muscle and cause an unwanted side effect like a droopy eyebrow or eyelid. Botox stays only where injected, it does not roam through the body. However, it may migrate up to 3 cm from where it is injected depending on the dilution and also Botox alternatives which may have different diffusion profiles.
These could lead to a wider area of spread and a greater risk of unwanted effects. So aftercare will include not touching or manipulating the area, to reduce the product spreading and affecting an adjacent muscle.
Since your head position could change with exercise (especially yoga or pilates), it would make sense to avoid these activities. However, there is no evidence that lowering or changing your head position after injection influences spread or increases the chance of an unwanted effect such as an eyelid droop.
When I inject Botox for my patients I do so with a specific dilution or reconstitution, which reduces the risk of the product spreading to an adjacent muscle, and also injecting into the bulk of the specific muscle I want to target. This way any small risk of the product spreading is reduced even further with my extensive anatomy knowledge and the care I take when reconstituting my product, which I always do in front of my patient.
One of the main reasons I ask my patients to not exercise or go to the gym following their treatment with either Botox or fillers is more to do with the risk of infection. Gyms are not the most hygienic places, and the injections break the natural barrier to infection, by creating a small wound in the skin. For this reason it is best to avoid touching the area, especially exposing the recently treated skin to gym equipment like stretching mats, or touching the equipment and then touching the face.
Of course I mitigate this risk by using tiny needles which are very comfortable, however my patients know to plan their day so this small risk is reduced is further.