Anti-Wrinkle Injection Aftercare: What to Avoid, and What Actually Matters

Anti-wrinkle injections take about fifteen minutes. The aftercare takes roughly a day, and most of it consists of not doing very much.

Search the question, though, and you will find instruction lists that contradict each other — four hours upright, no exercise for 48 hours, no flying, no lying down, frown deliberately for an hour afterwards. Some of that is sensible caution. A good deal of it is one clinic copying another. This guide sets out what we actually ask of you at the clinic, what the research says about why, and — more usefully — which of the things people worry about genuinely matter.

The short version:leave the treated area alone, stay upright and skip the gym for the rest of the day, avoid heat and alcohol that evening, and give your result a full two weeks before you judge it. If you develop difficulty swallowing, slurred speech or breathing problems at any point in the four weeks after treatment, treat that as urgent and call NHS 111. That is rare — but it is the one item on this page that cannot wait.

Your first few hours

You can drive yourself home, go back to work, and eat and drink as normal. The list below covers the rest of treatment day.

• Stay upright for about four hours. No lying flat, no face-down massage, no going home for a nap.
• Leave the area alone.No rubbing, pressing or massaging, and nothing tight across the treated area — headbands, swimming goggles, a helmet strap, a sleep mask.
• Skip strenuous exercise until tomorrow. Walking and normal daily activity are fine.
• Give makeup a few hours. The injection points are tiny punctures and are best left clean and uncovered for the first part of the day.
• Avoid heat this evening. Saunas, steam rooms, sunbeds, hot yoga and very hot baths all raise facial blood flow.
• Go easy on alcohol. It makes bruising at the injection points more likely.
• Move your face normally. You do not need to exercise the muscles deliberately, and you do not need to keep unnaturally still either.

What to avoid, and for how long

Do these rules actually do anything?

This is the honest bit, and it is worth reading before you spend an evening anxious about having bent down to load the dishwasher.

A retrospective study published in Toxins in 2025 looked at 5,014 patients treated for upper-face lines across six Italian centres between 2015 and 2020, all of whom were given a ten-minute precaution protocol and nothing more— none of the extended restrictions. No cases of upper eyelid droop were seen. Among the 4,000 patients who came back for follow-up at two weeks, adverse effects occurred in 5.99%, which the authors note is lower than rates reported elsewhere in the literature, and 90% of those who filled in a satisfaction questionnaire were very satisfied. Their conclusion was that omitting extended post-injection instructions did not appear to harm satisfaction or complication rates.

Separately, a 2026 modelling study in Toxicon simulated 10,000 paired virtual patients to ask whether ordinary behaviour moves the product around. At four hours, the median change in spread was 0.08 mm for bending, 0.11 mm for light exercise, 0.14 mm for superficial rubbing and 0.09 mm for mild heat — and 0.22 mm for all of them combined. What did drive the variation was injection depth and the properties of the tissue itself, not what the patient got up to afterwards.

Both studies come with real caveats, and we would rather state them than overstate the case. The Toxinsstudy was retrospective, had no control group, ran no statistical analysis and only followed patients for two weeks — limitations its own authors set out plainly. The Toxicon paper is a computer simulation, not a clinical trial, and its authors say directly that trials in real patients are still needed.

So why do we still ask? Because the restrictions cost you one evening, the evidence is suggestive rather than settled, and the rules that matter most — no pressure on the area, no facial for a fortnight — are really about the injection sites and bruising rather than about the product migrating. What the research does usefully tell you is where not to put your anxiety. Your result is determined by the dose, the placement and the experience of whoever is holding the needle, far more than by whether you lay down at three hours and fifty minutes.

What’s normal in the first week

• Tiny raised bumpsat each injection point, like small nettle stings. They settle within about 15–30 minutes.
• Pinprick redness for an hour or so.
• Small bruises in some people, particularly around the eyes. These fade over a few days and can be covered with concealer from the next morning.
• A mild headache or a heavy-feeling forehead in the first few days, as the muscles adjust to working differently.
• Uneven onset. One side very often starts to soften before the other. This is normal, and is precisely why the result is reviewed at two weeks rather than at day five.

When to judge your result

You will usually notice a softening from around three to five days, and the full effect settles by about two weeks. At Lady Young’s the results typically last three to four months, and many people find that with regular treatment they last a little longer over time.

Two weeks is the number to hold on to. It is when your result is genuinely finished, when a review appointment is worth having, and when any small adjustment is best made — a top-up placed too early, into a result that has not finished developing, is how people end up over-treated. For the same reason we do not repeat a treatment sooner than three months apart.

If you are still deciding between treatments, or wondering why a particular line has not responded, our guide to anti-wrinkle injections vs fillers explains which lines respond to muscle relaxation and which need volume instead. The cost guide covers how area-based pricing works, and the full menu sits on the aesthetics treatments hub.

The rare problems worth recognising

Almost nobody reading this will need this section. It is here because it is the genuinely important part of aftercare, and because most aftercare pages leave it out.

In July 2026 the MHRA updated the product information for botulinum toxin type A products to include a warning about iatrogenic botulism— the effect of the toxin extending beyond the treated area. The symptoms to know are severe drooping of the upper eyelids, difficulty swallowing, slurred speech, breathing difficulty and general muscle weakness. They typically appear between four and eight days after treatment, but can take up to four weeks to develop.

This is not theoretical. UKHSA reported 41 clinically confirmed cases of iatrogenic botulism in England between 4 June and 6 August 2025, across five regions; 32 of those people were admitted to hospital and 8 needed intensive care. The evidence pointed to the use of an unlicensed product. UKHSA’s advice to the public is to take precautions when booking aesthetic procedures, including checking that the product being used is licensed, and never to buy these products online to inject yourself.

If you develop any of those symptoms after treatment — here or anywhere else — contact NHS 111 straight awayrather than waiting to speak to your practitioner. Suspected side effects from any medicine can also be reported through the MHRA’s Yellow Card scheme. Do tell us as well, so we can support you, but never let that delay you seeking medical advice.

The aftercare that starts before you book

The most consequential aftercare decision is made before a needle comes anywhere near you. The NHS is specific about how to choose whoever treats you: look for a practitioner on a register accredited by the Professional Standards Authority, such as the Joint Council for Cosmetic Practitioners or Save Face; ask how many of these procedures they have done, what qualifications and training they hold, whether they belong to a relevant professional association, and what the insurance arrangements are. It warns plainly against practitioners who have only completed a short training course. It also tells you to ask what aftercare you can expect and who will look after you— which is the question people most often forget.

For what it is worth, here is our answer to that last one. Safina has 16 years in the industry, holds a Level 5 Ofqual qualification in aesthetics and is fully insured. Every treatment at the clinic is carried out by her personally, your aftercare instructions come from the person who injected you, and a review is arranged so nobody is left wondering. You can read more about her training and approach, see what is involved on the anti-wrinkle injections page, or simply get in touchwith a question — including after your treatment, which is exactly when most people want to ask one.

Sources

• MHRA Drug Safety Update, 15 July 2026 — Botulinum toxin type A products: updated warnings regarding risk of iatrogenic botulism (product information updated to warn of iatrogenic botulism; symptoms include severe drooping of the upper eye lids, difficulty breathing, slurred speech and difficulty swallowing; typically occurring between 4 and 8 days but up to 4 weeks after treatment; suspected side effects to be reported via the Yellow Card scheme).
• UK Health Security Agency, 18 July 2025 (updated 7 August 2025) — UKHSA issues warning over botulism (41 clinically confirmed cases of iatrogenic botulism between 4 June and 6 August 2025 across 5 regions of England; 32 hospital admissions and 8 requiring intensive care; evidence pointing to use of an unlicensed product; advice to check the product used is licensed and to contact NHS 111 if symptoms develop).
• Santorelli A. et al., Toxins 17(8):372 (2025) — Are Post-Care Recommendations Following Upper-Face Botulinum Toxin Treatment Scientifically Necessary? A Retrospective Study Based on 5000 Patients (retrospective multicentre study of 5,014 patients across six Italian centres, 2015–2020, given only a 10-minute precaution protocol; no cases of upper eyelid ptosis; adverse effects in 5.99% of the 4,000 patients followed up at two weeks; 90% of the 2,010 who completed the questionnaire very satisfied; the authors note the absence of a control group, the lack of statistical analyses and the short-term design as limitations, and call for prospective randomised trials).
• Rahman E. et al., Toxicon 271:108950 (2026) — Breaking the 4-hour rule: Multiscale computational modelling redefines post-injection restrictions for botulinum neurotoxin A (10,000 paired digital twins; median change in effective spread radius at 4 hours of 0.08 mm for bending, 0.11 mm for light exercise, 0.14 mm for superficial rubbing, 0.09 mm for mild heat and 0.22 mm for the combined scenario; variation driven mainly by diffusivity, internalisation rate and injection depth rather than behaviour; the authors state that clinical trials are still required to validate the findings in real patients).
• NHS — Choosing who will do your cosmetic procedure (look for a register accredited by the Professional Standards Authority such as the JCCP or Save Face; ask about numbers of procedures performed, qualifications, training, professional association membership and insurance; avoid practitioners who have only completed a short training course; ask what aftercare you can expect and who will look after you).