Aftercare advice for anti-wrinkle injections is repeated so often that it has taken on the authority of scripture: do not lie down for four hours, avoid the gym for two days, no facials for a fortnight. Most of it is sensible. Some of it is habit dressed up as science. Knowing which is which helps you follow the advice that matters without treating your own face like a fragile artefact for a fortnight.
Here is what we tell our own patients, and why.
Why aftercare exists at all
Two separate concerns sit behind the guidance. The first is bruising: the skin is punctured several times, and pressure, heat, alcohol and blood-thinning medicines all make a small bruise more likely. The second, more theoretical, is spread: if product is pushed beyond the intended muscle in the first hours, it can affect a neighbouring muscle and change the result. Neither concern is dramatic, and both are easy to reduce with a little restraint on the day.
The first four hours
Stay upright
The standard advice is not to lie flat, and not to bend over repeatedly, for about four hours. The reasoning is about pressure and gravity around the treated area rather than a proven window of risk. It costs you nothing to follow.
Do not rub, press or massage
This is the advice we consider most worth keeping. Rubbing can move product within the tissue and can worsen bruising. Clean your face gently, pat dry, and leave the treated areas alone.
Avoid heat
Hot showers, saunas, steam rooms, hot yoga and sunbeds in the first 24 to 48 hours increase blood flow to the skin and make bruising more likely. Warm water is fine. Baking yourself is not.
The first 24 to 48 hours
- Skip strenuous exercise for 24 to 48 hours. It raises blood pressure and bruising risk rather than displacing the medicine.
- Avoid alcohol for 24 hours. It thins the blood and increases swelling.
- Avoid facials, facial massage, gua sha, jade rollers and anything that presses hard on the treated areas.
- Normal skincare and make-up are fine, applied gently. Avoid strong acids or retinoids directly on the injection points for a day.
- Sleep normally. After the first four hours there is no need to sleep on your back.
The first two weeks
We ask patients to avoid other facial treatments in the same area for around two weeks: skin needling, lasers, chemical peels, filler, facial massage, and dental work where possible. Not because each of these is dangerous, but because a two-week window lets the effect develop in a predictable way and keeps the result attributable.
Waxing, threading and tinting can be done, though we suggest having brows shaped a few days before treatment rather than straight after, so the area is not pressed and plucked while it is settling.
What makes no real difference
Some of the most repeated advice has very little behind it, and we would rather say so than pretend otherwise.
- Practising facial expressions to 'work the product in' does not improve results.
- Arnica has weak and inconsistent evidence for preventing bruising. It is harmless for most people, so take it if you like it, not because it is essential.
- Avoiding all facial movement on the day is unnecessary.
- Drinking extra water does not speed up or slow down the medicine.
- Waiting a week before wearing make-up is not required.
What to expect, day by day
- Day 0: tiny marks that flatten within hours; occasional small bruise.
- Day 1 to 3: possible mild headache or tenderness; the face looks unchanged.
- Day 3 to 7: lines begin to soften. This is when most patients first notice movement changing.
- Day 10 to 14: full effect. This is the point at which the result can be judged, which is why our review sits at two weeks.
- Week 10 to 16: movement gradually returns, usually sooner after a first treatment.
If nothing has happened by two weeks
This is uncommon but does occur. Roughly one to two people in a hundred have a genuinely weak or absent response to a first treatment, and there are several possible reasons: dose, placement, an unusually strong muscle, a product-specific response, or, rarely, neutralising antibodies from previous frequent treatment.
The right response is a proper review with photographs and a clinical examination, not a reflexive doubling of the dose. Sometimes the answer is a small adjustment in a slightly different pattern. Sometimes it is a different product. Occasionally it is honest advice that the treatment is not going to deliver what you were hoping for.
When to call the clinic rather than wait
- Increasing redness, warmth, pain or discharge at an injection site.
- Brow or eyelid droop that is affecting your vision or confidence.
- Any change in swallowing, speech or breathing, which needs urgent medical attention rather than a review appointment.
- A result that feels markedly uneven once the full two weeks have passed.
Our own protocol
Every patient at Skiin leaves with written aftercare, a direct contact route, and a review appointment already booked. We take photographs at treatment and at review, so that any change is judged against a record rather than a memory.
If you are considering treatment, read about anti-wrinkle injections in Manchester or about the side effects doctors actually see.
This article is general information, not medical advice. Always follow the aftercare instructions given by the clinician who treated you.
