Could my Botox be moving?

Botox moving? My Botox (forehead area) seems to "move" back and forth from morning to afternoon. When I first wake up, sometimes it seems to be less wrinkled on one side--then later it looks about the same amount of wrinkling on both sides. At certain times more of my eyelids show than at other times. Could it be moving around the area? I have heard it can migrate shortly after being injected, but I thought it was done with that fairly quickly. Is this normal? Thanks for any help you can provide! --Carrie

Carrie –  Thank you for writing.  Other readers have mentioned this too, but no, after the first 6-8 hours or so, it can’t move – it’s bound to the receptors at that particular muscle group.    When it’s injected, it does diffuse slightly from where the actual injection was.   Dysport diffuses slightly more than Botox which can be good or bad, depending on the effect the doctor is trying to achieve. 

But then………… why do you have these changes in your forehead?   Here are some thoughts.  If you notice it most just after getting up, and you side sleep at all, it is probably the “sleep lines” created by crunching our faces into the pillow.   This effect is more noticeable as we age.

The change in the amount of “eyelid show”  (good term!!  :))  during the day is usually due to fluid shifts.   In the am, our faces are “plumper” due to rehydration of the uppper body from the lower body during sleep.  During the day, gravity causes fluid to accumulate more in our legs and feet.   As the day goes on, fluid shifts down and the whole face dehydrates a little causing the brow to sag slightly.   This is especially noticeable with lack of sleep, dehydration, too much alcohol, etc.    Too much salt, baked goods, sugar, certain drugs etc does the reverse – too puffy! 

Hope this helps,  Dr. I


Dr. Brandith Irwin, MD

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