Botox is a low-downtime treatment, but a few small choices in the week before can make a meaningful difference in your results, recovery, and how clean your face looks afterward. This is the practical checklist.
1. Stop blood thinners (with provider approval)
72-96 hours before injection, with your prescriber’s OK, pause:
- Aspirin (only if not medically required)
- Ibuprofen, naproxen, other NSAIDs
- Fish oil + omega-3 supplements
- Vitamin E supplements (above 200 IU)
- Ginkgo biloba
- Garlic supplements
This reduces bruising risk by ~40-60% in our experience. Never stop a prescribed blood thinner without your prescriber’s explicit OK.
2. Cut alcohol 24-48 hours before
Alcohol dilates blood vessels, which makes bruising more likely and recovery slower. Two glasses of wine the night before is the most common bruising trigger we see.
3. Hydrate aggressively
Well-hydrated skin and tissue bleed less, bruise less, and recover faster. Aim for 2-3L of water in the 48 hours before. Many patients add a Hydrate IV the day before — it’s overkill for some, but for the bridal/high-event-stakes patients it’s a meaningful difference.
4. Take arnica (oral or topical)
Start arnica supplementation 3-5 days before. Available OTC. Reduces bruise size and recovery time when bruises do appear. Topical arnica gel can also be applied to the planned injection sites starting 24 hours before.
5. Confirm timing relative to events
Botox results begin showing at 3-5 days, peak at 10-14 days. Schedule your appointment based on:
- Wedding / major event: 14-21 days out (well past peak, no surprises)
- Big work meeting / on-camera: 14 days out
- Holiday / beach trip: 7-10 days out is fine
- Daily life: any day, but skip immediately before a high-altitude flight or exercise-heavy event
6. Communicate with your injector
Email or text your injector 24-48 hours before with:
- Photos of any new lines or asymmetry you noticed
- Recent dental work, illness, or supplements you started
- Major events on the calendar
- Whether you want to under-correct (recommended for first-timers) or maintain
7. Day-of: skip the gym + eat first
- No intense exercise the morning of (raises blood pressure, increases bruising)
- Eat a normal breakfast/lunch — low blood sugar makes the appointment less comfortable
- Avoid caffeine spikes (one cup OK, espresso bombs not)
- Arrive with a clean face — no makeup if possible
What to expect right after
- Tiny pinpoint marks at injection sites for 30 minutes – 4 hours
- Mild headache for some patients on injection day
- Onset begins 3-5 days, full effect at 10-14 days
- Don’t lie flat for 4-6 hours after
- Don’t rub or massage the area for 24 hours
- No yoga inversions, hot Pilates, sauna for 24 hours
When to call your provider
- Significant asymmetry at the 14-day mark (often correctable with a touch-up)
- Brow droop or lid heaviness (rare, but reach out)
- Headache lasting longer than 48 hours
- Any sign of allergic reaction (rare with Botox)