3 Ways to Sleep On Your Side After Botox (Doctor-Approved)

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This article has been written by Dr. Darshan Shingala (M.D, MPH) – a qualified and practicing medical doctor – for maximum factual accuracy and reliability.

If you have just had Botox treatment on your face and you are a side sleeper, then you might be worried that sleeping in this position may ruin the effects of the procedure.

So can you sleep on your side after Botox treatment or not?

You should avoid sleeping on your side for the first week after your Botox treatment to ensure that the cosmetic effects of the treatment won’t be ruined. You should not lie down or put any pressure on the injection sites for at least 4-6 hours after the Botox has been administered.

But what if you are a strict side sleeper, how can you sleep on your side after Botox treatment?

To sleep on your side after Botox treatment, wait as long as possible before transitioning back to this position (minimum of 24 hours) and use a soft side sleeping pillow to reduce facial pressure – have your Botox in the morning to naturally allow for the Botox to settle before lying down.

In the rest of this article, I have used the knowledge that I’ve gained through my many years as a practicing medical doctor to help you understand the risks of side sleeping after Botox and what you can do.

However, your first point of guidance must be with your own surgeon in order to get the advice that’s best for your individual situation.

Related: 7 tips for sleeping safely after Botox (plastic surgeon’s guide).

Avoid Side Sleeping for 1 Week After Botox

How Should I Sleep After A Botox Treatment?

Ideally, you shouldn’t sleep on your side for at least a week after Botox treatment on your face because putting pressure on the injection sites can ruin the effects of the procedure.

Some experts say that it’s safe to return to your regular nighttime routine, sleeping pattern, and sleeping position approximately 4 to 6 hours after the Botox procedure – whilst others say that it’s advisable to avoid sleeping on your stomach or on your side for approximately a week after Botox as a precautionary measure [2, 5, 8].

I usually tell my patients that it would be best if they could sleep flat on their back, facing upwards, for at least the first night after having their Botox procedure done.

The most critical time is 4-6 hours immediately after the Botox was injected – you should not lie down or apply any pressure to your face during this period because some clinical studies have demonstrated that it could take a few hours for the Botox to settle into the site of injection [1, 2].

If you lie down immediately after a Botox procedure, it is possible that the Botox might migrate to other muscles in your face.

This may lead to facial muscle weakness and put you at further risk of developing several medical conditions or complications [3, 4, 5].

Therefore, it is recommended that you refrain from lying down right after your treatment.

Furthermore, in order to refrain from putting unnecessary physical pressure on the injection site, you should avoid rubbing the treated area, applying any form of compressive force on the area, massaging it, or sleeping on your side or stomach [2, 5, 8].

Click here to find out if a therapeutic mattress can help you sleep better.

Sleep Flat On Your Back After Facial Botox Treatment

After 4-6 hours have passed, you may lie down – however, it’s recommended that you sleep on your back to avoid putting pressure on your face.

With regards to sleeping on your side after a Botox procedure, it would be best to follow the advice of your doctor.

In most cases, your doctor is likely to suggest that you refrain from sleeping on your side for at least the first night after your Botox procedure.

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3 Ways to Sleep On Your Side After Botox

If you are a strict side sleeper, then the following 3 strategies can help you to get back to sleeping in your favorite position as soon as possible:

1: Resume Side Sleeping Gradually

It’s recommended that you avoid side sleeping for at least one week after treatment to allow the Botox to settle down – with back sleeping being the best position during this period.

However, sleeping on your back might be quite challenging for you if you are a side sleeper naturally.

In such a case, I would advise that you transition back to sleeping on your side gradually by following these points:

  • Anchor yourself with pillows – in order to force yourself to sleep on your back in the first 24 hours after Botox, place several pillows next to your hips and shoulders to stop you from turning over.
  • Use a neck pillow for stability – I usually advise my patients to consider using a special neck pillow in order to stabilize the posture of the neck and keep pressure away from the injection sites.
  • Monitor swelling – if you do not notice any swelling or bruising after 48 to 72 hours subsequent to your Botox treatment, then you may be able to sleep on your side if your surgeon is in agreement. However, it is important to make sure that your pillow is very soft, comfortable, and fitted with a clean pillowcase, so that you do not experience any discomfort while sleeping.

2: Optimize Your Pillows, Bedding, and Mattress

After Botox, it is essential that you establish a good after-care routine, which will help you to recover quickly, overcome any minor side effects, and transition back to your pre-Botox routine as soon as possible.

An important aspect of recovery is to achieve restful sleep at night since all the reparative processes of the body occur during the nighttime while we are asleep.

To help you sleep better on your side after having a Botox procedure, you might want to make a few changes to your bedding arrangement, as listed below:

2.1: Use a Specially Designed Side-Sleeper Pillow

To help you sleep on your side after Botox, I would suggest that you switch your regular pillow with a specially designed side-sleeper pillow.

A side-sleeper pillow is essentially constructed to provide maximal support while side sleeping, and it helps in optimizing the quality of your sleep.

In general, most side-sleeper pillows are designed in a half-moon or crescent shape.

However, some newer shapes and designs are also available, such as a wedge-shaped pillow, and a wide pillow with a distinctive U-curve on the bottom end – added as a space for the shoulder to rest while you are sleeping.

Check out these 9 tips for sleeping with a cast on your broken leg.

2.2: Use a Pillow with a Soft Filling 

After getting your Botox injections, you will want to minimize the intensity of physical pressure applied to the treated areas.

To achieve this while side sleeping, it would be a good idea to opt for a pillow that has a soft filling, so that it can easily conform to the contours of your face and neck, without putting any unnecessary pressure on the parts of your face that were injected with Botox.

Since you might be sore, or experience mild bruising and swelling after Botox, using a soft pillow becomes an even more essential component of your after-care routine.

There are several options that are easily available to consumers online when choosing a soft pillow filling.

For instance, you may opt for latex, down feather, shredded memory foam, gel, fiber, or cotton fillings for your pillow, depending on your preference and budget.

Please keep in mind that most pillows tend to collapse with extended use over time, which is why most manufacturers recommend replacing, or re-fluffing old pillows, at least once a year.

So perhaps it would be a good idea to replace your old pillows with ones with softer fillings this time around.

Click here to find out if you can wash memory foam pillows.

2.3: Choose a Mattress for Side Sleepers

Side sleepers tend to have different sleeping requirements when compared to back sleepers, as they need balanced cushioning for their shoulders, neck, back, and hips.

To sleep comfortably on your side, especially after Botox, it would be best if you try to sleep on a mattress that offers extra contouring and support for your body.

For instance, you can choose a mattress that is made of quilted memory foam, supportive pocketed coils, or gel visco foam.

I personally recommend the Puffy Lux Hybrid mattress – click here to see why.

2.4: Use Bed Linens Made from Breathable and Soft Fabrics

Since your bed sheets, duvet cover, and pillowcase will be right against your skin while you sleep, it is important to make sure that after Botox, your bed linens are freshly cleaned, and made from natural, soft, and breathable fabrics.

There are several different fabrics and weaves you can choose from, depending on your lifestyle, preferences, and budget.

However, bedding made from natural materials, such as cotton, linen, and silk, tends to be the most comfortable for the majority of people.

Click here to see this silk bedding set I’ve just reviewed.

3: Get Your Botox Injected in the Morning

As you know, it is absolutely not recommended that you lie down for at least 4 to 6 hours right after your Botox procedure.

Hence, a morning appointment tends to work best for most of my patients so they have ample time in the day for things to settle down.

So, for instance, if you got your Botox done at 9 am, you would not have to worry about disturbing your sleep as you would have approximately 12 hours of wakefulness before you go to bed.

As per the common medical recommendation, you should try to sleep on your back for at least the first night after Botox.

However, if you are a natural side sleeper, and you unintentionally change your sleeping position in the middle of the night, the risk of Botox migration would be greatly reduced if approximately 12 to 18 hours have passed since your appointment.

Thus, I would recommend you schedule your Botox appointment at least before noon, and ideally during the early morning hours.

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Conclusion: Avoid Side Sleeping if Possible for 1 Week

The absolute minimum amount of time that must pass before lying down in any position after Botox is 4-6 hours, with most surgeons recommending at least one night of back sleeping before side sleeping is resumed – waiting up to 1 week decreases the risk of complications even further.

If you are a natural side sleeper, it might be difficult for you to continue sleeping on your back after the first night, so you might find it difficult to wait until the recommended period of 1 week has passed before you begin sleeping on your side.

Hence, you can try to gradually transition back to sleeping on your side after your Botox procedure after the first 24 hours have passed.

In order to safely sleep on your side after Botox, you must make sure that your pillows and mattresses are soft and supportive.

It is also recommended that you use bed linens made from natural, breathable, and soft fabrics, and consider using a specially designed side-sleeper pillow for optimum sleep.

In general, it is advisable to schedule your Botox appointment during the morning hours, so that there is sufficient time for the Botox to settle in before you sleep.

Up next: click here to see the top 3 therapeutic mattresses.

Sources and References

1: Carruthers J, et al. Overview of botulinum toxin for cosmetic injections. http://www.uptodate.com/contents/search. Accessed Jan. 4 2022.

2: Schuh FD. Patient care after Botox injections. Plast Surg Nurs. 1999;19(4):218. doi:10.1097/00006527-199919040-00015

3: Botox (prescribing information). Madison, N.J.: Allergan Inc; 2018. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=33d066a9-34ff-4a1a-b38b-d10983df3300. Accessed Jan. 10, 2022.

4: Foster JA, Wulc AE, Holck DE. Cosmetic indications for botulinum A toxin. Semin Ophthalmol. 1998;13(3):142-148. doi:10.3109/08820539809066090

5: Avram MR, et al., eds. Injectables. In: Procedural Dermatology. New York, N.Y.: McGraw-Hill Education; 2015.

6: Khan JA. Cosmetic botulinum neurotoxin application. Int Ophthalmol Clin. 2005;45(3):107-122. doi:10.1097/01.iio.0000167241.28311.48

7: Wilkes J. AAN updates guidelines on the uses of botulinum neurotoxin. Neurology. 2016;86:1818.

8: Mendez-Eastman SK. BOTOX: a review. Plast Surg Nurs. 2000;20(2):60-67. doi:10.1097/00006527-200006000-00003

Medical Disclaimer

No part of this website offers medical advice – always consult with a qualified professional for the best guidance.

Image Attribution and Licensing

Main image: ‘Sleeping Woman’ by choreograph – (used with permission and commercially licensed through Envato Elements).