Risk factors. As with all procedures and medications, Botox has some risks. They can be minimized if the patient follows the instructions of their aesthetician or dermatologist after their Botox treatment. One warning, for example, is not to rub or massage the injection site soon after the session and to sleep with the head elevated for a day or two. This keeps the Botox from migrating to places where it is not needed. If this happens, the patient might develop the signs of botulism, which are difficulty breathing, swallowing and speaking, blurred vision and muscle weakness. If a patient has these symptoms, they should seek medical help right away.