Juvederm Ultra, Restylane, and bruising

 Erin,

Thanks for the question.  While it is impossible to predict the likelihood of bruising when undergoing injectable filler procedures with products such as Juvederm Ultra or Restylane, in general, we recommend patients refrain from drinking alcohol, and abstain from medications such as NSAIDS( ibuprofen), aspirin, Vitamin E, and any other medication which predispose to "thinning" the blood, prior the procedure. Additionally, I like to ice the area of injection prior to the procedure and then immediately after. Having said this, again, bruising is variable. Areas that tend to bruise more, in my experience, include the periorbita (around the eye), and the lips, whereas the nasolabial folds tend not to bruise as frequently.  

Hope this helps. 

Unfortunately, there is no way to prevent bruising, as bruising is actually bleeding in the tissues under the skin and any time you place a needle into the skin, there is always a chance that a bruise can occur. However, with that said, there are ways to reduce the likelihood that you will bruise.

First, unless you have a medical condition that would make this necessary, you should stop taking aspirin, ibuprofen or other antinflammatory medications at least 5 days prior to your procedure.

The selection of your doctor is also very important as some doctors are much better at this than others. I typically take about an hour to treat an entire face, where many of my colleagues do this in 15-20 minutes. The faster the doctor injects, the more likely he or she will cause a bruise. I also inject very gently, making sure not to force the product into the skin while many, if not most, doctors force it into the skin; again, there is a greater likelihood of bruising with this technique.

Finally, if you use ice before, during and after your cosmetic injections, this can help minimize bruising.

While unsightly, bruises typically fade and do not cause any lasting trauma.

To reduce the chance of bruising from a cosmetic injection such as BOTOX, Restylane, Radiesse, Sculptra, etcetera, steer clear of the following for 2 weeks before your treatment, and do let your injector know if you have taken any of the items below:

1. Prescription medicines to thin the blood such as Coumadin, Heparin, and Persantine. ALWAYS ask your doctor first prior to stopping these medications as they are preventing dangerous blood clots in your body. (You will only be allowed off of these for a few days, if at all).
2. Over the counter medicines that thin the blood such as aspirin or aspirin-like products (e.g. Advil, ibuprofen, Motrin). This includes medications that relieve pain due to headache, arthritis, and menstrual cramps. Tylenol (acetaminophen) or Extra Strength Tylenol by itself is okay, but be careful, as some Tylenol products are used in combination with blood-thinning medications, such as Tylenol Migraine or Tylenol Arthritis.
3. Herbal supplements and vitamins that thin the blood, such as Vitamin E, Gingko Biloba, Feverfew, Ginseng, Red Clover, Fish oil, and garlic supplements. If you dont want to take any chances, stop taking your multi-vitamin also if it contains more than 40 IU (units) of vitamin E.

To further decrease your chance of brusing, apply ice or cold compresses as soon as possible after (or during) your treatment; let your injector know of any obvious veins to watch out for, and go to a trusted and experienced injector who knows how to inject carefully and precisely, while avoiding as many blood vessels as possible.

Even if you follow all the advice above, it is still possible to bruise. If you have an important event or photos coming up, allow at least 2 weeks for recovery so you won't be disappointed.

38 of 38 found this helpful

Helpful?

Contact the doctor

Blowing ice cold air from the Zimmer unit on the area while injecting fillers not only cuts down the chances of bruising but also makes the injections almost painless. We also use excellent technique and tiny needles and arnica pills as well.

2 of 2 found this helpful

Helpful?

Contact the doctor

The answers here offer excellent information about how to avoid injection bruising.  We give our patients much of the same information before their treatments but in some cases, bruising is unavoidable either because the patient cannot stop their medications or because they are more prone to bruising.

In these cases, we have an excellent post injection bruising removal technique. Pulsed dye lasers are designed to treat vascular conditions like Rosacea and port wine stains so the target for this laser is the hemoglobin in the blood. We have found that using this laser the day after an injection procedure causes a bruise will generally resolve the bruising within 48 hours.  When left untreated some bruises have lasted up to 14 days.  While this is not a preventative solution, it is a great way to fix the problem once a bruise has occurred.

Helpful?

Contact the doctor