How to Help Control Bruising Before Restylane Injections for Tear Troughs?

I am planning to get Restylane injections for my hollow tear troughs. I was wondering what supplements to avoid and what I can take to help control the bruising/swelling beforehand. Should I take Arnica supplements before the procedure? How many days before, what doses? Drink lots of water? Arnica topical gel after? Before? I know bruising and swelling aren't completely preventable, but I just want to know how to prevent it as much as possible. I will do everything it takes.

Doctor Answers (10)

Minimizing bruising from tear trough injections with hyaluronic acid treatments such as Restylane or Juvederm

+3

To minimize bruising you should avoid aspirin for two weeks before injections, and for two days before you should avoid nonsteroidal antiinflammatory agents such as Alleve, ibuprofen, Motrin, Advil, vitamin E supplements, Fish Oil, Garlic tablets, Ginko biloba, Ginseng and avoid exercise immediately following the injections.  Taking Arnica montana and bromelain may help minimize bruising. Slow injection technique and a small needle help. Sometimes the doctor mixes the Restylane or Juvederm with local anesthetic with epinephrine that can minimize bleeding.  The topical application of vitamin K creams immediately after the injections might minimize bruising.


Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Minimizing bruising with injectables

+2

I think the key is to avoid any supplements, do avoid aspirin and antiinflammatory agents for two weeks prior. Some foods like heavy garlic products and alcohol can thin the blood as well.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

How to minimize bruising with injectables

+2

I would avoid all blood thinning products such as aspirin, motrin, advil, excedrin, alleve,etc. 7-10 days prior to injection.  In addition I would ice the area for 10-15 minutes before and after the injection. You can also take Arnica (homeopathic medication) before and after the injection to minimize the bruising. Pineapple juice can also help break down the byproducts of hemoglobin in your blood and minimize visible bruising.

Even with all these measures taken, some people may just bruise more than others. Sometimes this is due to technical reasons where the injector inadvertently injures a small blood vessel which can cause bruising.

Consult with an experienced injector or surgeon prior to your planned injection.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 150 reviews

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Bruising following Fillers injections..

+2

Yes you can minimize bruising following Fillers injections (regardless of the type of fillers: Radiesse, Restylane, Perlane or Juvederm). First avoid any blood thinners like: aspirin, ibuprofen, etc but also less known ones like Fish oil, and Vit. E. Try to stop those about 1 week prior to the Filler injections. Start taking Arnica Montana pills 3 days prior or at least few hours before fillers injections. Before the injections ask your doctor to apply ice over the areas to be injected with the filler. Then apply ice off and on for few hours following the injections of fillers. Most of the doctors using fillers may have Arnica Montana gel to be applied right after the injections. if not you need to get some and apply it over the injected areas for about 3 days. Same for the Arnica pills. The tear trough area usually will bruise if the filler is injected too superficial. 

Henri P. Gaboriau, MD 

Henri P. Gaboriau, MD
Seattle Facial Plastic Surgeon
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How to Help Control Bruising Before Restylane Injections for Tear Troughs

+2

The previous expert posters have given you a list of things to avoid and do to help "prevent" bruising. You must be aware that no matter what you do you still can become bruised so adjust your life schedule just to be safe with the appearances. Best of luck. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Steps to diminish bruising before and after filler injections

+2

1. Avoid aspirin, Advil, Motrin, ibuprofen, all NSAID products 2 weeks before and after the injections. (If you take blood thinners, speak to your doctor about discontinuing these medications)

2. Stop all herbal supplements and vitamins 2 weeks before and after the injection.

3. Eat fresh pineapple and/or take Bromelain supplements three days before and 1 week after injections. (I have not found topical creams or Arnica to work as well as Bromelain)

4. Ice the injected areas 20 minutes on and off for about 3-4 hours after injection.

5. Do not exercise after the injections.

6. Sleep with your head on two pillows the first night.

7. Remember, despite doing all the things on this list,  any time a needle is inserted into the skin, bleeding and bruising can occur. If bruising occurs, use ice compresses for the first 2-3 days, then on the third day begin using to warm compresses.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Minimizing bruising for under-eye Restylane: non-cutting needle

+2

There are two aspects to minimizing the chance of bruising with injections to the tear troughs. First is what the patient can do, which is to avoid all supplements, vitamins, and other things such as ibuprofen or aspirin that can affect bruising. Ask your doctor if you are unsure about any particular one. Arnica may help, but significant bruising is related to a puncture of a capillary by the needle, which brings us to the other aspect: technique. If I feel there is a chance of bruising I would use a non-cutting needle, so that there is much less chance of causing the bruise.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 27 reviews

Avoid blood thinners before Restylane injections

+2

Hi,

Here are the things that I find are helpful in avoiding bruising after a Restylane treatment near your eyes.

  1. Avoid anything that thins the blood for 2 weeks prior to the treatment.  The most common blood thinners are medication prescribed to thin the blood (Coumadin, Persantine, Plavix, etc), Aspirin, NSAIDs (Motrin, Advil, Aleve), fish oil, and vitamin E.  There is actually a long list of supplements that thin the blood.  Your doctor should be able to provide this list to you.  It is very important not to stop any blood thinned medication or supplements, recommended by your doctor, unless stopping the blood thinner is approved by your doctor.  Check before stopping any blood thinners.
  2. Following the procedure use lots of cold compresses for the rest of the day. 
  3. Avoid exercise for the rest of the day
  4. Keep your head elevated until bedtime.

I have not found that supplements like Arnica help reduce bruising.

Hope this is helpful. 

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 8 reviews

Things to do to prevent bruising from fillers

+2
There are a few things that you do that can definitely help. 1. Avoid NSAIDs, such as aspirin, iboprofeln, naproxen, etc. 2. Avoid supplements such as gingko and vitamin E which can make you bleed a bit more. 3. Ice the area immediately after the procedure. 4. Arnica pills and cream and Vit K cream may be of help, and need to be taken and applied before the procedure. Bromelain found in pineapples may also help. Just remember these are not studied enough and the evidency of helping is not strong.

Hassan Galadari, MD
Dubai Dermatologist

Bruisestick ointment for injections on the face

+1

There are many options for helping the bruising. Bruisestick ointment contains both Arnica montana and Bromelain to control bruising. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 49 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.