What's the difference between necrosis and hematoma after Juvederm lip injections?

How do you know if you have recieved a hematoma vs necrosis immediately after a juvederm plus injection in the lip. There was very little Juve injected (aprox 0.2 ml) in center of one side top lip and immediate purple and black filled sack formed underneath injection site, very swollen and dark in color. The pain subsided within a couple hours. Anti-inflamatories and ice were applied immediately, but after couple hours we changed to nitropaste and warm compress due to the darkness of the swollen sack on underside of top lip just below injection site.

ANY ADVICE would be greatly appreciated!

2 answers to “What's the difference between...”

A: sounds like a hematoma

W. Tracy Hankins, MD

 This sounds pretty classic for a hematoma, the darkness from a intravascular injection which could lead to necrosis would be much later than you experienced.

A: White blanch first then purple and black.

Arnold R. Oppenheim, MD

 If you had necrosis you would have had a white blanching first as the area would not have  enjoyed a blood supply. This would last for while (at least an hour) and then the region would darken and turn black as the tissue began to die.       It sounds like one of your blood... more

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Comments

Marlborough
1 post
1 Feb 2009

How long after surgery can you conclude that there is no infection

Michael Sinclair MD
141 posts
18 Jul 2008

It sounds to me like you got a bruise. If the needle cuts a small blood vessel, it will bleed under the skin causing the swelling and dark discoloration. This almost always resolves with no treatment. If the area being injected turned white or became very pale, that is usually from injecting some of the filler inside a small blood vessel, which is quite rare. The filler cuts off the blood supply, which causes the tissue to become pale or white. If that happens you can get some tissue necrosis which will take a while (at least a few months) to heal. Nitropaste, Hyaluronidase and warm compresses are the usual treatments for this problem. Severe cases can be treated with hyperbaric oxygen therapy.

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