Is It Normal To Have Massive Swelling And Bruising After Juvederm Ultra XC Injected into Lips? (photo)

Question

Injected Fri afternoon by board certified PS. Fair-skinned white woman, late 40s, can bruise easily, so ~ a week prior took Arnica (4-5 pellets ~ 3-4 x/day) + used PrevEdem + Arnica gel over it to prevent bruising, + quercetin & bromelain supplements. Looked good right after, but bruising and swelling set in, progressively worsening to horrendous proportions. How do I fix this? How long will it last? Is allergic reaction, infection, hematoma? Icing makes it worse! Pics are before + progression.

Vlada Groysman, MD · Answer

You need to stop using of your supplements and topical preparations. Just recently, I had a patient who was allergic to the preservative in arnica. Is your tongue swollen as well? Do you have a rash anywhere else? Those things can also point to an allergic reaction. Either way your physician needs to see it. He could suggest oral steroids. Swelling and bruising from juvederm are expected. Make sure to discontinue aspirin and ibuprofen and avoid alcohol since this could worsen bruising and swelling.

Young R. Cho, MD, PhD · Answer

Thank you for your question.  It is very common for the lips to look 
over corrected or fake the next day.  This is due to all the swelling 
that ensues.  I often tell my patients that this
 is the "oh my gosh" day.  It can be 'oh my gosh' my lips are so 
swollen!  It could also be 'oh my gosh' I love my lips even more than 
yesterday.  Either way, the swelling may last a few days with every day 
showing a decrease 
in swelling. The more you ice the first day or two, the less swelling 
you will have.   I would wait a few days to a week and then return to 
your injector if you still have concerns after that.  If you like the 
look of the lips at some point during the swelling reduction, then take a
 picture.  This way you know what volume you like in the lips for the 
future.

Itzhak Nir, MD, FACS · Answer

This is most likely the result of swelling and bruising from the injection of the Juvederm. Everybody reacts differently, and we all swell differently. Please be rest assured that in a week or so, everything will normalize. If it does not, then you may have an allergic reaction to the product, but this is highly unlikely.

Sam Naficy, MD, FACS · Answer

No it is not "Normal" to have Massive swelling after Dermal fillers but we always expect some swelling after trauma to the lips. Bruising can happen as well but there is no way to predict who is going to bruise unless you were on blood thinners prior to the injections. You need to follow up with your doctor, of course. But rest assured It will more than likely resolve in a few days whether you do anything else or not.

Matthew Schulman, MD · Answer

Swelling is totally normal, but you clearly have more swelling than normal. It is unlikely to be an allergic reaction as this is very very rare. You should call your plastic surgeon - even if it is Easter! You may benefit from a short course of steroids to decrease the swelling.

Lorrie Klein, MD · Answer

We treat many patients daily with Juvederm in our Orange County office, including many lips. We frequently see swelling but it is not typical to swell as much as you are showing in your photos. Some people are just "swellers", whether its laser, fillers or surgery, they just swell a lot. As a dermatologist, I am very familiar with contact dermatitis from products applied to the skin. That would be the most likely other cause. So stop using the topical arnica product you are applying. The other possible cause of a contact dermatitis could be a topical numbing product your doctor may have applied before your injection. If you were allergic to either of these topical products you could experience significant swelling. Call your doctor, he/she can probably prescribe an oral steroid medication for a few days to take down the swelling quickly.

Kenneth Hughes, MD · Answer

There are a couple of possibilities here, 1) allergic reaction to something, most likely topical anesthetic used prior to injection or medication taken or injected. 2) more than anticipated swelling after injection of product. The risk of infection or expanding hematoma is very small. Call the plastic surgeon who injected or the office for advice. They may want to treat like an allergic reaction. Kenneth Hughes, MD Los Angeles, CA

Nana N. Mizuguchi, MD, FACS · Answer

Your injection was yesterday. It is normal for many people to swell as you have done at this time. Sleep with head of bed elevated and apply ice as much as you can for 24 to 48 hours. It should be much better within 2-3 days but swelling may not totally resolved for 10 to 14 days. Try not to worry at this early date. It is not unusual.

Donald B. Yoo, MD, FACS · Answer

There is a bit of "fish-eyeing" in your after pictures because your camera is so close, so it's a little difficult to get a sense of how large your lips have really become. True allergic reaction to Juvederm is exquisitely rare, while temporary swelling for 2-3 days is completely normal and expected. From the pictures it does not look like infection or an expanding hematoma.

Hardik Soni, MD · Answer

Thank
you for your question. It is common to have some swelling and bruising after
lip augmentation. This can take up 2 weeks to resolve. You can ice your lips to
help reduce and swelling and take Arnica to help reduce bruising. If you still
have any concerns please contact your expert injector. All the best!

Is It Normal To Have Massive Swelling And Bruising After Juvederm Ultra XC Injected into Lips? (photo)

Answers (18)