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What to Do About Restylane Bruising?

asked 3 years ago by Imjustcurious in California
Latest answer by B. Pat Pazmino, MD
Question viewed 15,293 times
Tags: bruising, lumps

I had Restylane injected under my eyes, just above my cheeks. I developed severe bruising that lasted for almost 6 weeks. It has been 6 months since the procedure, and I still have what looks like lingering bruises where the Restylane was injected. Also, the doctor who did this over-filled the right side and you can clearly still see the filler bulging out in a line under my eye where he injected it.

Will the bruising and bulging go away? What can I do about it? Do I need to have other treatments? I don't want to have any injections to dissolve it at this point because of the bruising.

12 answers to What to Do About Restylane Bruising?

Bruising for 6 months after Restylane

If you still have bruising or discoloration 6 months after injections, it's possible that you have a condition called hemosiderin staining. We use q-switched lasers to resolve the dark discoloration. It's also possible that you are experiencing the Tyndall Effect, which is caused by injecting dermal fillers too superficially (too close to the surface of the skin). In this case, it's possible to resolve with hyaluronidase. If you're worried about additional bruising you may want to find a... more

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

Is it truly a bruise? Maybe Restylane was injected too superficially.

At our Sonoma County plastic surgery office, we see many patients for filler injections. These are active, Wine Country-lifestyle plastic surgery patients who want to minimize down time. As such, we ask that patients do not take aspirin or Ibuprofen for one week prior to injection with any fillers. We inject slowly and use ice to help minimize swelling.At the completion of the procedure we often apply Arnica gel to the treated areas. Many patients also take Arnica pills to help with... more

Francisco Canales, MD
Santa Rosa Plastic Surgeon

Hyperpigmentation or staining may be a cause of your prolonged 'perceived' bruising.

It would be advisable to go back to your treating physician for re-evaluation. After six months, your bruising should have resolved months earlier. In fact, it is usual for the bruising to have subsided three weeks from the time of the initial Restylane® injection. There is something else going on. The Tyndall effect has been discussed by many of the other physicians. This is represented by a bluish discoloration to the skin due to the product being placed too superficial in the... more

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Bruising is very common in the lower eyelids

Lower eyelid fillers are a very difficult procedure with a high incidence of bruising in the best of hands. Your description sounds like bruising. As Dr. Beraka said, it is possible that the bruising is not actually bruising, but is the Tyndall effect instead. For most patients, bruising will resolve. It may take several months. 6 months is on the longer end... some may take 8 or 9 months. Infrequently, some patients will have "permanent bruising" where the lower eyelid skin retains the pigment more

Sirish Maddali, MD
Portland Plastic Surgeon

Give it time.

First of all, please be very cautious before having anyone inject anything around your eyes. The skin around your eyes is much thinner than elsewhere on your face and body. Therefore, having injections in this area has a higher incidence of visible material and side-effects from the injections - such as bruising. The discoloration you are describing may be bruising which should resolve over time. However, the discoloration may actually be the injected material as well. If the injectate... more

David Shafer, MD
New York Plastic Surgeon

Time is your friend

Even though most of the injectable fillers show significant resorption at 6 months some patients can experience lasting effects beyond that. Try gentle massage and give it another 3 months. The bruising should resolve within this period of time. You are right to not consider additional treatments at this time. I hope this helps.

Steven H. Williams, MD
San Francisco Plastic Surgeon

Bruising after Restylane injection

Restylane is a very popular and effective hyaluronic acid-base dermal filler. It has been used widely throughout the face for the correction of deep lines and wrinkles. The trickiest area to inject in the face is the area under the eyes, because this area has very thin skin, which can make lumps obvious, and a high concentration of blood vessels, which can create long-term bruising. In our practice, we provide patients with ice packs to use immediately after their injection. If you... more

B. Pat Pazmino, MD
Miami Plastic Surgeon

Bruising with cosmetic fillers - Restylane, Juvederm, Botox, Radiesse

Bruising can occur after cosmetic fillers such as Juvederm, Restylane, Radiesse, and Perlane. If you are prone to bruising, I would suggest over the counter medications such as Bruise Stick or Bruise Pak to reduce swelling and bruising after these procedures.

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

How to Minimize Your Chances of Bruising From Filler Injections

Hi Curious, Your question is best evaluated in person where it can be determined exactly what is going on. That having been said, to minimize bruising from Restylane or other fillers, it is best to not take any blood thinning products for about 2 weeks before your treatment. You may take oral Arnica Montana for a few days before the injections. At the time of the treatment, have your injector place ice over the skin immediately prior to the injection. Physicians need to note any... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

This sounds like product over-injection, not bruising

No briuse would last this long. It is very common, however, for this area to be injected with too much material, or too superficially, which results in a blue hue. Please get the area injected with hyaluronidase to resolve this problem quickly. Untreated, it will last many months. Good luck.

Mary Lupo, MD
New Orleans Dermatologist

It may not be bruising.

Injections under the eyes can be very tricky, even though I do use them in selected patients with good results. 1) When Restylane is injected too superficially, it can create a bluish discoloration in the skin which can look like bruising. This is called the Tyndall effect. Successful treatment of this has been reported with lasers. 2) Long term "bruising" can also happen in this area (blood pigments in the skin) and this doesn't always go away. I have seen this. Laser treatment... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Most likely

The bruising and bulging for the most part will probably go away. If there was significant bruising and it has lasted for now more than 6 months, then some of the them may not have resorbed. This is not very common but can happen. GIve it some more time for the restylane to be resorbed. It may still go away. Patience is a virtue.