Extreme bruising after Juvederm in lips and nasal folds. (Photos)

Question

I received Juvederm in my lips and nasal folds. I bruised pretty quickly after and the next day I look like this. I also have a couple of bumps in my mouth and on the side of my nose. I went to a reputable plastic surgeon with great reviews. I know some bruising is normal but is this normal?

Brian S. Biesman, MD · Answer

It is not uncommon to experience bruising after injection of soft tissue fillers.  Bruising is easily managed with vascular laser treatments.  Laser treatments help the bruises disappear quickly, safely, and effectively.  I would strongly recommend to an injector who has this technology available should you wish to have a bruise treated.  It is not too late to have your bruises treated if they are still prominent.  Best of luck.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs and I am sorry to hear of your bruising.  Your picture demonstrates more bruising than is typical for smile line and lip treatments but anytime a needle is used the potential exists.  I prefer to use cannulas in the smile lines as a known artery runs in the fold and if injured it can lead to significant side effects including extensive bruising.  At this point there is nothing to do but wait and allow your body time to heal.  You can accelerate the process with cold compresses, sleeping with your head elevated, arnica montana/bromelain supplements, and eating fresh pineapple and dark leafy green vegetables.  Hope this helps.

Jon Kurkjian, MD · Answer

Swelling and bruising is a normal part of getting injections. Some people may bruise or swell worse than others. Typically, most if not all should be gone within 2 weeks post injection. If you have concerns with remaining bruising, please return to your PS and have them evaluate you.

Kris M. Reddy, MD, FACS · Answer

While it is not common to bruise after dermal fillers in the nasolabial folds, it is quite possible to bruise after dermal filler in the lips. An expert and experienced phyTo minimize bruising in the future, stay off of aspirin, Motrin, Advil, Aleve, any anti-inflammatory, any fish oil product, flax seed oil, green tea, or herbs for two weeks. Also, the proper use of Arnica Montana before the treatment helps limit or prevent bruising and swelling.

Leonel Calderon, MD · Answer

Good Afternoon and thank you for your question. With any injectable procedure side effects always include the risk of bruising and swelling. There are several ways to reduce your chances of bruising prior to injections such as avoiding any anti-inflammatory medications (Advil, Motrin) and specific vitamins/supplements such as Omega 3, Garlic, Gingko Biloba, and St. John’s Wort.  Getting your daily dose of Vitamin K (fresh spinach, broccoli, and kale) and Bromide (pineapple) is also an excellent way to reduce  your chances of bruising. Additionally, the usage of a micro-cannula needle will aid in reducing your chances of bruising. I highly recommend for my patients to use Arnica pills as well.  It’s important to remember that even with following all of these instructions there still is a chance to bruise and bruising can last up to two weeks.  Best of luck to you.

E. Ronald Finger, MD · Answer

Bruising can certainly occur following any sort of an injection. Thank you for your photos. Your bruising does appear excessive, but it should not affect your overall result.
To minimize bruising in the future, stay off of aspirin, Motrin, Advil, Aleve, any anti-inflammatory, any fish oil product, flax seed oil, green tea, or herbs for three weeks. These products reduce your ability to form a good blood clot, thus more bleeding an bruising.
I also use a micro-cannula (DermaSculpt) for my injections, which reduces bleeding and bruising.
Thank you for your question and photographs, and best of luck to you.

Elba Pacheco, MD · Answer

Hi and thank you for reaching out. Bruising is very possible after filler injections. Yours does not look out of the ordinary although it is hard to hide. You have three options: 
1) Prosol (Inflamenz) 3x/day, a natural supplement that reduces bruising an swelling after procedures. 
2) IPL/BBL photorejuvenation treatment-will help break down the bruising
3) Makeup and time
Luckily you should be able to enjoy the wonderful results soon. 
Best of luck!
 Dr Elba Pacheco

Fereydoon S. Mahjouri, MD · Answer

If you were not on blood thinner, this much of bruising is unusual. the lumps that you feel under your nose and in the mouth suggest that part of the juvederm was injected too deeply. Your PS could consider HYLA injection into those lumps.

Steven Wallach, MD · Answer

Bruising is patient dependent. Some don't get any and others get a lot.  I tell my patients that if they feel some lumps then they can gently massage them down.  You are best to ask your doc.

Marguerite A. Germain, MD · Answer

Hi there!! Thank you for your question and the pictures.  Bruising after a filler is actually quite common. Your bruising is not beyond what would be expected for more intense post-filler bruising. Your lips look like they have great shape so when the bruising and swelling subsides, they should look really good. The biggest thing you need to be concerned about is if you have significant pain. If you do, be sure to call your plastic surgeon to be seen ASAP.  Significant pain after filler can indicate vascular compromise. The bumps that you describe should also subside in the next few days. Again, if you have pain, that is when it may be an issue. In my office, I treat my patients to laser post filler if I anticipate that they will bruise. This substantially decreases the longevity and intensity of the bruising. Juvederm is a great product for the lips. Best of luck to you from Charleston, SC!!

Extreme bruising after Juvederm in lips and nasal folds. (Photos)

Answers (11)

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