Does the likelihood of getting a lip hematoma decrease over time with continued lip filler treatments? (Photo)

Question

I recently was injected with Juvederm in the lips by a very experienced Nurse Practitioner Injector. I ended up getting 2 hematomas (top left lip and bottom right lip). It took over a week for the 2 hematomas to completely go away (the bottom one actually bled out to below my lip line). It was definitely 2 hematomas and not just normal bruising. My injector told me she's never had someone get 2 hematomas during one treatment before. How likely is it this will continue to happen if I get injected again?

Kyle Coleman, MD · Answer

Bruising after fillers can vary depending on technique and patient characteristics.  One can never have a 100% chance to avoid any bruising; however, significant bruising should be avoided with good technique and patients avoidance of blood thinning agents.   Avoid ibuprofen, aspirin, alcohol, vitamin E and fish oil supplements prior to fillers.  Cold compresses prior to and after treatment may reduce the risk of bruising.  It is a good idea to see an expert physician who does their own injectables; sometimes it may cost a little more but is generally worth it in the long run.

Jason Emer, MD · Answer

Swelling and bruising are common with fillers on the lips as there are many blood vessels in this area. I suggest cannula injection to limit issues.  Best, Dr. Emer.

Monika Soni, MD · Answer

Thank
you for your question and photographs. Lip augmentation with fillers always
cause minor bruising and swelling. The chances of getting Hematoma are very low
unless the procedure is being done by an inexperienced injector. Please consult
with an expert for an evaluation. All the best!

Hardik Soni, MD · Answer

Thank
you for your question and photographs. Lip augmentation with fillers always
cause minor bruising and swelling. The chances of getting Hematoma are very low
unless the procedure is being done by an inexperienced injector. Please consult
with an expert for an evaluation. All the best!

Michele S. Green, MD · Answer

There is always a chance of bruising after fillers.  To decrease the chance of bruising you should make sure that you don't take any blood thinners before your injections.  For the best cosmetic results please consult a board certified dermatologist who understands the facial anatomy.  Best, Dr. Green

Hratch Karamanoukian, MD, FACS · Answer

Thank you for your Q and pics.Technique is key to reduce bruising and hematoma formation. Q switched lasers can help resolve it as well as taking oral natural supplement Bromelain. Read my ebook about Bromelain on the link below. It is a free access ebook.Having the same issue the next round is again dependent on technique and experience. The likelihood does not diminish with subsequent filler sessions if the same person is doing it, unless they get better at their technique over time. Having said that, this could happen to the most experienced providers too.Dr. karamanoukian#RealSelf100 Member

Benjamin Barankin, MD, FRCPC · Answer

The likelihood of developing bruising or hematoma is based on several factors. The most important, is not hitting a blood vessel to begin with. This is best achieved by having an expert injector (e.g. dermatologist) who knows the lip anatomy intimately inject you. Next would be to minimize blood thinners before and after treatment, things like aspirin, ibuprofen, alcohol. Minimizing exercise day of and next day; avoiding hot tubs, sauna, jacuzzi as well. Using ice packs immediately after and on/off for 24hrs also helps. Eating a fresh pineapple helps, and some people feel arnica is helpful too. If a bruise/hematoma occurs, your dermatologist can make it disappear much faster using a laser.

Steven F. Weiner, MD · Answer

The most important factor which causes this is injector technique. The next important factor is whether you were taking anything which can thin the blood including supplements. I will treat this with a vascular laser and it will only last a couple days. Cannulas will decrease the risk of bruising as well.

Julian W. Dixon, MD · Answer

Thanks for your question. Unfortunately lip bruising and hematoma formation is a risk of filler in this area. In our practice we use a micro-cannula technique that has greatly reduced the incidence of bruises like you describe. Additionally icing prior to the procedure can be helpful. Hope this helps.

Matthew Elias, DO, FAAD · Answer

Thank you for your question.  Hematoma formation after lip filler is extraordinarily rare, there is a risk of bruising anytime you have lip filler.  For the future I would recommend being treated by a board certified Dermatologist/PS and being treated with a microcannula to mitigate against the risk of hematoma formation.  Microcannulas are blunt tipped and should not penetrate any vessels leading to a much lower risk of bruising or hematoma formation.  The hematoma you got after filler could have potentially been treated as a courtesy with a laser like the Excel V to expedite the healing process and resolve the hematoma a day or two after the laser treatment which would be performed on day 2-3 after the filler placement.  Regards, Dr. Matt Elias

Does the likelihood of getting a lip hematoma decrease over time with continued lip filler treatments? (Photo)

Answers (13)