Botox Bruise - How long will it be like this? Will ultrasound or laser help at least to change a color to yellow?

Hi Vow.  That is an extremely pronounced bruise for Botox injections.  In addition, Botox is usually not injected under the eye.  Was this at the outer eye for crow's feet or could it be a dermal filler for under eye circles?  The latter is much more likely to cause the kind of bruising you have.

In any event, this kind of bruising is resolved pretty easily if it is treated at approximately 48 hours after the injections with a pulsed dye laser (V-Beam and V-Star are most common).  These types of lasers are highly absorbed by hemoglobin and so are able to heat and break down the blood causing the bruise.  The key is not to wait too long.  After the bruise starts to turn yellowish, the procedure will not work.  Our experience is that this is anything past 72 hours after injection.  Good luck.

Bruising after Botox can occur. Most of the time it is visible the same day or the very next day. In some cases, however, it may become visible several days later. A bruise occurs when blood leaks out of a traumatized blood vessel. It could be that with strenuous activity or rubbing or due to blood thinners that an injured blood vessel dislodges a clot and causes some blood to leak into the tissue and thus cause a visible bruise (e.g. heavy exercise a few days later may results in a bruise). The bruise typically dissipates within a week or two.  We often use Intense Pulse Light (IPL) to accelerate the clearance of a bruise.

It can sometimes take a week or two for a bruise to go away. Seeing your photo, it appears that it's on it's way out. I recommend you wait it out and you can try taking arnica supplements. 

It can take up to 2 weeks for this to go away, and your photo shows that it's on its way out, since it's no longer all purple and red - there's yellow. However, I should ask if it was actually Botox that you received, or filler? 

In our office, we utilize the Plato's Bruise Balm for patients who develop bruising after injections or fillers. The Bruise Balm may help expedite the resolution of your bruise. Best, Dr. Karamanoukian Los Angeles

Pulsed-dye lasers and focused IPL treatments work well to expedite the resolution of bruising.  The laser energy targets breaks up the pigment and allows your own body to reabsorb them more quickly.  It's important to seek out a physician experienced and familiar with this indication to achieve the best results.

Any needle used for a filler or Botox can cause a bruise since small veins and capillaries are not visible as they underneath the skin and it's just luck that they're not hit more often.  On the other hand, botox underneath the eyelid is usually only one needle stick, superficial and this bruise in this photo seems excessive for such treatment.  Some people are more prone to bruising if they have genetic problems with clotting, or take medication that can thin the blood such as aspirin (no matter how low a dose), Alleve, Motrin, Ibuprofen, Advil, fish oil, Vitamin E, Gingko, Ginseng, Garlic Tablets, and others.  If you had filler, however, such as Juvederm or Restylane and it was injected for the tear trough, then your bruise, although rare for this too, would be more commensurate with such treatment.

I have found that warm compresses rather than ice a few days after treatment helps get rid of bruises quicker than no treatment.  Topical vitamin K (we use Auriderm as not all Vitamin K penetrate the skin equally), Anrica montana by mouth, and V-beam laser treatment all can add to a hastening of resolution.    Green and yellow concealers exist and neutralize the red/purple color and you may need to try each to see what hides the color better. Special makeup, using a concealer first that makes the purple more of a brown shade, is useful as a base coat and then foundation. Some brands are Physician's Formula, Covermark and Dermablend.
 

After Arnica Montana, you could try the supplement Bromelain (which is a pinneaple extract).  If your doctor happens to have a pulsed dye laser, PDL - often called a Vbeam - that would help speed up the healing tremendously.  Please visit the link below to learn more about Botox and what you can take BEFORE getting injected to prevent bruising next time.

A Vbeam pulsed dye laser can help speed up healing of a bruise.  Look on Candela's website under Vbeam to find a doctor who has this device in your area.  Some people also take Bromelain which can help speed up the healing time.  Good luck!

Eating Pineapple for the Bromelain is a good start.  The millions of people who believe in homeopathy can't all be wrong.  Arinica Montana, in both under-the-tongue tablets and gel form will help it too.  Keep Arnica around the house for that unanticipated bump or trauma.    Take Arnica on your way to your next Botox treatment.