Delayed Bruising After Botox?

I have had Botox for the first time and had initially no bruising or swelling. After day 3, I acquired some bruising and some swelling. Is this normal?

Doctor Answers 16

Delaying bruising after Botox

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Yes, it is common for bruising and swelling to appear a couple of days after your treatment. It can take up to 2 weeks for this to go away. You should talk to your injector if it lasts longer than this. 

Delayed bruising

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Swelling, redness, discomfort and bruising are common and settles down within 3 days or so. This sounds like what happened to you. Rest assured, the bruising will subside over the next week or so. Follow your injector's post-care instructions to facilitate healing.

Delayed Bruising After Botox

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Bruising after Botox is not common.
If it does occur, it can occur immediately or a few days after the injection.
It should disappear in a few days. The next time try taking some Arnica Tablets before your Botox Injections. Avoid taking health supplements such as fish oil, krill oil or flax seed oil a week prior to your injections. And stop all prescription and OTC drugs that increase your risk of bleeding.

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Bruising after Botox

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Bruising after Botox may occur and it can appear a dya or two or even three after the procedure.  It will get better with time.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Bruising after Botox

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Bruising can occur after cosmetic Botox injections around the eyes. The onset can be immediate or delayed. I usually prescribe an over the counter Arnica based medicine such as Bruise Stick, Bruise Pak, or a Boiron Arnica supplement.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Delayed bruising after Botox

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Hi Waschke,

Unfortunately you can have delayed bruising with Botox. The bulk of the trauma in a Botox injection occurs at the point where the needle enters the muscle. Because the muscle lies under the skin, it can sometimes take a few days for the bruising from the injection to become apparent.

The good news is that this bruising should resolve soon. If it is problematic for you or if you would like faster resolution, consider finding a local practitioner that uses pulsed dye lasers as these can be used to cut down the bruising duration to as little as 48 hours with a quick treatment on this laser. Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Delay in Botox bruising absolutely possible

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I do a considerable amount of Botox injections. The cause of the delayed bruising is due to the needle hitting and cutting a deep capillary (most likely). A small drop of blood spills, and about 3 days later, it migrates to the surface. It should start to fade by the time you read this.

The Bruising Was There

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When Botox is injected it is injected somewhat deeply into the muscle. Any time muscle is violated it tends to bleed because they are very vascular. This bleeding is very minor and bruising is prevented by holding pressure on the injected site for several seconds. However, if the minor bleeding is not stopped a bruise will develop. Because this bruise is deep to the skin it may take several days until it is visible at the surface. This is a common finding in liposuction

So no worries. The bruise will resolve in time.

Delayed appearance

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The bruising actually occured at the time of injection of your Botox. It merely took 3 days for it to surface. This is not uncommon, even though most bruising appears in 1-2 days. At any rate, it will resolve over the next few days. Before the next treatment ask your plastic surgeon what you can do to minimize your risk for bruising (stop aspirin, advil, motrin, vitamin E, etc.). Good luck!

Delayed bruising can occur with any injection

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Dear Waschke,

Whenever an injections is administered, bruising can occur. The bruise results from the needle causing a small opening in a blood vessel and some blood leaks out staining the tissues. The bruise usually lasts about a week to 10 days.

During treatment, some bleeding may be noticed after an injection. Pressure can be applied immediately to decrease the amount of blood that leaks from the blood vessel. This can reduce the amount of bruising.

Generally, the risk of bruising is increased if you are taking a blood thinner such as aspirin, Plavix, etc.

Furthermore, strenuous physical activity immediately after the treatment can lead to more bruising.

We incorporate several measures to decrease the risk of bruising. We use Arnica Montana, which is a natural plant extract that helps reduce bruising. We also use magnification to visualize the tiny blood vessels better and avoid them during the treatment. We also encourage our patients to avoid strenuous physical activity following treatment.

Once the bruising has occurred, a green based make-up can help to camouflage the bruise. Arnica may also help it resolve more quickly.

Good luck with your surgery.

A. Peter Salas, MD
Manhattan Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.