Bruising with Radiesse - Is this normal?

I think that bruising is a side effect of the injection, not the filler. I use a blunt micro-cannula, the "Magic Needle". Since it is blunt it is much less likely to cause bruising. Another benefit is that it does not require any anesthetic, so patients do not need nerve blocks and have numb faces and lips when they leave. These micro-cannulas come with a slightly larger needle that is just used to make a tiny puncture for the thin cannula to pass through. This spot is the only place that is anesthetized. This works very nicely for the lips as well.

Bruising may occur with any filler injection and tends to be more frequent with a thicker filler that is injected deep like Radiesse. It is not usually the fault of the surgeon. To alleviate bruising a patient should refrain from aspirin containing medications, NSAIDs, Vitamin E, Omega 3 products, and blood thinners for at least a week prior to injection and to use arnica before and after the injection. Also icepacks are helpful prior to and after the injections.

 

Hi Emeline. Bruising and swelling are the most common side effect of Radiesse injections, but because the product is placed deeper in the tissue, we actually see less bruising (but more swelling) with Radiesse than we do with Restylane, Perlane or Juvederm.

While it's not necessarily your surgeon's fault, there are some pre-care instructions that your injector can give you to help minimize the likelihood of bruising (as mentioned below aspirin, ibuprofen, vitamin E, and fish oil).  

In addition, there is actually a laser remedy that we use for bruise reversal.  While many injectors are not aware of this, a pulsed dye laser treatment administered approximately 48 hours after injection can usually break down the bruise within 1-2 days after the procedure.  We use the Cynosure V-star pulsed dye laser for this treatment.

Bruising is unpredictable but it can happen. It is not the surgeon's fault. It rarely happens to the same extent on both sides. If you take aspirin within the week before injection the bruising is more likely. I use ice before injection. It seems to help with the pain and bruising.

This location commonly bruises as a result of the facial vein and artery anatomy.  I would advise you to use warm compresses and Bruise-Stick ointment to the area once the bruise appears. 

Bruising can occur with any facial filler.

Steps to reduce bruising


Avoid blood thinners and herbal supplements

See an experienced injector who can inject atraumatically

An experienced injector will have "tricks" he or she uses to minimize bruising both from a technical standpoint as well as post injection.

Bruising with any dermal filler is very possible. You can decrease your risk for increased bruising by not taking aspirin, ibuprofen, vitamin E, and fish oil for at least one prior to injection and one after injection. Tylenol is okay to take for pain.  Ice 24 hours injection might help with the bruising and swelling and you can use cover-up makeup while you are healing.

Hi Emelline,
Okay, who punched you? Just kidding.
Unfortunately many patients do have some bruising with Radiesse. In my experience patients over 60 usually bruise worse, as well as those who don’t want anyone to know that they were injected, and those patients who are the most talkative. Very few patients, like you have severe bruising.
Radiesse bruises a bit more than other fillers used in my practice. Patients need to be counseled prior to their injections that bruising is a possibility. All injecting physicians experience patients with bruising like you have suffered. It is not your physicians "fault", just bad luck.
You should take Arnica for a week, avoid all blood thinning products, and have a very light social schedule for one week if you should decide to have Radiesse again.
Good luck and be well.
Dr. P

Thank you for your question! Radiesse is a synthetic substance made up of calcium hydroxylapatite.  It is FDA approved to be injected below the surface of the skin. It is intended for the correction of moderate to severe facial wrinkles and folds for restoration and correction of the signs of facial fat loss. Common side effects of Radiesse include bruising, swelling, redness, inflammation, small bumps, itching, pain, skin discoloration, scarring, swelling, tenderness, or mild bleeding at the injection site. Best of luck!

Unfortunately, bruising can be difficult to predict. Radiesse is a thicker, denser filling substance and there can be some post treatment bruising, even with the most skilled injectors. 
To prevent this from happening in the future you can try avoiding aspirin and aspirin products before treatment. Avoid wine and alcohol for 3 days before. Avoid fish oils, but add 1 cup of fresh pineapple to your daily diet for 2-3 days before and after treatment. Pineapple is rich in bromaline that reducing inflammation and bruising risk. 
Also, Arnica Montana is helpful in reducing your risk of bruising. It can be taken just before your injections and repeated 2-3 times a day for 2-3 days to reduce your healing time.